990022_INSPECTIONS_20171231

M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 990022 FacilityStatus: Active Permit: AWC990022 El Denied Access
Inpsectlon Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Follow-up County; Yadkin Region:
Winston-Salem
Date of Visit: 07/31/2014 Entry Time: 02:00 pm Exit Time: 2A5 pm Incident 9
Farm Name: Douglas Farms Owner Email:
Owner: Joe D Douglas Phone: [phone]
Mailing Address; 5828 Wells Rd Hamptonville NC 27020
Physical Address: 5828 Wells Rd Hamptonville NC 27020
Facility Status: Compliant ❑ Not Compliant Integrator:
Location of Farts: Latitude: 36' 07' Longitude: 80' 52' 15"
From WSRO: US Hwy 421 north, Left onto Windsor Road (SR1100) off Hwy 421, Proceed South on SR1100 and then turn right
onto Wells Road (SR1108) just after crossing the bridge. The farm is approx. 0.7 mile on the left,
Question Areas
Certified Operator: Randy D Douglas Operator Certification Number: 21396
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Randy Douglas Phone:
On -site representative Randy Douglas Phone:
Primary Inspector: Patrick Mitchell Phone:
Inspector Signature: Date: D� 01
Secondary Inspector(s):
Inspection Summary:
On July 31, 2014 a site visit was made by WSRO staff to the subject facility to verify the closure of the waste storage pond. The
following observations were noted during the visit:
- The WSP dam has been removed, the area has been graded to blend with the surrounding landscape, and grass cover has
been established.
- There were no cattle stocked on the lot at the time of the site visit.
page: 1

0,
0 Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
0
Facility Number: 990022 Facility Status: Active Permit: AWC.990022 ❑ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Reason for Visit: Other County: Yadkin Region: Winston-Salem
Date of Visit: 05/07/2014 Entry Time: Q];35 PM Exit Time: QZ:15 PM Incident #:
Farm Name: QgWalas Farms Owner Email:
Owner: Joe D Douglas
Phone: [phone]
Mailing Address: 5828 Wells Rd Hamptonville NC 27020
Physical Address: 5828 Wells Rd
Facility Status: E Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 36°07'15" _,_ Longitude: "
From WSRO: US Hwy 421 north. Left onto Windsor Road (SR1100) off Hwy 421. Proceed South on SR1100 and then turn right onto
Wells Road (SR1108) just after crossing the bridge. The farm is approx. 0.7 mile on the left.
Question Areas:
Dischrge & Stream Impacts Waste Col, Star, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Randy D Douglas
Secondary OIC(s):
Operator Certification Number: 21396
On -Site Representative(s): Name Title Phone
24 hour contact name Randy Douglas Phone:
On -site representative Randy Douglas Phone:
Primary Inspector: Patrick Mitchell Phone:
Inspector Signature: Date: S/o/��
Secondary Inspector(s):
Page: 1

a.
Permit: AWC990022 Owner - Facility: Joe D Douglas Facility Number: 990022
Inspection Date: 05/07/2014 Inspection Type: Compliance Inspection Reason for Visit: Other
Inspection Summary:
On May 7, 2014 WSRO staff visited the subject facility. This site visit was conducted due to it being reported by Yadkin Soil & Water
officials that the wsp serving the facility is being properly closed. The following items were noted during the review:
- There were no cattle present at the time of the inspection.
- The wsp had been emptied, and the dam of the structure was breached. The Permittee indicated that this was inspected by Ms.
Leigh with Yadkin S &W, before the dam was demolished.
The Permittee indicated that Yadkin S & W had approved the wsp for backfilling with soil.
- The sludge removed from the wsp was temporarily stockpiled adjacent to the wsp, and was being actively land applied to a field
approved in the NRCS closure plan.
- The Permittee indicated that the waste had been sampled, but the results were not complete yet.
- A follow up inspection will be necessary to review records associated with the closure and subsequent land app. activities.
Page: 2

Pem11t: AWC990022 Owner - FenWty: Joe Douglas Facddy Number: 990022 Permit: AwCa50022 Owner - Facility: Joe 0Datxj- Facility Number: 990022
Inspection pate: MMM2014 Inspecti— Type: ConpNenoe Inspection Ream for Matt: Odor inspection Date: 0510712014 tnapect1w Type: Compliance inspectim Plaaean for Visit: Olhw
Regulated Operations design Capacity Current Population
Cetde
O Cattle - Milk Caw 100 0
Total Design Capacity: 100
Tote! SSLW: 140.000
Waste Sbuctures
Type Identifier
r.�
Designed Observed
Clraed Date Start Date Freeboard Freeboard
Page: 3
Discharges & Stream Impacts
Yes No NA NE
1. Is any discharge observed from any pad of the operation _
❑ ■ ❑ ❑
Discharge originated at
SLMCWM
❑
Application Field
0
Other
❑
a. Was conveyance man-made?
❑ ! ❑ ❑
b. Did discharge reach Waters of the State? (d yes. notify DWQ)
❑ ! ❑ ❑
c What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (d yes. notify DWQ)
❑ ! ❑ ❑
2. Is there evidence of a past discharge from any pan of the operation?
❑ ! ❑ ❑
3. Were there any observable adverse impacts or "rdial adverse imps= to Waters of the Stale other than ❑ ! ❑ ❑
from a discharge?
Waste Collection, Storage & Treatment
Yes No NA NE
4. Is storage capacity lass than adequate?
❑ ❑ ■ ❑
It yes, is waste ievel into stnicfural freeboard?
❑
5. Are there any immediate threats to the iMagMy of arty of the structures observed (l.e1 large trees. severe
❑ ❑ ■ ❑
erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed ardlor managed through a waste management ❑ ❑ ■ ❑
or closure plan?
7. Do any of the structures need maintenance a improvement?
❑ ❑ ■ ❑
6. Do any of the structures lack adequate mariners as required by the pamut? (Not applicable to roofed pile,
❑ ❑ ■ ❑
dry stacks andlor wet stacks)
9. Dow any pad of the waste management system ottler than the waste =cLums require maintenance or
❑ ❑ ■ ❑
improvement?
Waste Application
Yes No NA ME
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or
❑ ■ ❑ ❑
imprvemeM?
11. Is there evidence of incorrect application?
❑ ■ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy motels (Co, Zn, ate)?
❑
Page: 4

Permit: AWC99= Owner -Facility: .foe D Douglas
Fadlity Number: 99DO22
Penult: AWC990022 Owner -Foci ity: Joa D Doupa
Facility Number: 990022
hop.cfbn Data: M712D14 Irnpectlen Type: Cwrplimtn inspectim
Ruaen for Yi.h: Omer
Iuep.dtan Daft; 06OT12M4 impectim Type: toapsarca tnspeclim
Rsp far visa: Omer
Waste Application
Yea No NA NE
Records and Documents
Yes No NA NE
PAN?
❑
Checklists?
❑
Is PAN> 10%110lbs?
U
Design?
❑
Total Phosphorus?
❑.
Maps?
❑
Feltura to incorpaste menureestudge into bare soil?
❑
Lease Agreements?
❑
�Outside of acceptable crop window?
❑
Other?
Q
Evidence of wind drt8?
❑
If Other, please specify
Application outside of application arse?
❑
21_ Does record keeping need improvement?
❑ ❑ ❑ ■
Crap Type 1
Cam {Grain)
N yes. check the appropriate box below.
Crap Type 2
Smnl Gram fwh.at
Waste Application?
❑
Bally, One)
Crop Type 3
Weekly Freebomd?
❑
West.- Analysis?
❑
Crop Type 4
Soil analysis?
❑
Crop Type 5
Waste Transfers?
❑
Crap Type 6
Soil Type 1
Weather code?
❑
Soo Type 2
Rainfall?
❑
Soil Type 3
Sting?
❑
Soil Type 4
Crop yields?
❑
Soil Type 5
120 Minute Inspections?
❑
Sol Type 6
Monthly and 1' Rainfall Inspections
❑
Do the reraivstg craps differ from those designated to tine Candied Annnal Waste Management
❑ ■ ❑ ❑
Sludge Survey
❑
CAWMPJ?
22. Did the faclly fail to instal and maintain a rain gauge?
❑ 000
15. Does the receiving crop atdlor land application site need improvement?
❑ N ❑ ❑
23. if selected, dd the facility fail to Install and maintain a rainbreaker on inigoWn equipment (NPDES
only)? ❑ 1300
16. Did the facilityfail to secure andloroperate per the irrigation design or wettable ape determination? ❑ ■ ❑ ❑
24, Did the facility fall to calibrate waste application equipment as required by the permit?
❑ ❑ ❑ ■
17. Does the facility lack adequate acreage for land application?
❑ E ❑ ❑
25- is the facility out of compliance with permit conditions related to sludge? If pas, check the appropriate ❑ ONO
18. Is there a lack of property operating waste application equipment?
❑ n ❑ ❑
bax(es) below:
Records and Documents
Yes No NA NE
Failure to complete annual sludge survey
❑
19. Did the fae ty fail to have Certificate of Coverage and Permit readily available?
❑ ■ ❑ ❑
Failure to develop a POA for sludge levels
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ ■ ❑ ❑
Nan-complant sludge levels in any lagoon
❑
If yes, check the appropriate box below.
Lest sttucture(s) and data at first survey indicating noncompliance:
WUP?
❑
26- Did the facility fall to provide documentation of an actively certified operator In Charge?
❑ ■ ❑ ❑
Page: 5
Page, 6

Psrmit: AWC990022 Owner -Facility: kr DDougas Facility Number: SOM22
inspee0oa MW OWIMU14 Insp-d0 Type: Cor pliance Impaction A— for v6d: Ou—
Records and Documents
Yea No NA NE
2?. Did the tacky fail to secure a phosphorous loss assessment (PLAT) comfirabon?
❑ ■ ❑ ❑
Other Issues
Yes No NA NE
213_ Did the facility fail to properly dispose of dead animals within 24 hours andfor dom mein and report
❑ ■ ❑ ❑
mortality rates that exceed normal rates?
• 29, At the time of the inspection did the fac i ity pose an odor or air quality contain? If yes, contact a regional
❑ ■ ❑ ❑
Air Quality representative imma"lietely,
30. Did the facility fail to notify regional DWQ of emergency aiasafiions as required by Permit? p,e_ discharge.
❑ ■ ❑ ❑
freeboard problems. overappli ation)
t. Oo subsurface fee drains exist at the fa lUty?
❑ ■ ❑ ❑
yes, dr erkk the appropriate box below.
Application Field
❑
Lagoon f Storage Pond
❑
Other
❑
If Other, please specily
32. Were any addaiorraf problems noted which cause rommmpliance of the Pemit or CAWMP? ❑ ■ ❑ ❑
33. Did the Reviewedinspedor fail to cl=us reviewlmspection with on -site represertatNe? ❑ ■ ❑ ❑
34. Does the tactility require a tollorr-up visit by same agency? 1 ❑ ❑ ❑
0
Page: 7
ZI

•
2
Type of Visit: A Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: YRoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: q,12.0a,-,j Departure Time: b; Z.Oaa, County: �J Region: Wt RO
Farm Name: A%AAIgr '-°trNl f Owner Email:
Owner Name: —roe— D+ _bD_1 _ Phone:
Mailing Address:
, NC- 270 2-a
Physical Address: t t L j f
Facility Contact: A a A! Title: Phone: (?X) qSZ— yr,31
Onsite Representative: Integrator:
Certified Operator: CertificationNumber:
Back-up Operator: Certification Number:
Location of Farm: Latitude: 749.0 07 ' ! S f' Longitude: Y Q a SL 1, Is— � f
1 ,, L •�.r L Ir,i~e.� It Ulf �...,►vt a.� �- .
Swine
Wean to Finish
Design Current
Capacity Pnp.
Design Current
Wet Poultry Capacity Pop.
La er
Cattle
DairyCow
Design Current
Capacity Pop.
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
D , $oultr, Ca ON P.o
La ers
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
TurkeyPoults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge, originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes XNo ❑ NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
❑ Yes [] No ❑ NA ❑ NE
[:]Yes []No
❑ Yes XNo
❑ Yes x No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Facili Number: - 2 Date of Inspection: 3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ YesXNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: WS-P
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3g ti
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ><No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes XNo ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes XNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes bfNo ❑ NA ❑ NE
maintenance or improvement? TTTTTT
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window f❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14, Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
R_eauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes F No ❑ NA ❑ NE
[]Yes IF
❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes X,No ❑ NA ❑ NE
[:]Yes WNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
❑Waste Application ❑Weekly Freeboard ( Waste Analysis ❑ Soil Analysis ❑Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 mute Inspections [:]Monthly and I" Rainfall Inspections j[9 Madge prw}.
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes N No XNA ❑ NE
Page 2 of 3 21412011 Continued

* Faidi Number: - Date of Ins ection: E
24. Did the facility fail to calibrate waste application equipment as required by the permit? k1yes
[:]No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes ❑ No X
NA ❑ NE
the appropriate box(cs) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes tdNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes )ZNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [] Yes YNo ❑ NA ❑ NE
and report mortality rates that were higher than normal? /
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes XNo ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
[]Yes �No
❑ Yes A No
❑NA ❑NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes N6- ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE'
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use, drawings of facility to better explain situations (use additional pages as necessary).
11 � �C. LIAR tAA� 4fla16" !— J a"t- 4V samp�- L 0 �f � �% �elGQnlilr
1 a}- b.A Ike
Z �•la, ��, �� - ��fb in l r�l zap , �d�� �l A to
trzow -&t!e j On Sv! 14..n lei JI'J,
1/1013 2,18
�11A/3. 1,1/ ! N
Reviewer/Inspector Name: FA 4-r re-k r' I Gt1+4 ` Phone: C334 -,52V,5_
Reviewer/Inspector Signature: Date: ! fz g tz3
Page 3 of 3 21412011

*z
(Type of Visit: A �mpliance Inspection 0 Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency O Other 0 Denied Access
Date of Visit: Arrival Time: qm Departure Time: 1QD County: ' 6 CA Region: L_S R a
Farm Name: D-o L4 � A, $ �afM Owner Email:
Owner Name: 'Fee D . PO L41 [4I Phone: C.33G� 4/6 F- � 5�'f.�
Mailing Address: -19� �_ W e-Ib �,-Q•�-„01�✓l V f N G 270 7�
Physical Address: �.
Facility Contact: R&ftLl o%d te' Title: Phone: 67(.) vrz - y�'3l
Onsite Representative: Integrator: 11
Certified Operator: Certification Number: ;1 fr, k�
Back-up Operator: Certification Number: 7-13� / zoj z
Location of Farm: Latitude: Longitude:
1+ , yz1 IQ., L wM fof led,, K N+ �I ., �I� &_., FA, a, Levi4-:
Swine
Wean to Finish
Design Current
Capacity Pop.
Design Current
Wet Poultry Capacity Pop.
Layer
Design Cugrent
Cattle Capacity Pap.
Dairy Cow 190
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
Design Current
Dr, P,uulE . Ca acit P,o
Layers
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
PPullets
Beef Feeder
Boars
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharees and Stream Stream Imiacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes WNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facility Number: - Z 2 . Date of inspection: Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes XNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: tJa �r Ortd
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
g I!
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.) ky
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes WNo ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ NA ❑ NE
maintenance or improvement?�fNo
XNo
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
(foiA S' �
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑WUP []Checklists []Design ❑ Maps []Lease Agreements
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
0
❑ NA
❑ NE
❑ Yes
kNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
A
❑ NA
❑ NE
❑ Other:
�21. D es record keeping need im rovement��fyw ❑ Yes No ❑ NA ❑ NE
ste Application ► Weekly Freeboard [Waste Analysis Soil Analysis° Weather Code
13 Rainfall Stocking Crop Yield Q 20 Minute Inspections Monthly and V Rainfall Inspections E3 slfflvwomwe�-
22. Did the facility fail to install and maintain a rain gauge? ❑ YesANo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No XNA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: 2 - S 2 1 Date of Inspection: 5;62M '� 1
24. Did the facility fail -to calibrate waste application equipment as required by the permit? ❑ Yes >KNO
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon.
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes 1 No ❑ NA ❑ NE
❑ Yes XNo
❑ Yes X'No
❑ Yes XNo
❑ Yes Wo
❑ Yes XNo
❑ Yes No
❑ Yes XNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other. comments.:,
Use drawings of facility to better explain situations (use additional pages as necessary). .
Z J, yJa,sdc ,3e�,�-- jo Ia,Qe► 7.0I Z , Kes w4 ad c,k ; no—
C"`
27� auk �t 11 � �t C��.c„c r� j ZZ 13,
P�°
141A.Cam- J
rr w 0 P & z A+J
%SI f
3 �
Z1. 2��2 Sall G�alysl� nb�- cDl y�'
/ tea �arr� Slo/-Z 6� ��►��, % 5���- l ��a� - Z rr�1 3 60(hO I�
)e' j, r,.A r pill
Reviewer/Inspector Name: �Q;-�f R. K J" `r I Phone: (326) ~l `%
Reviewer/Inspector Signature: Date: OFZ1 ZD 1Z-
Page 3 of 3 2/4/2011

Itype of visit: tkCompuance inspection U taperation Keview V structure 1✓vam11110n V technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:Arrival Time: Departure Time: County: \jtj I Region:
Farm Name: P)o v Q I &r W Owner Email:
416 Owner Name: (j U _,S Phone: — 4
Mailing Address: S i\jc - g� o 02
Physical Address:
Facility Contact: I�Lk1'1(� i,� .L) ©U C� Qs Title: Phone: a - 3
Onsite Representative: Integrator:
Certified Operator: Certification Number: rs , n eA
Sack -up Operator: Certification Number: b 0- 13
1 a6 l a
Location of Farm:
Latitude:
Longitude:
u5 2 �e
ort o
11vin
sor jQm
�hfdhfo
K errV
J
o�
1,e-
o�fo
\Ne
2�
�grrn on le�'f,
Design
Current;
Design
Current
Design C►urrent
Swine
Capacity:
Pop.
Wet Poulty
Capacity
Pop.
Cattle
Capacity Pop.
RWean
to Finish
Laye
DairyCow
0
%
Wean to Feeder
Non -Layer
DadCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
Dr, , .P,oultr; ..
Ca aeit
Pao
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
"
Pullets
Beef Brood Cow
Turkeys
Other -
Turkey Puults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes )4'oNo ❑ NA ❑ Nl'
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes LyNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes JkNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: - Date of Inspection.
c)jjj
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: W �OY1
S� Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the mkegrity of any of the structures observed?
❑ Yes
No
0
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
710
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ❑ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes & No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop TYPe(s): _�5 MAII 0- lr7Q 1 , 0 n f`n
13. Soil Type(s):
14, Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
Yes [:]No
Yes Wo
❑ Yes N"N' o
❑ Yes rNo
oYes
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑ Yes ,rNo ❑ NA ❑ NE
❑ Yes jjNo ❑ NA ❑ NE
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
WW
21. oes record keeping need improvement? K'Yes ❑ No ❑ NA [] NE
aste Application ❑'eeekly Freeboard ste Analysis Soil An is Trarae€ers— �7eather Code
Rainfall 612focking [Crop Yield [Minute Inspections onthly and L" Rainfall Inspections [=Sludge -Se cy
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [;g No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No E;]"*NA ONE
21412011 Continued
Page 2 of 3

F'acili Number: - Date of inspection: Q
24. Did the facility fail to calibrate waste apation equipment as required by the permit? ❑ Yes ONo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes [—]No NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
gNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
9�No
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
�No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
CgNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
77��
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
ONo
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Yes
❑ No
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
� No -❑
NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any,additionalerecommendations or any other comments
m §
Use drawing- s:of'facility to better explain situations (use additional pages;as hece'ssary):
al �o Io q- as l Soi �e_s4- rgorts ? a10 Akt,S5Sejo �v+ ad�� c'O�-�'
q--©' �.. • V
Cr�l i b r��%-r a n d o C+ . a. o r f. ��51,1�1° i` V �-i-
n.
�- a �0 5� F �
-- � �
3 Fpsc 0,AAed +� i - ios �g �-- a �
S ,I a -I �S-��Li �0. E'_
R e Wu� revtSkor). Cie P�ti• R00% W�P
l Fr6Nti so,Q H LOOY-6 Q ,
45
Reviewer/inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
Phone:
r—
Date: I o`t-
2/4/2011

Type of Visit
Compliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
jlRoutine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: ® Arrival Time:
Departure Time: V County:
le-1 rl Region: Yvs�
Farm Name: M i b�LZ<
&
16
Owner Email:
Owner Name: b.
Phone:
Mailing Address: JrS aZ IT[�Q-'�'
�J
1w j r
Vt !� &)
_.
Physical Address: 0.m
_
Facility Contact:
U0.
Title:
Phone No: T 5 a _q S3
Onsite Representative:
Certified Operator:
Back-up Operator:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: ®°ILI Longitude: � ° �"
U 5 4 A I N. Lie + a In+o V'J i r 2 d. h+ ovJo qa bear r
l,j+ on+o W e tLs Fo_rm on 13+.
Swine
�esignurrent Design
C*apac'sty Population WFRI Poultry Capacity
JEI Layer I
Current Design Current
Population C•atrle Capacity Population
I Dairy Cow 1100
❑ Wean to Finish
❑ Wean to Feeder
❑ Non -Layer
Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Layers
❑Non -La Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
I IEJ Other
❑ Dry Cow
ElNon-Dairy
❑ Beef Stocker
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Beef Feeder
El Beef Brood Cow
Number of Structures: m
Discharges & Stream Im acts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes
gNo
❑ NA
❑ NE
❑Yes
[I No
❑NA
❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes V. ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
Page 1 of 3 12128104 Continued

Facility Number: q— a. . Date of Inspection D
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �No. ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 11 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: a5fe-�onU
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Li 9
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ElNE
(ie/ large trees, severe erosion, seepage, etc.) �No 6. Are there structures on -site which are not properly addressed and/or managed ElYes ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes KNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. 'Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes WNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes -�No
❑ NA [INE
❑ Excessive Ponding ElHydraulic Overload ElFrozen Ground ElHeavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > t0% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) abA.4)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes [124o ❑ NA ❑ NE
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. is there a lack of properly operating waste application equipment? ❑ Yes
6(No ❑ NA ❑ NE
NrNo ❑ NA ❑ NE
�No El NA El NE
�No ❑ NA ❑ NE
Comments (refer to`questioi `##): Explain any. YES' answers and/or any recommendattons'or,ariy othee,!iomments.'�
Use drawings of facility to better explain situations. (use, additional pages as necessary): <<
f
ReviewerAns ector Name
Phone: p .�
Reviewer/Inspector Signature: Date:
Page 2 of 3 L ' r 12128104 Continued

Facility Number: — a *of Inspection I X 1�, 1 •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [ No ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists El Design El Maps ❑Other
21. vast,
rd keeping nee7weekly
ovement? ff�+e ❑ Yes �No ❑ NA ❑ NE
e A licat' n Freeboard Waste Anal sis Soil Anal sis 11PP Y Y El-
waste
Stocking B/Crop Yield �720 Minute Inspections [ 'Monthly and I" Rain Inspections L Keather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ;4NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes rr❑- No JZNA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes XNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes )% No ❑ NA ❑ NE
Other Issues XYes
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes �No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes �No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 34 No ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes VNo ❑ NA ❑ NE
A "onal Comments':andhi'-Drawings A > T
«#� , '",�.
LAJ) a009 -- aot o
bd_ibrw�ioh for
:S6%j f re-su t+s ?
a.009 ? Afkq a-009. c
aoI i
ot
D
.
l o,S - .
Page 3 of 3 12/28/04

Division of Water Quality -
Facility Number p2 Division of Soil and Water Conservation
0 Other Agency
IType of Visit Compliance Inspection 0 Operation Review 0 structure Evaluation 0 Technical Assistance I
Reason for Visit X Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time:
Farm Name: hO I4-rra
County: Region: WS A
Owner Email:
Owner Name: 01j41(15 Phone:
Mailing Address: !S 5 �-
4S9
Physical Address: �0.YV1 „ „ ___ Ny _t rt 6LJ e_, )E..,2 =`d -7 S.2—
Facility Contact: Title: Phone No: 14 5 oZ — qe3
Onsite Representative: Integrator:
Certified Operator: h
p`�5 Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: ©° ©� Longitude: MI° L
L)s 4.74 N, on+o vu i Vd 5or (Z +- bn bGrr j2�,
On W el 1'5 rid . �Oul-m o
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
LJ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
II ❑ Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turke Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
Dairy Cow
Q Q
Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: FT
d. Does discharge bypass the waste management system? (1f yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
El Yes El No El NA ❑NE
12128104 Continued

Facility Number: — 2A4 Date of Inspection �.
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
)(No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structure Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No [INA ElNE
K
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
-4No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental
threat, notify DWQ
7, Do any of the structures need maintenance or improvement?
❑ Yes
9,No El NA ❑ NE
rr __No
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require
❑ Yes
No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
INo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
# No ❑ NA ❑ NE
El Excessive Ponding El Hydraulic Overload El Frozen Ground El Heavy Metals (Cu, Zn, etc.)
////
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) /]n,i,(�,� Q WA 1 f P*t'j
13. Soil type(s) Y
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
M No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
El NA
El NE
Comments (refer to question ft. Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
3 al d ire s heir �on d oar vte� ?
e.
jo - a o0�7 .
AL
T
Reviewer/Inspector Name 5 Phone:
Reviewer/Inspector Signatur .AA A Date:
V 12128104 " Continued

Facility Number: — @of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need i provement? if yes; e ❑ Yes ANo ❑ NA ❑ NE
aste Appli anon Wee y Freeboard Waste Analysis Soil�alysisGGGRainfall Stocking Crop Yield 120 Minute Inspections onthly and 1" Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ONA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?] Yes ❑ No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? /❑ Yes E❑( No O(NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ICI No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification'? ❑ Yes WNo ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes No
❑NA
❑NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
ElYes No
q
❑NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes I](] No
❑ NA
❑ NE
General Permit? (ie/ discharge; freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes No
❑ NA
❑ NE
Ad 'tionaal►Commentsland/or Drawings:
ra_On COCA+ 0
? t Au"
I . Pool 5611 --esf ? R&Ar
w'l q 043, =_ -� - 9 . 4; - M
Page 3 of 3 12128104

02-
i Type of Visit [I �Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit:
Farm Name:
Arrival Time: Departure Time: County:
xs Fa:rnn Owner Email:
Region: �_ap-C3
Owner Name: _T6 e t)' v q S Phone: 'f%<g —4 5-1 -3
Mailing Address: a1 �.t S Road I �n V 1_`1e
r
Physical Address:p
Facility Contact: U Q Title: Phone No- 4— Sam
r
rOnsite Representative: Integrator:-�
Certified Operator: ��Q Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: IAA° ©� Longitude: °
u s q a I Iv,b�ef 6n W'lnA50r 2d +9kfon M .&t bex-rL( P-d .
dnfo w t' l I S • Fo-irrn on le_ +.
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other .
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
_ ❑ Layer
i. ❑ Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
Dai ry Cow
F 100
Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: 1E
d. Does discharge bypass the waste management system'? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes
xNo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes �(No ❑ NA [IN E
Yes ❑ No ❑ NA ❑ NE
12128104 Continued

Facility Number: 9 — Z Z . Date of InspectionUllalm
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes A No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
L
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes $No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes o ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes V�No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes i.�,No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) XNo
9. Does any part of the waste management system other than the waste structures require ❑ Yes ❑ NA ❑ NE
maintenance or improvement?
Waste Anplication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift Application Outside of Area
0
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
[�►No ❑ NA ❑ NE
No ❑ NA ❑ NE
XNo ❑ NA ❑ NE
*o ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (Ilse additional pages as necessary):
5• Fi 5
4' uU
t
o
Revi er/Inspector Name
Phone:
Reviewer/Inspector Signatur .
Date: a
Page
A�q !VA

Facility Number: — 10ate of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes _XNo
No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑Yes ❑NA ❑ NE
the appropirate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. iWrc
cord keeping need i provement? If yes, ch k the appropriate bo. Clow. ❑ Yes ❑ NA ❑ NE
ste ApXtocking
tion We ly Freeboard Waste Analysis Soil alysis �
Rainfall Crop Yield spec ions Monthly and 1" Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit'?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal`?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes 1d No
❑ NA
❑ NE
❑ Yes
❑ No
ANA
❑ NE
❑ Yes
V No
NA
El NE
❑ Yes
❑ No
�fNA
❑ NE
❑ Yes
/K No
❑ NA
❑ NE
❑ Yes
jNo
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
P(No
❑ NA
❑ NE
[]Yes
KNo
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
[VNo
'
❑ NA
❑ NE
❑ Yes
(No
❑ NA
❑ NE
Additional i
1
�U
r
m
9
12128104
LJ

Division of Water Qualit}W
Facility Number a9 Division of Soil and Water Conservation d A
O Other Agency
Type of Visit
Compliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
Routine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: " County: C"" 1 Region:
Farm Name: rt ]�ttQ a� Q i` (� Owner Email: Owner Name: SO c� O U I Phone: 4 6 DC
y r9 3
Mailing Address: fopy i l lt°
Physical Address: CQ^.
of i n
Facility Contact: 0-5 Title: Phone No• a sue_
Onsite Representative: Integrator:
Ili
Certified Operator: O yQ Operator Certification Number: + ��
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ®e d7 L,�bJ Longitude: ®o ©1 I E I
US ya1 N Le � or-1 \N'n Sor On err� •
Pck-rrn 0 h [f_�+ _
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ La er
❑ Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Capacity Population
❑ Dairy Cow
106
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: En
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes *No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El Yes
❑No
El NA
El NE
❑ Yes
�rNo
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
12128104 Continued

Facility Number: — 02
Date of Inspection 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1^ Structure 2 Structure 3 Structure 4
Identifier: �J
❑ Yes jNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in): _
Observed Freeboard (in): _
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yesj�10
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes o
through a waste management or closure plan?
❑NA [I NE
El NA El NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? �Yes &No ❑ NA ❑ NE
8, Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes kNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes y<No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes W No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or l 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
rNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
'Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
0 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
O No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
XNo
❑ NA
❑ NE
Comments (refer to question ##): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
SwtitcV,. hon trio-e& - kVAA_L�
AL
�6
�
q
Reviewer/[nspector Name r0 (��� Phone:
eviewer/[nspector Signature: Date:
`` / �� J =--- r r Zr
1 %

Facility Number: 1fl— ad, I lRate of Inspection i 1
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 2 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes WNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. es record keeping neei
rovement? If yes, c eck the appropriate bo below. ❑ Yes ❑ No ❑ NA ❑ NE
Waste Appli tion
ly Freeboard Waste Analysis Soil alysis ❑
Rainfall tocking Yield 120 Minute Inspections Monthly and 1" Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No
ElNA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ElYes ❑ No 9NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes bdNo ❑ NA ❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
KNo
ElNA
ElNE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
KYNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
`-Yes
❑ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
. No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
XNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
JkNo
❑ NA
❑ NE
4ddit_onal Comments and/or Drawings:
Uri
eacv� cL+ e- ? 4A'P_&�
Specla l'l 5t LA
Iy ..,op. 4r„ - --
��j JF7(6 U_) Ir—QJ�
�' rt r e,55 u re-.
12128104

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 990022 Facility Status: Active Permit: AWC990022 __ ❑ Denied Access
Inspection Type: Qompliance Insperjega Inactive or Closed Date:
Reason for Visit: Routine County: Yadkin Region: Winston-Salem
Date of Visit: 02/23/2006 Entry Time: 10:05 AM Exit Time: 11:15_AM __ Incident #:
Farm Name: Douglas Famis Owner Email:
Owner: Joe D Douclas Phone: 210-468A593
Mailing Address: 5828 Wells Rd } ammptonville NC27020--
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude; Longitude: 80°52'15"
From WSRO: US Hwy 421 north. Left onto Windsor Road (SR1100) off Hwy 421. Proceed South on SR1100 and then turn right onto
Wells Road (SR1108) just after crossing the bridge. The farm is approx. 0.7 mile on the left.
Question Areas:
Discharges & Stream Impacts
Records and Documents
Certified Operator: Randy D Douglas
Secondary OIC(s):
Waste Collection & Treatment Waste Application
Other Issues
Operator Certification Number: 21395
On -Site Representative(s): Name Title Phone
On -site representative Randy Douglas Phone:
. 24 hour contact name Randy Douglas Phone:
Primary Inspector: Melissa Rosebrock Phone:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
3. Fungus noted in creek below leachale entry.
9. Operator plans to re -trench new layout. May need diversion soon.
18. Need pressure gauge for gun.
21. Last waste analysis was sent February 2006 for January 2006 applications. Check next visit.
24. Calibration completed 1/26106. Not due again until October 2008.
Date:
Page: 1

I
Permit: AWC990022 Owner - Facility: Joe D Douglas Facility Number: 990022
Inspection Date: 02/2312006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle
© Cattle -Milk Cow 100 77
Total Design Capacity: 100
Total SSLW: 140,000
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
ka,t, Pond WSP 5a.00
Page: 2

0 0
Permit: AWC996022 Owner - Facility: Joe D Douglas Facility Number: 990022
Inspection Date: 02/23/2006 inspection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts Yes No NA NE
1. Is any discharge observed from any part of the operation? ❑ ■ ❑ ❑
Discharge originated at
Structure ❑
Application Field ❑
Other ❑
a. Was conveyance man-made? ❑ ■ ❑ ❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ) ❑ ■ ❑ ❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ ■
❑
❑
2, Is there evidence of a past discharge from any part of the operation?
❑ ■
❑
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a
■ ❑
❑
❑
discharge?
Waste Collection, Storage &Treatment Yes No
NA
NE
4, Is storage capacity less than adequate?
❑ ■
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large trees, severe
❑ ■
❑
❑
erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a waste management
❑ ■
❑
❑
or closure plan?
7. Do any of the structures need maintenance or improvement?
❑ ■
❑
❑
8, Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits,
❑
■
❑
❑
dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
■
❑
❑
❑
improvement?
Waste Application
Yes
No
NA
NE
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or
❑
■
❑
❑
improvement?
11. Is there evidence of incorrect application?
ONOO
If yes, check the appropriate box below,
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
Page: 3

•
0
Permit: AWC990022 Owner - Facility: Joe D Douglas Facility Number. 990022
Inspection Date: 02/23/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No NA NE
PAN? ❑
Is PAN > 10%110 lbs.? ❑
Total P205? ❑
Failure to incorporate manure/sludge into bare soil? ❑
Outside of acceptable crop window? ❑
Evidence of wind drift? ❑
Application outside of application area? ❑
Crop Type 1 Corn (Silage)
Crop Type 2 Fescue (Pasture)
Crop Type 3 Small Grain (Wheat,
Barley, Oats)
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste Management
❑ ■
❑
❑
Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ ■
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
❑ ■
❑
❑
17. Does the facility lack adequate acreage for land application?
❑ 0
❑
❑
18. Is there a lack of properly operating waste application equipment?
Cl ■
❑
❑
Records and Documents
Yes No
NA
NE
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ ■
❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
❑
❑
If yes, check the appropriate box below.
WUP?
❑
Page: 4

Permit: AWC990022 Owner- Facility: Joe D Douglas
Facility Number:
990022
Inspection Date: 02/23/2006 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Records and Documents
Yes
No
NA
NE
Checklists?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
❑
■
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
❑
Inspections after> 1 inch rainfall & monthly?
❑
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
❑
Stocking?
❑
Annual Certification Form (NPDES only)?
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
■
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)? ❑
0011
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■
❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
■
❑
❑
26. Did the facility fail to have an actively certified operator in charge?
❑
■
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
■
❑
❑
Other Issues
Yes
No
NA
NE
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
❑
■
❑
❑
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those ❑ ■ ❑ ❑
mortality rates that exceed normal rates?
30. At the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air ❑ ■ ❑ ❑
Quality representative immediately.
Page: 5

•
0
Permit: AWC990022 Owner- Facility: Joe D Douglas
Facility Number: 990022
Inspection Date: 02123I2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Other Issues Yes No NA NE
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit? ❑ ■ ❑ ❑
32. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ ■ ❑ ❑
33. Does facility require a follow-up visit by same agency? ❑ ■ ❑ ❑
Page: 6

Facility Number
Type of Visit
Reason for Visit
Date of Visit:
Farm Name: _
Owner Name.
(Division of Water Quality
Division of Soil and Water
O Other Agency
Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Arrival Time: Departure Time: �.� County: I Region:+-f
` f
1 ] atilOwner Email -
cz- <(' -A '9.
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: _,.
Back-up Operator: _
a,- e)
Phone No: C -,— &f E4 — 3 (J
Integrator:
Operator Certification Number: tt .
Back-up Certification Number:
Location of Farm: Latitude: 0
Longitude: Mo HI us"
us -a Ue + On, n 5� s r 1 ioo t�• W+o 11 owl bexr `
1AJk U� iS - i6XMO
Design Current Design Current
Swine Capacity. Population Wet.Poaltry Capacity Population
10 Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Gilts
Other
❑ Other
❑ La er
❑ Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
[I Pullets
ElTurkeys
❑ TurkeyPoults
❑ Other
Design Curren#
Cattle' Capacity„ Population'''
Dai Cow
0
DairyCalf
El
Dairy Heifer
El
Dry Cow
El
Non-Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
r
Number of Structures:-
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure El Application Field El Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes lNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑Yes
1�No
❑NA
[I NE
Yes
❑ No
❑ NA
❑ NE
12128104 Continued

Facility Number: — • Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage pius heavy rainfall) less than adequate? *Yes �No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structur I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
[ No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
�No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
threat,
,No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require Yes
❑ No ❑ NA ElNE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
KNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes
*No [:I NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
0 0 ..
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No ElNA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
ElYes
o ElNA
ElNE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
[IYes
No [INA
❑ NE
17. Does the facility lack adequate acreage for land application?
ElYes
No ElNA
[3NE
18. Is there a lack of properly operating waste application equipment?
El Yes
No ❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
oC 0• � � rJ �• �lSt%1It C .0
` �rnrCtW�b
Cil J
kifsewer/Inspec ame � �- - _ -_ - --------� Phone:
Reviewer/Inspector Signature: Date: of_31 d
il
Page 2 of 3 1 . 1 1 ' 12128104 Continued

� F �
Facility Number: — Paeofinspections 0
Required Records & Documents /
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. D es record keeping need improvement?�a�r�ia ❑ Yes No ❑ NA ❑ NE
Waste Application Rf Weekly Freeboard L�Waste Analysis �i7soii; nalysis n
DRainfall Stocking Crop Yield � 120 Minute Inspections M'onand 1" Rain Inspections M,4Veather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
IANo
❑.. NA
ElNE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
El No
L29.NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
� No
��❑``NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
*A
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
�No
0 NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
P(No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
,No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
' o
❑ NA
ElNE
33.
Does facility require a follow-up visit by same agency?
El Yes
o
❑ NA
❑ NE
Additional Comments and/or Drawings:
gqM.,,n,,,_ aooy�,,..__.,�po , Lr,,.,� ✓Ivnt.r
Page 3 of 3 12128104

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency _
Facility Number: 990022 Facility Status: Aglive Permit: AWC990022 ❑ Denied Access
Inspection Type: Compliance -Inspection Inactive or Closed Date:
Reason for Visit: Routine County: Yadkin Region: Winston-Salem
Date of Visit: 02/16/2005 _ - Entry Time: 09:15 AM Exit Time: 10:30 AM Incident #:
Farm Name: Dgualas Farms Owner Email:
Owner: Joe_D 12oualas
Phone: [phone]
Mailing Address: §828 WellLEW Jdamptonville NC 27020
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 36"07'15" Longitude: 60°52'15"
From WSRO: US Hwy 421 north. Left onto Windsor Road (SR1100) off Hwy 421. Proceed South on SR1100 and then turn right
onto Wells Road (SR1108) just after crossing the bridge. The farm is approx. 0.7 mile on the left.
Question Areas:
0 Discharges & Stream Impacts Waste Collection & Treatment Waste Application
0 Records and Documents 0 Other Issues
Certified Operator: Randy D Douglas Operator Certification Number: 21396
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
On -site representative Randy Douglas Phone:
24 hour contact name Randy Douglas Phone:
Primary Inspector: P40ssa Rosebrock Phone: [phone]
Ext.383 I b
Inspector Signature: Date:
VVW
Secondary Inspector(s):
Phone:
Phone:
Inspection Summary:
9. Need to replace top few inches of gravel in the leachate pit closest to the fresshwater pond.
18, Need to un-stop nozzle on both irrigation reels. Both guns need pressure gauge (or one portable gauge). Pressure aguge on reel
closest to WSP does not work. Jimmy Haynes does applications.
22. Need rain gauge on site.
28. Need copy of irrigation plan and/or design including PSI for irrigation gun, nozzle type, etc.
Page: 1

0 9�
Permit: AWC990022 Owner- Facility: Joe D Douglas
Inspection Date: 09/16/2005 Inspection Type: Compliance Inspection
Facility Number: 990022
Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle
Cattle -Milk Cow 100 45
Total Design Capacity: 100
Total SSLW: 140,000
Waste Structures
Tvoe Identifier Closed Date Start Date Deslaned Freeboard Observed Freeboard
Waste Pond WSP 45.00
Page: 2

0 •
Permit: AWC990022 Owner • Facility: Joe D Douglas Facility Number: 990022
Inspection Date: 09/16/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Disr_hargras A Stream Impacts
1. Is any discharge observed from any part of the operation?
Yes
❑
No NA NE
0013
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
M ❑ ❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
0 ❑ ❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
0 ❑ ❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑ ❑
3. Were there any adverse impacts or potential adverse Impacts to Waters of the State other than from a discharge?
❑
Yos
M ❑ ❑
No NA NE
Waste Colleetinn. Storage & T.featment
4. Is storage capacity less than adequate?
❑
■ ❑ ❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large trees, severe erosion,
❑
M ❑ ❑
seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a waste management or
❑
❑ ❑
closure plan?
7. Do any of the structures need maintenance or Improvement?
❑
0 ❑ ❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks
❑
❑
and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
■
❑ ❑ ❑
improvement?
Yes
No Na NE
Waste Appliraflon
10, Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement?
❑
0 ❑ ❑
11. Is there evidence of incorrect application?
❑
0 ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total P205?
❑
Failure to incorporate manurelsludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
Crop Type 1
Fescue (Pasture)
Crop Type 2
Small Grain (Wheat,
Barley, Oats)
Crop Type 3
Corn (Sllage)
Crop Type 4
Crop Type 5
Page: 3

Permit: AWC990022 Owner -Facility: Joe D Douglas
Inspection Date: 09116/2005 Inspection Typo: Compliance Inspection
Facility Number. 990022
Reason for Visit: Routine
Waste Application
Crop Type 6
YPs
No NA
NE
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certifed Animal Waste Management Plan(CAWMP)? 00
❑
❑
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
❑
0 ❑
❑
17. Does the facility lack adequate acreage for land application?
❑
E ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
YPs
0 ❑
No NA
❑
NE
FSgrnEda and ❑ncuments
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
❑
❑
If yes, check the appropriate box below
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
❑
01313
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
❑
Inspections after > 1 inch rainfall & monthly?
❑
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
❑
Stocking?
❑
Annual Certification Form (NPDES only)?
❑
22. Did the facility fail to install and maintain a rain gauge?
❑ ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
❑
❑
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
❑
❑
26. Did the facility fail to have an actively certified operator in charge?
❑
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Page: 4

• •
Permit: AWC990022 Owner • Facility: Joe D Douglas Facility Number, 990022
Inspection Date: 09/16/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP? ❑ n ❑ ❑
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those mortality ❑ .
rates that exceed normal rates?
30. At the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air Quality ❑ ❑ ❑
representative immediately.
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit? ❑ ❑ ❑
32. Did Reviewer/Inspector fall to discuss review/inspection with on -site representative? ❑ ❑ ❑
33, Does facility require a follow-up visit by same agency? ❑ 0 ❑ ❑
Page: 5

Type of Visit ACompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit XRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
° w5Ro
Date of Visit:l^1 11� Arrival Time: � Departure Time: ®County: I Region:
Farm Name: D6 e3 S f�-&ArM S Owner Email:
Owner Name'. 'Toe- � u II 145 �, _ Phone: 46 ? — [
�9
1
Mailing Address: - 5-1 a1 ��^T 2 KX_ 2 _70 old
Physical Address:
Facility Contact: RPhone No:
Onsite Representative: - Ot) Integrator:
Certified Operator: OL` Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ® e � I � Longitude: ° 1 f IJl
u5 Nw� q(A nor ► , Lef � Ort4o W M156r Rd 52 I I Uo on+a We[ 15
Z(� . Fo r'm t S 4n le__4 a 9A. bn�
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feedei
Farrow to Finish
Gilts
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
f❑ Non -La es I-
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Dischar_es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
Dairy Cow
Q
Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes �(No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

• Date of Inspection `9 1/ATD0 5A
Facility Number: — 2 Z
Waste Collection &Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑YesNo
❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
' +
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
XO ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
Wo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
�k<o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
*0 ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
Yes
❑ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Vo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
R(oEl NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground El Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window Q Evidence of Wind Drifln ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes ZNo
El NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[]
Yes o
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
)(Yes ❑ No
❑ NA
❑ NE
117/7
U arm I
sir ►n ;I,.... _ , �,=111F=-a
do

Facility Number: — Z D& Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Vo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. D es record keeping need i provement? I f yes, ch;Zte
e appropriate box b ow. ❑ Yes El No ❑ NA ❑ NE
2Waste Application Weekly Freeboard Analysis oil nalysis
Rainfall Stocking ❑ Crop Yield 120 Minute Inspections Monthly and V Rain Inspections eather Code
22. Did the facility fail to install and maintain a rain gauge? XY es ❑ No ❑ NA El NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No E dNA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? 00. 0 (P ❑ Yes
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern'?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (iel discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
❑ Yes
KNo ❑ NA
❑No NfNA
)(No ElNA
❑ No )(NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ Yes kNo.
o ❑ NA ElNE
❑ Yes ,� �/❑ NA ❑ NE
L�Q
❑ Yes No ❑ NA ❑ NE
❑ Yes VNo ❑ NA ❑ NE
❑ Yes *No ElNA ❑ NE
❑ Yes NjNo ❑ NA ❑ NE
Additional Comments and/or Drawings:
40
165— 11 05— = lod
J
12128104

k ash s
33 a ,E EI 4 I I..'
3� d 11 3> d, i i i 3 I I I Q.� y i ��:,£ a B C E '.t ,°,�I,i:l E 3 I a•{: , h 1 , i / 1 i I,' kt,'
IiI
t[ ' y0 Other A ency1M
,Ett
�,ifil!lrE��I IE.,°IriIEItr, €c E?[IaeS 3S'd.(Eirta r iE,'-Ek] jlE3V€�IIEEii. :�yt ! '-j! lE
EEIfIi�j JI
a �J
Type of Visit Q Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit OO Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
F— Facility Number 99 22 Date of Visit: 11/23/2004 Time: 1250
Not O erational O Below Threshold
®Permitted ®Certified © Conditionally Certified [3 Registered Date Last Operated or Above Threshold: ...............
Farm Name: 1?lRpglflS.k'fllCg0.S............................................................................................. County: 'Aldkip.............................................. !'!'SRC),..,,...
Owner Name:JQe,.d?....................................... D.O.ugls,s........................
Mailing Address: W&W.9IIS.RSI d....................
Facility Contact: 13,an:dy..M.U910 ............................................... Title:............
Onsite Representative:R8j3dy,<j)QU9W5..................
..........................................
Certified Operator:R07Udy.D ............................... Muglas....................
Location of Farm:
Phone No: 93.J.6-46.-459...........................
ROn[ P1011YA k.-M.............................................. Z.7ON..
Phone No ................. .........
Integrator: ..................... .................................................................
Operator Certification Number: Z,13.96.............................
T rom WSRO: US Hwy 421 north. Left onto Windsor Road (SR1100) off Hwy 421. Proceed South on SR1100 and then turn A
-ight onto Wells Road (SR1108) just after crossing the bridge. The farm is approx. 0.7 mile on the left.
❑ Swine ❑ poultry ® Cattle ❑ Horse Latitude 36 • 07 15 ♦f Longitude $0 • 52 15
Design '
Current Design
current
Design Current
Swine Capacity.Population,
I Poultry Capacity,
Population. Cattle
Capacity Population
❑ Wean to Feeder
JE1 Layer
❑ Dairy
100 79
❑ Feeder to Finish
❑ Non -Layer I
I JE1 Non -Dairy
❑ Farrow to Wean
I
❑ Farrow to Feeder
❑ Other
1
❑ Farrow to Finish
Total Design Capacity
100
❑ Gilts
❑ Boars
'Total_SkW
E
140 000
Number of Lagoons 0
ilnlrlino Pnnrlc / gntid Trnnc -
Disc�har e_S & Stream lmnacts
1. is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes to No
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ®No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier.......W.asle.pond.....................................................................................................................................................................................
Freeboard (inches): 28
12112103 Continued

Facility Number: 99-22 40 Date of Inspection 11/23/2004
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees; severe erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ® No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ❑ No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ® No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc > 3000
12. Crop type Fescue (Graze) Small Grain (Wheat, Barley,
13, Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ®No
b) Does the facility need a wettable acre determination? ❑ Yes ®No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement? ❑ Yes ®No
16. Is there a lack of adequate waste application equipment? ❑ Yes ® No
Odor Issues
17, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? (7 Yes ® No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ® No
Air Quality representative immediately.
Comments'(refer to question' #): ;Explain any YES answers and/or any recommendations or any other comments.`
Use,drawmgs of facility to bettervi plain situations. (use additional pages as necessary) El Field Copy ®Final Notes
E ij ' `"T
Al. v �. €.., Al:
'�-7�--'�
8. Gravel silage leachate pits appear to be retaining the leachate just long enough. May want to pipe to pond near upper silo, though. +
16. Need gauge on irrigation gun.
23.Operator has sent soil samples. Waiting on results.
requirements of new permit with operator.
Reviewer/inspector Name )!Mel'ssa Rosebrock
Reviewer/Inspector Signatu [�j��„� /� Date:
12112103 Continued

Facility Number: 99-22 I)of Inspection 1I/23/2004 •
Reauired Records & Documents
21.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
22.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
23,
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
® No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
®No
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
28.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
NPDES Permitted Facilities
30,
Is the facility covered under a NPDES Permit? (if no, skip questions 31-35)
❑ Yes
® No
3 L
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33,
Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
.. � . — �,. �
ddltionallColnment5 and/or; Drawlnps
„ ,,, 3i.-._ - Io.:...I r b,'{
d tll 'I l l r III, ] F
f, ,r , 1_, i qt I <.I'''� Y L. ,.;d I , I r .avl
I ;
I
r
12112103

!Type of Visit ID Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Z Date of Visit: 07 1 ime:
Not Operational O Below Threshold
Permitted [3Certified©Conditionally Certified © Registered Date Last Operated or Above Threshold: » ... _.
Farm Name: .. URA? .�a..r ! L ....__..__. _ .. County: �L�.!? W.........»» ...» ...._.__.»»_..
1 ,� J C,s� Owner Name: _...�I..�..:�._. ...:.........�OU..�.»._».»..» ....._.__._._»..... Phone No:..._......�.......�.__.�._.....:..»Z»...»».... ...........
Mailing Address:.. ... :� 15._.� 1`�'�`.:.».. ».Wn �t� 1 �_� e... »...».».»GA`µ-7» _....»...............
r `
�i
Facility Contact. .....! �i ?fir .. �`'.v` �-?__ Title:
Onsite Representative: .... ... .'-...... ..V. .. 'T� ..._
UQ
Certified Operator:......... ..».»�.......»».».......». ....
Location of Farm:
PhoneNo: _._»....»»....»..»»...._..__._........
Integrator:...».»»..»....»....»......».».».._.......»... q !»�.,......
Operator Certification
U 5 no , Le o 0o wi l s P, [ o { nrlto •
n on
❑ Swine ❑ Poultry gCaftle ❑ Horse Latitude �.Y'J� ®` 0`i Longitude ®• S 2 ` �"
Wean to Feeder
,;'
rr.
❑ Layer
& v w
Feeder to Finish
❑ Non -Layer
Farrow to Wean
Farrow Feeder
4tiY°:
Other
to
Farrow to Finish
Total Deny },
0 Gilts
S 4 � » ' r
�, '� A
EJ Boars
t�
�ti.u�uc ,...';;l:apaCti3';'".t otlirlal
A
: Numl�erkaf'ingoons � a �f`�''a �
. � � q.�rGa"�l +s"Sh'SG�r r.� ,�'', + �. iy'aya,r ui.,"•„+d1 yC r 1 A� ��sF4� c
.., ..�f}fir ?ir' '."�< i 'i• . Lsn�6
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes *0
Discharge originated at: El Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes •❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ yes' ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes >No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes )eo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes
Sytructur ]� Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
12112103 Continued

Facility Number q9 — ZI Date of Inspection a
S. Are there any immediate threats to theqpgrity of any of the structures observed? (ie/ trees severe erosion, ❑ Yes �To
seepage, etc.) '
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes O No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes )S(o
8. Does any part of the waste management system other than waste structures require maintenancermprovement? ❑ Yes )(No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes *0
elevation markings?
Waste Anulication 1�
10. Are there any buffers that need maintenance/improvement? ❑ Yes
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes [[ ��_ o
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type rQ -
13. Do the receiving crops differ with those designated in dU Certified Animal Waste Management Plan (CAWMP)? ❑ Yes No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes *No
b) Does the facility need a wettable acre determination? ❑ Yes SfNo
c) This facility is pended for a wettable acre determination? ❑ Yes 6eNG
I5. Does the receiving crop need improvement? ❑ Yes o
16. Is there a lack of adequate waste application equipment? ❑ Yes No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below 'rs�_
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes o
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes o
roads, building structure, and/or public property)
20, At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes XNO
Air Quality romsentative immediately.
Field Coon ❑ F'mal Notes
t,
r
Reviewerftspector Name
ReviewerAULq ctor
12112103
Date:
I
11,73 7L�
Continued

Facility Number: — D to of Inspection ,. b
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
XNo
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUP, checklists, design, maps, etc.)
❑ Yes
*o
23. D s record keeping need ' provement? I es, check the ap ate box below.
❑ Yes
��o
Waste Application Freeboard Waste Analysis S Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
o
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
*o
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
hAo
28. Does facility require a follow-up visit by same agency?
❑ Yes
o
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
O�No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
12112103

hnical Assistance Site Visit
• DWon of Soil and Water Conservation
O Natural Resources Conservation Service
O Soil and Water Conservation District
O Other...
Facility Number 99 - 22 Date: 917104 Time: 1 9.30 Time On Farm: fi0 WSRO
Farm Name Douglas Farms County Yadkin Phone:
910-468-4593
Mailing Address 5828 Wells Road Hamptonville NC 27020
Onsite
Representative Randy Douglas _ Integrator
Type Of Visit PurRose Of Visit
® Operation Review
❑ Compliance Inspection (pilot only)
❑ Technical Assistance
❑ Confirmation for Removal
❑ No Animals -Date Last Operated:
❑ Operating below threshold
❑ Swine ❑ Poultry ® Cattle ❑ Horse
Design Current
Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
pO Routine
O Response to DWQ/DENR referral
O Response to DSWC/SWCD referral
O Response to complaint/local referral
O Requested by producer/integrator
O Follow-up
O Emergency
O Other...
Design Current
Capacity Population
❑ Layer
❑ Non -Layer
® Dairy
❑ Non -Dairy
pO Routine
O Response to DWQ/DENR referral
O Response to DSWC/SWCD referral
O Response to complaint/local referral
O Requested by producer/integrator
O Follow-up
O Emergency
O Other...
Design Current
Capacity Population
❑ Layer
❑ Non -Layer
® Dairy
❑ Non -Dairy
® Dairy
❑ Non -Dairy
goo1
69
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes ® no
2. Is there evidence of a past waste discharge from any part. of the operation that waste reached ❑ yes IS no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees, ❑ yes ® no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes ® no
requiring DWQ notification?
6• Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes ® no
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes ® no
Structure9 Structure 2 Structure 3 Structure 4 Structure 5
Identifier WSP
Level (Inches) - 48
CROP TYPES Fescue- raze I lCorn, Silage Wheat
SPRAYFIELD
SOIL TYPES Cf132
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

Facility Number 99 - 22 Date:
9/7/04
PARAMETER
pO No assistance provided/requested
❑ 8. Waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9. Waste spill contained on site
❑ 10. Level in structural freeboard
25. Waste Plan Revision or Amendment
❑
❑
❑ 11. Level in storm Storage
26. Waste Plan Conditional Amendment
❑
❑
27. Review or Evaluate Waste Plan wlproducer
❑
❑
❑ 12. Waste structure integrity compromised
[113. Waste structure needs maintenance
28. Forms Need (list in comment section)
El
❑
29. Missing Components (list in comments)
❑
❑
❑ 14. Over application >= 10% & 10 lbs.
El
❑
❑ 15. Over application < 10% or < 10 lbs.
30.2H.0200 re -certification
❑ 16. Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
32. Irrigation record keeping assistance
❑
❑
❑ 17. Deficient irrigation records
❑ 18. Late/missing waste analysis
33. Organizelcomputs rization of records
❑
❑
❑ 19. Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
[120. Late/missing soils analysis
❑ 21. Crop needs improvement
35. Sludge or Closure Plan
❑
❑
❑ 22. Crop inconsistent with waste plan
36. Sludge removallclosure procedures
❑
❑
37. Waste Structure Evaluation
❑
❑
❑ 23. Irrigation maintenance deficiency
[124. Deficient sprayfield conditions
38. Structure Needs Improvement
❑
❑
39. Operation & Maintenance Improvements
❑
❑
40. Marker check/calibration
❑
❑
Regulatory. Referrals
1E]
41. Site evaluation
❑
❑
Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
43. irrigation design/installation
El
El
❑ Other...
system
Date:
44. Secure irrigation Information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45. Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
46. Wettable Acre Detennination
❑
❑
The waste plan was revised for additional crops
47. Evaluate WAD certification/rechecks
❑
❑
and fields.
48. Crop evaluation/recommendations
❑
❑
2 • The cattle have been fenced out of the creek and
49. Drainage worklevaluation
❑
❑
water boxes installed.
50. Land shaping, subsoiling, aeration, etc.
51. Runoff control, stormwater diversion, etc.
❑
❑
❑
❑
3
52. Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4.
54. Mortality BMPs
❑5.
❑
55. Waste operator education (NPDES)
❑
❑
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6.
58. Croplforage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

•
Facility Number 99 - 22 Date: 917104
MENTS:
Waste analysis: 6-16-04 ALD 1.7 Ibs.N11000 gals. I
Soil samples dated 5-30-03
The silage leachate drains appear to be working.
The cattle have been fenced out of the creek and water boxes were installed.
The facility and records look good. Good farm.
TECHNICAL SPECIALIST lRocky Durham
SIGNATURE
Date Entered: 9/10104 Entered By: lRocky Durham
03/10/03

Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint Q Fallow up O Emergency Notification O Other ❑ Denied Access
Dale of Visit: ltl18/2003 Time: 0940
Facility Number 99 22
0 Not Operational 0 Below Threshold
Permitted 0 Certified E3 Conditionally Certified 13 Registered Date Last Operated or Above Threshold_
Farm Name: >Q......................... County: 'YA..dkU.....................
ou>;las �>tf[��L�LC....................................-•--•--•--•--. WSRO.....
Owner Name: dot~_D�------------____-- I29ligl$5--------------------------- Phone No: 3�ft=9b$�923----------------.-----.-------
Mailing Address: 5.87.8..1'!.'.ailsAgad.................................................................................. HampXQ.n.yiJJr....N.0 ............................................... VAN ..............
Facility Contact: dandy...UvA Ni......................
............. ............................................... Phone No: .................
Onsite Representative: RaDl�YA9.u1±1Ss------------------------------------- Integrator: ----------------------------------------._.
Certified Operator: Ramdy-D.......................... Duglo ... Operator Certification Number: 21.39.6 ............................
Location of Farm:
From WSRO: US Hwy 421 north. Left onto Windsor Road (SR1100) off Hwy 421. Proceed South on SR1100 and then turn
right onto Wells Road (SRI 108) just after crossing the bridge. The farm is approx. 0.7 mile on the left. T
[]Swine ❑ Poultry' IN Cattle []Horse Latitude 36 a 07 15 f. Longitude 80 ' =6 15 «
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated ]low in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...-Wastlw.Psaid,_...__-_----•---------------------------
Freeboard (inches): 33
05103101 0l03o'L % Continued

Facility`Number: 99-22 . Datc of Inspection 1111812003 .
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes ®No
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes Co No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ®No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
IN No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
®No
12. Crop type Small Grain (Wheat, Barley, Fescue (Graze)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No
15. Does the receiving crop need improvement?
❑ Yes
® No
16. Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
®No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
®No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit.by same agency?
❑ Yes
® No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ® No
IM No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
® Field Copy ❑ Final Notes
3. Newly constructed silage gravel pits appear to be keeping leachate from entering the creek. Cattle have now been fenced from the
creek and water boxes installed. Creek and repairs look great!
19. Recordkeeping looks real good. Spring 2003 soil test results look ok. Fields have been limed.
19. Waste analysis; 7/14/03, ALD=3.5 lbs. N/1000 gal.
Reviewerllnspector Name
Rosebrock
Reviewerllnspector Signature:
05103101
Date:
Continued

Facility Number: 99-22 )�ot' Inspeclion 11/18/2003
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Mduitliffi—a lgomment an or raw ngs:
05103101
05103101

0 0 q .',30,q M
IType of Visit Acompliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit C Routine o Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Date of Visit: Time: 0
Facility Number
Not Operational 0 Below Threshold
APermitted O Certified O Conditionally Certified %J Registered Date Last Operated or Above Threshold:
1/1
Farm Name: — btc County: �-f
Owner Name: To DO Phone No: 3 566
Mailing Address: S 02 2t i.�l { N C, a-7 0 aU
Facility Contact: _ U Title: Phone No:
Onsite Representative: Integrator: 1 Q
Certified Operator: �t�15 - Operator Certification Number:
Location of Farm:
0 4d-1 Nrffi , Q on 1N �n sor 1CeI Ls
�[
❑ Swine ❑ Poultry cattle ❑ Horse Latitude ' 0` �� Longitude
Design Current
swine capacity ro ulatton
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean I
Farrow to Finish
Gilts
Boars
Number of Lagoons
Holding Ponds 1 Solid Traps
Design Current Design Current
Poultry Capacity Population Cattle CapacW Population
❑ La er Dairy
❑ Non -Layer I riNon-Dairyl
❑ Other
Total Design Capacity I qz
Total SSLW L
Drains Present ❑ Lagoon Area
No Liuuid Waste Manaeement
Discharges _ Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. Ifdischarge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. if discharge is observed, what is the estimated Flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3, Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
'i"Vaste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
true ure Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
❑ Yes XNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
No
❑ Yes
No
❑ Yes
KN 0
Structure 6
05103101
Continued

Facility Number: 99— Z Z. Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.) r `
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? (If any of questions 4-6 was answered yes, and the situation poses an ❑ Yes No
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes NNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes XNo
9. Do anv stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ,(No
Was e A lication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive P%nding
12. Crop type
13. Do the receiving crops differ with
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
❑ PAN ❑ Hydraulic Overload
16. is there a lack of adequate waste application equipment?
Regyrired Records & Documents
17. Fail to have Certificate of Covera_e & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Ani al Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) `r
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie.% discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review,'inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
2S._ Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes �No
❑ Yes _XNo
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
ANo
%No
No
�No
/
f19.No
M.M.
❑ Yes >(o
❑ Yes 9 —
No
❑ Yes lEi:l o
❑ Yes XNo
❑ Yes )6o
❑ Yes �No
❑ Yes rko
❑ Yes jji�No
❑ Yes ON
I® No violations or deficiencies were noted during this visit. You will receive no further correspondence about tliis visit. I
-•. ��.Nl,^f x hY ..6!-fir "."4:��1�if ':aIDi ¢- � •' e
t'
Comments,(refer to gaestion �:''Eiplsin.aity YES answers. andlvr7any,recootmendatlons orany,-other„rnmmeuts. �� Et��t��•�'•a�H�
3 - Nark r e� -- r• }hyd �3 s � taro w�..:....._...r -:. a.'>„ t
Use drawings of fnciltty to better, esplatn _sitnsttons :(use aarlt anal pages as nec�ess>iry) Field Copy ❑Final Notes
Reviewer/Inspector Name
Reviewer/Inspector Signal
Date:
05103101
Condnued

Facility Number: -- 2 Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ,�No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes RPI0
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) El Yes
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ❑ No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Eg-*Cs—$fiiu
AdditionaLComments and/or Drawings:
-7/1 /0
0
UP 6,1 /00 - dhe-�
41
cora 2on — ?,-quxej cft-v
O5103101

nical Assistance Site Visit
DWon of Soil and Water ConservatioAW
Q Natural Resources Conservation Service
Q Soil and Water Conservation District
O Other...
Facility Number 99 - 22 Date: 115/03 Time: 1 13:15 1 Time On Farm: 60 WSRO
Farm Name Douglas Farms County Yadkin
Phone: [phone]
Mailing Address 5828 Wells Road Hamptonville NC 27020
Onsite
Representative Randy Douglas Integrator
Type Of Visit Purpose Of Visit
® Operation Review
❑ Compliance Inspection (pilot only)
❑ Technical Assistance
❑ Confirmation for Removal
❑ No Animals -Date Last Operated:
❑ Operating below threshold
❑ Swine ❑ Poultry ® Cattle ❑ Norse
Design Current
Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
O Routine
Q Response to DWQ/DENR referral
O Response to DSWC/SWCD referral
O Response to complaint/local referral
O Requested by producer/integrator
O Follow-up
O Emergency
O Other...
Design Current
Capacity Population
❑ Layer
❑ Non -Layer
❑ Dairy goo ss
❑ Non -Dairy
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes ® no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached ❑ yes ® no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees, []yes ® no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes ® no
requiring DWQ notification?
5- Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes ® no
and/or public health?
8• Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes ® no
Structurel Structure 2 Structure 3 Structure 4 Structure 5
Identifier W SP
Level (Inches) 24
CROP TYPES Fescue -graze liCorn,Silage heat 11
SPRAYFIELD
SOIL TYPES
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03
O Routine
Q Response to DWQ/DENR referral
O Response to DSWC/SWCD referral
O Response to complaint/local referral
O Requested by producer/integrator
O Follow-up
O Emergency
O Other...
Design Current
Capacity Population
❑ Layer
❑ Non -Layer
❑ Dairy goo ss
❑ Non -Dairy
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes ® no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached ❑ yes ® no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees, []yes ® no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes ® no
requiring DWQ notification?
5- Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes ® no
and/or public health?
8• Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes ® no
Structurel Structure 2 Structure 3 Structure 4 Structure 5
Identifier W SP
Level (Inches) 24
CROP TYPES Fescue -graze liCorn,Silage heat 11
SPRAYFIELD
SOIL TYPES
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03
❑ Dairy goo ss
❑ Non -Dairy
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes ® no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached ❑ yes ® no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees, []yes ® no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes ® no
requiring DWQ notification?
5- Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes ® no
and/or public health?
8• Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes ® no
Structurel Structure 2 Structure 3 Structure 4 Structure 5
Identifier W SP
Level (Inches) 24
CROP TYPES Fescue -graze liCorn,Silage heat 11
SPRAYFIELD
SOIL TYPES
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

n
Facility Number 99 - 22 Date:
4115/03
PARAMETER
pO No assistance provided/requested
❑ 8. Waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9. Waste spill contained on site
10. Level in structural freeboard
25. Waste Plan Revision or Amendment
❑
El❑
❑ 11. Level in storm storage
26. Waste Plan Conditional Amendment
❑
❑
27. Review or Evaluate Waste Plan wlproducer
❑
❑
[112. Waste structure integrity compromised
28. Forms Need (list in comment section)
❑
❑
❑ 13. Waste structure needs maintenance
29. Missing Components (list in comments)
❑
❑
[114. Over application >= 10% & 10 lbs.
❑
❑
[115. Over application < 10% or < 10 lbs.
30.2H.0200 re -certification
[116. Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
32. Irrigation record keeping assistance
❑
❑
❑ 17. Deficient irrigation records
❑ 18. Late/missing waste analysis
33. Organ! zelcom puterization of records
❑
❑
❑ 19. Latelmissing lagoon level records
34. Sludge Evaluation
❑
❑
❑ 20. Late/missing soils analysis
[121. Crop needs improvement
35. Sludge or Closure Plan
❑
❑
[122. Crop inconsistent with waste plan
36. Sludge removal/closure procedures
❑
❑
37. Waste Structure Evaluation
❑
❑
❑ 23. Irrigation maintenance deficiency
❑ 24. Deficient sprayfield conditions
38. Structure Needs Improvement
❑
❑
39. Operation & Maintenance Improvements
❑
❑
40. Marker check/calibration
❑
❑
Regulatory Referrals
41. Site evaluation
❑
❑
❑ Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
43. Irrigation design/installation
El
❑
❑ Other...
system
Date:
44. Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45.Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
46. Wettable Acre Determination
❑
❑
1
47. Evaluate WAD certificationlrechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
2.
49. Drainage worklevaluation
❑
❑
50. Land shaping, subsolling, aeration, etc.
51. Runoff control, stormwater diversion, etc.
❑
❑
❑
❑
3
52. Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4.
54. Mortality BMPs
❑
❑
55. Waste operator education (NPDES)
❑
5.
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6
58. Crop/forage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

0
Facility Number 99 - 22 Date: 4115103
ICOMMENTS:
Waste analysis: 10-21-03 LSD 1.5 Ibs.N./1000 gals. I
Mr. Douglas was pouring concrete today for drop boxes and guttering to collect silage leachate from the two trench silos.
r. Douglas also intends to install pipe. and a gravel filled pit to filter the leachate. Mr. Douglas is installing these structures in
�sponse to a Notice of Violation and as suggested by the Division of water quality inspector.
Mr. Douglas has just applied waste to the pasture adjacent to the WSP and has sent off a waste sample. Records will be
)mpleted when the sample analysis is obtained.
Talked to Mr. Douglas about some of the proposed requirements of the new State animal waste permit.
TECHNICAL SPECIALIST IRocky Durham
SIGNATURE
Date Entered: /21/03 I Entered By: JRocky Durham
3 03/10/03

Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 99 22 date of Visit: 11l2Q/2002 Time: 1000
0 Nat O erational 0 Below Threshold
■ Permitted N Certified 0 Conditionally Certified 13 Registered Date Last Operated or Above Threshold : ...................
Harm Name: MuglasYarms.............................................................................................. County: YAdWn............................................... !'. BRQ........
Owner Name:J.QC.Q..................................... .. Paug.la...... ::............................................... Phone No: -4t r.4SQ.(&ttQlll............................................
MailingAddress: 5B.A.W..9As.RLo,Ad....................................:,............................I.............. ta>u pts nyllte...NG............................................... 27.020 .............
Facility Contact: liantdy-Douglas .......................... ..Title. Phone No:
Onsite Representative: Rudyj).Qugi,,as................ ...... Integrator: ................................................................
Certified Operator:Rmdy.D� Rmdy.D. .............................. D.QUZW ............................................ Operator Certification Number: 21�9C.............................
Location of Farm:
From WSRO: US Hwy 421 north. Left onto Windsor Road (SR1100) off Hwy 421. Proceed South on SR1100 and then turn
right onto Wells Road (SR1108) just after crossing the bridge. The farm is approx. 0.7 mile on the left. I -IV
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude F 36 • 07 11 15 {{ Longitude
� 2I.,501"Ou
r nf
s ,.D sign Cu�rent, f 1.1-urrenti
acit :1?aulation
Poultry ;Ca acit Po ulation Cattle Ca acit'Poulat on
'
❑ Wean to Feeder
Layer
❑ Y
'"' ®Dairy
92
92
-;,
❑ Feeder to Finish
❑ Non -Layer
[I Non -Dairy
❑ Farrow to Wean
❑ Other
❑Farrow to Feeder
1
❑ Farrow to Finish
` ° y i". C
£ o^
Total Destgn�Capaclty 92
�T
❑ ['lilts
❑ Boars...
i `Tot��LW 12$,800 �.
�W
Number of Lagoons 5 ❑Subsurface Drains-Nresen-t-110Lagoon Area ❑Spray Field Area
Holding Ponds / 5olid Traps 0 ❑ No Liquid Waste Management System
., Aw
DischaMea & 51[camln)pacts
1. is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes [--]No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ❑ No
2. is there evidence of past discharge from any part of the operation? ❑ Yes ® No
' 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ......Waac.Ptand.....................................................................................................................................................................................
Freeboard (inches): 42
05103101 / Continued

Facility Number: 99-22 1 Date of Inspection 11120/20p2
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees�vere erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes ®No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ® Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Small Grain (Wheat, Barley, Fescue (Graze)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19, Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes IN No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
[:]Yes ®No
® Yes ❑ No
[:]Yes ® No
13 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
o menu 1 efe t lion # : Explain an. an we and/or any recommendations or any other COMM
drawings o fa li to better explain situation . u additiona pages as necessary : ❑Field Copy ® Final Notes
8. Evidence of accumulated waste sludge was observed in the creek. Source appears to be heifer lot and leachate. Send NOV.
17. Could not locate copy of the Certificate of Coverage in the records. DWQ to send copy to Randy along with freeboard form.
24. Need to check facility again after repairs described in #8 are initiated.
Records look good.
wer/Inspector Name [Melt aRosebrock
E
wer/Inspector Signature. Date:
O5103101 Continued

Facility Number: 99_22 Dof Inspection 11/20/2442 0
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
it
05103101

4.
In Diivisioa of Water Qaal[ty, , f £, , ,�
��1Div9ioofSailand,iYater,Conservafalosir
tid x
Type of Visit Q� Co pliance Inspection 0 Operation Review 0 Lagoon Evaluation '
Reason for Visit Routine Q Complaint Q Follow up O Emergency Notification Q Other
❑ Denied Access
Facility Number Efate of Visit: 11=6time: U-y�-Z—I
In Not Operational Below Threshold
Permitted ertitied ©Conditionall Certified D Registered Date Last Operated or Above Threshold:
Farm Name: County:
Owner Name: Q Phone No: �4 '
Mailing Address: t+ / J 7 6
Facility Contact:
Onsite Representative:
Certified Operator:
Location of Farm:
❑ Swine ❑ Poultry
;�J'��f. E Kl..,/ ,
Cattle ❑ Horse Latitude
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in galimin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste CWketion &. Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
tructu e 1 S cture 2 Structure 3 Structure 4 Structure S
Identifier:
Freeboard (inches):
❑ Yes )(No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes XNo
Structure 6
05103101 Continued

Facility—
Number: t7� Date of inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 1hlo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? (If any of questions 4-6 was answered yes, and the situation poses an ❑ Yes X<O
immediate public health or environmental threat, notify AWQ)
7. Do any of the structures need maintenance/improvement? ❑ Ye �'NO
8. Does any part of the waste management system other than waste structures require maintenance/improvement? Yes ❑"`No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes o
11. Is there evidence of over application? 0 ,❑ Excessivending [I PAN ❑ Hydraulic Overload El Yes No
12. Crop type
13. Do the receiving crops differ witA those designated in th# Certified Animal Waste NVAagement Plan (CAWMP)? ❑ Yes NNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes No
b) Does the facility need a wettable acre determination? ❑ Yes No
c) This facility is pended for a wettable acre determination? ❑ Yes No
15. Does the receiving crop need improvement? ❑ Yes No
16. Is there a lack of adequate waste application equipment? ❑ Yes No
Rewired Reczds_& Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? Yes ❑ No
18. Does the facility fail to have all components of the ertifed imal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) J J El Yes o
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes o
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes 10
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application) ❑ Yes No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes r F
24. Does facility require a follow-up visit by same agency? Xycs ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes �*
[] No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Coniinents (refer to_;question #) Extaln any YESpanswers and/or any recommendations ar an o erjconiients. „ 3 '
U e iirawin s of€facl) to better ex" lain situations' rise additional a es i s ttecessa < .__,
F� p. ;p g _ ry�If,Field Conv
..
❑Final Notes
E ry33 jj a �
. n&k toe . u at
Reviewer/Inspector Name le
ro'
Reviewer/Inspector Signature Date:
O5103101 r� I Continued
9

Facility Dumber: — ate of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i,e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
MOM
Mawr
iPFJ
O5103101
C77—CS=o
❑ Yes kN1
ElYes
■ A.

Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 99 22 Date or visit: 6/6/2UU2 Time: 9:15
Q Not Operational O Below Threshold
■ Permitted ■ Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
FarmName: DoU91M.Fa3 rMS.............................................................................................. County: YA. .............................................. WSRO........
Owner Name: J.Qc.O....................................... Dowba ...................................................... Phone No: 910::468.7.459..3........
MailingAddress: 50.2A.. AN.R4?, d................................................................................. Ummmicla']tlil SIG.............................................. 2.7.02,0 .............
FacilityContact: ....................................... .......................................Title:................................................................ Phone No:...................................................
Onsite Representative: Randy.D.Quglas.......................................................................... Integrator:.............. ...................... .... .... .........................
Certified Operator: Randy..l.?............................... UQUzWS............................................ Operator Certification Number: 213,96..............
...............
Location of Farm:
turn left onto Windsor Road (SR1100) off Hwy 421. Proceed South on SR1100 and then turn right onto Wells Road +
SR1108) just after crossing the bridge. The farm is approx. 0.7 mile on the left. Shop is 0.1 mile further down Wells Rd.
[]Swine []Poultry ® Cattle []Horse Latitude F 36 • 07 • 15 it Longitude 80 ' S2 6 15it
t Desi n ': iirr%rit .a.:
g `C
aR,. �;
r.�
n Cuire ti
Destg, Current,` 'Desi101
a acit Po ulation Poultry
,
Ca acit P.o ulation CattleCa acit 1Po ulation
❑Wean to Feeder,,,,
❑Layer
®Dairy1 92 84
Q Feeder to Finish
❑ Non -Layer
I I ❑ Non -Dairy
i
F
❑Farrow to Wean
�. ��
Farrow to Feeder
❑ Other
( '
;;
T'atal Design�Capactty' 92
❑ Farrow to Finish
❑ Gilts
i
f;
Total SSLW F 128,800
❑ soars
°ir- Number of Lagoons ' � ❑Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area
��Holdg.onds /.,.Solid Traps 0 ❑ No
Liquid Waste Management System ,,
Discharges 8� Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes IN No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? []Yes ® No
Waste Collection R Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure fi
Identifier: ....................
Freeboard (inches): 32
05103101
Continued

Facility Number: 99-22 Date of Inspection 6/6/2002 _,= V,
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ treesfvare erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes ®No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
jyaste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Fescue (Graze) Corn (Silage & Grain)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge? I
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ® No
❑ Yes ® No
[]Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
❑ Yes ® No
❑ Yes IN No
❑ Yes ® No
❑ Yes ® No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
o menu refs to a lion # : Explain any San a and/o any ecommendations or an other commelts.
drawin o facrli o better explain situation . u e a ditional pa as necessary : ❑Field Copy ❑Final Notes
Facility and records are in compliance.
wer/Inspector Name Rocky Durhamer/Inspector Signature: Date:
E
05103101 Continued

Facility Number: 99-22 D f Inspection 6/6/2002
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
ante analysis: 7-20-01 LSD 0.64 lbs.N/1000 gals. 10.69 lbs.N/1000 gals. B
analysis dated 4-16-02
FA
[-]Yes ❑ No
❑ Yes ® No
❑ Yes ® No
[]Yes ® No
❑ Yes ® No
[:]Yes ® No
[]Yes ❑ No
J
05103101

vision of Water Quality
vision of Soil and Water Conservation 0
O Other Agency
Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 8 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
ih+te. ul' Visil: 111I/2001 Time: ot140 Printed on: 11/1/2001
Facility Number 99 22
0 Not Operational 0 Below Threshold
Permitted ■ Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:....... ..................
Farm Name: D.Qug1as.Far.mb..LL.0 ...................................................................... .. County: yAdk!R .............................................. WSRQ........
OwnerName: RAntdy...................................... JDauglo ...................................................... Phone No: b-4.Gar. Q...........................................................
Mailing Address: 582B..W.911s.t3omd................................................................................. t ampl;oAlX7t le —SIC............................................... 279M .............
FacilityContact: RAndy.1DQIM9110.............................................Title:................................................................ Phone No:...................................................
OnsiteRepresentative: Randy-D!DUg1m.......................................................................... Integrator:......................................................................................
Certified Operator; Rudy„D............................... vanam ............................................ Operator Certification Number: 2,1J.96..............................
Location of Farm:
Turn left onto Windsor Road (SR1100) off Hwy 421. Proceed South on SR1100 and then turn right onto Wells Road +
'SR1108) just after crossing the bridge. The farm is approx. 0.7 mile on the left. Shop is 0.1 mile further down Wells Rd.
❑ Swine ❑ Poultry ® cattle ❑ Horse Latitude 36 ' 07 . 4 1564 Longitude 80 ' $2 15
Design Current
Swine Canacitv POnulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ® Dairy 92 83
❑ Non -Layer 10 Non -Dairy
❑ Other
Total Design Capacity 92
Total SSLW 128,800
Number of Lagoons 0 10 Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps 11 ❑ No Liquid Waste Management System
Discharges R Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes ❑ No
c. if discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
❑ Yes ❑ No
❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste, Collection K Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: '.....Starage.PAnd....................................... ................................ :........................................ ................................... ...................................
Freeboard (inches): 60
05/03/01 1/6 �� a L! �,- / Continued

Facility Number: 99-22 Date of Inspection 11/1/2001 Primed nn; 11/1/2001
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ treesevere erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? Yes ®No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Fescue (Graze) Small Grain (Wheat, Barley,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25, Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Ycs ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ®No
❑ Yes ® No
❑ Yes ® No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer "to uestion#�) ; E£1x(.plDa n` a 1y YES answers and/or any recommeJnldCa�tions orany other comments. ,
LB➢'rBtF�RF'LIF•`s.F ; '' 1v� T M' "t�4+'.§1S . '_ ' A __, 1 �� Fh
drawings I fa Ilit to 6etteer�ex�plamy isituattons.
Use use addtttonfill ages as pecessa}ry Field Copy ®Final Notes
16. Jimmy Haynes does waste application for this facility.
DWQ to send change of ownership farm to operator.
w
Reviewer/Inspector Name Melissa Rosebrock
ReviewerlInspector Signatur Date: i
05103101 i 1 r v Continued

Facility Number: 99-22 D• C Inspection 11/1/2001 Printed on: 11/1/2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 Fours'?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover'?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes [:]No
❑ Yes ®No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
J
O5103101

,qm
ITVpe of Visit to Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit Routine O Complaint O Fonow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: i Time:
Q Not Operational KBelow Threshold
0 Permitted 0Certified 0 Conditionally Certified 0 Registered Date Last Operated or
rr}A1bove Threshold: fie"...
Farm Name: .... � %? .. ............�County:......� ftd`4.0................. .......... .......................
Owner Name: ah Phone No:3 7 G
FacilityContact: ..h%.......... 5.........•}}}.....Title: ........................................................... Phone No:...................................................
Mailing Address:...........��?..$. a......�........ -�:4.........R.J......................... � ..V.�.�.� ..,1..1 ............ 7•d4�.0.............
Onsite Representative: .....1...... .1?...jQ:.......................................... Integrator:............
Certified Operator:........ 44,_t............................................ Operator Certification Number:.... .3lip......
Location of Farm:
❑ Swine ❑ Poultry Ocattle ❑ Horse Latitude Longitude
Design Current Desigm Currenf' Design Current g
Swine Cauacity Population• Poultry, ;Ca aci Po ulation Cattle Cti aci Po' ulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Layer 11 jjg Dairy 1 106 1'•
❑ Non -Layer I 1 10 Non -Dairy
❑ Other
T0tW,D1''sign. Capacity, .
Total,SSiW d 0 C
Number o�
f Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
i6 . ..
Holding Po"/ Solid Traps_. ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ®No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes []-No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes x No
},, lStruuc't_ur I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ..fl ol.,5k! �I A....................................................................................................................................................................................
Freeboard (inches): 0
5/00 Continued on back

Facility Number: — Date of Inspection I I 1
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, YesXNo
seepage, etc.) ❑
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes (�No
(If any of questions 4-6 was answered Yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes X No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes *0
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes No
0
12. Crop type �1.00 MAAjP , .LAVA YJ A A A�w. )
13. Do the receiving cr4s differ with th$se deMignafed in the Certified Mimal Waste Management Plan (CAWMP)? ❑ Yes R No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes No
b) Does the facility need a wettable acre determination? ❑ Yes J No
c) This facility is pended for a wettable acre determination? ❑ Yes No
15. Does the receiving crop need improvement? ❑ Yes No
16. Is there a lack of adequate waste application equipment? ' ❑Yes I
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes No
18. Does the facility fail to have all components of the Certified nimal Waste anagement Plan readily available?
(iel WUP, checklists, design, maps, etc.) 1// ❑ Yes No
19. Does record keeping need improvement? (ie/ irrigation, free oard, waste analysis & soil sample reports) ❑ Yes o
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes VNo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes No
24. Does facility require a follow-up visit by same agency? ❑ Yes No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes No
R Y101400�.o)' dtfeaenO ire A4{.ed• �l0669 t�tis'vJsjt; • X00 lll-tee$iye 0t
i6 res' 6fiden& ahb,6i this :visit.
f- F„', E,'.:'xa. 4 .:.o•: P '3.: ; ,'! kl, 1.,...3?".: S i-'tl.fi.'i"Ei .E ". -....` 3.8,3f E1!'il,. ilEli6E a3, >EE .�"'. �EEEr E3EFE.,:,e. E It .Fi E;;Et'.€P?'ii` -E1p" ..'!E<t 19E.E3 aikf>.'•'. 0, t E. f P- E lv e� IE.:PSt.4El.,ei@'� 3,: 't�� "I d v tt'i F4 ;
Comments (refer to? gnesfion #). i iExp! ain aay AYES' answet�s an±d/ar auy rccammendations nr anyffother rommcttt�. ! if (#;, ,I {
E r.. , , j<i'd'•_€ t,. €• _'.:: ! � �,i,:.. F. .i k:i i'!, :' � �. } E,..,. fq 1fl t F •�-!'€�� Al "31' f 4t € + P E ? 6;a F� EE i k f EI�N
Use'drawui of facility to better;expluin situations. (use additional pages ag neeessary): . 11 n ,
AL
�. jj@ € .: {§ �, a�,lt3N[ EE9i�� Ey
Reviewer/Inspector Name „ ° i !�, ?d.@-ii, lr IkriTl: �i 3fE; ;� :1 •E ?i rij a 3 edFu I !"a
Reviewer/Inspector Signatu Date: a / sao I

Facility Number: -1 — of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below -Yes— 'dv
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes )(No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes XNO
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? El Ve � 1.;�
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) . ❑ Yes P(No
31. Do the animals feed storage bins fail to have appropriate cover? No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? _Q-Y-es--[D o
Additional Cornments—an-2-br Drawings:
i
� I
i
J
5/00

Type of Visit O Compliance Inspection *Operation Review O Lagoon Evaluation
Reason for Vlslt *Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 99 22 Date of visit: 6/11/2l?01 Thne: 9:15 Printed on: 10/25/2001
L_ 0 Not O erational 0 Below Threshold
Permitted ■ Certified 0 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: ...............
Farm Name: DaUgGAS.k:atruas............................................................................................. County: YJAdkli[t.............................................. WSRQ.......
Owner Name: Joel).......
Mailing Address: 5020..WAN.Rmd.
Facility Contact:
t)Auglw ...................................................... Phone No: 9.fQ- .68.59,3..........................................................
Onsite Representative: Rudy.D.Qug as.........
..............I kialon>glow.UkAC.............................................. Z.7NO-
.. Title: ................................................................ Phone No:
......................................... Integrator:............................................................. .........................
Certified Operator: Rudy .................................... UQUgWS.....
Location of Farm:
Operator Certification Number: 2139.6......
turn left onto Windsor Road (SR1100) off Hwy 421. Proceed South on SR1100 and then turn right onto Wells Road
SRI108) just after crossing the bridge. The farm is approx. 0.7 mile on the left. Shop is 0.1 mile further down Wells Rd. w
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 ' 07 15 Longitude 80 • 52 15 44
A S n.. �3 „re—ter,
#� ��yDestgn 3r: Current
i w s rt '.' "''�Z�.t';i� u. -
yP.o
i •� 7 r x b ,* '�saxr,..� 3
Design Currenta Design , Current,
P H n -'r nt°;S', E 61'�'^�'
PQ� Cat_ tl
5,wme .'€... Ca acrt ulation
u1trY Caacit P,o ulat orf _ :` Ga actt Po uliikiony'
❑ Wean to Feeder
❑ Layer ®Dairy 92 76 '
❑ Feeder to Finish
❑ Non -Layer
"'°
❑ Non -Dairy
❑ Farrow to Wean
1
v�
`"'
❑ Farrow to Feeder
❑Other
00
t5
T0ta1 DesigniCapact ty
�,
92
❑ Farrow to Finish
.;Tota1.SSL5W+�,,
128,800 }�
0 Gilts
Boars
gtgx
Numb`erofjLagoons ❑ Subsurface Drains Present ❑ Lagoon Area
❑ Spray Field Area
Holding Ponds lid Traps 1� ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...................................................................................................................................................................................................................
Freeboard (inches): 24
05103101 Continued

W
Facility Number: 99-22 Date of Inspcclion 1 6/11/2001 . Printed on: 10/25/2001
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes ®No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
t2. Crop type Fescue (Graze) Fescue (Hay) Corn (Silage & Grain)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? []Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Document,5
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20, Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency'?
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes -❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ® No
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
❑ Field Copy ® Final Notes
19. Need to record the weekly freeboard levels, per the General Permit requirements.
16. Mr. Douglas contracts someone, Jimmy Hanes, to irrigate his waste. The contract applicator arrived today to apply waste. The
iste pond was at the max. liquid level.
Jere were a couple of application fields that called for a ton or more of lime to be applied and Mr. Douglas stated that they had
iplied lime in the Fall.
verall facility and records look good.
Reviewer/Inspector Name Rocky Durham
Reviewer/Inspector Signature: Date:
05103101 ' Continued

,! 'Facility Number: 99-22 I's )fInspection ti/11/2001 is Printed on: 10/25/2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation'?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, andlor public property)
29, Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
05103101

Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 99 22 Date of visit: 10/3/2000 Time: 090Q Printed on: 10/3/2000
Q Not Operational 0 Below Threshold
E Permitted 0 Certified 13 Conditionally Certified [] Registered Date Last Operated or Above Threshold:.........................
Farm Name: Raines.d~arms.............................................................................................. County: Y;Adlda .............................................. WSRQ ........
OwnerName: JAt<.D....................................... Dauglast...................................................... Phone No: 336:460;459.3 ..........................................................
FacilityContact: HAntdy.Domglits.............................................. Title:................................................................ Phone No:...................................................
MailingAddress: W#MAs.ftad.................................................................................. RamplQuAlkM .............................................. 27QZQ .............
Onsite Representative: Ra jftdy.j)011gjaa.......................................................................... Integrator:......................................................................................
Certified Operator: Rat]tidy..D, . .............................. DRndaN............................................ Operator Certification Number:113.9.6 .............................
Location of Farm:
['urn left onto Windsor Road (SR1100) off Hwy 421. Proceed South on SR1100 and then turn right onto Wells Road A
SRI108) just after crossing the bridge. The farm is approx. 0.7 mile on the left. Shop is 0.1 mile further down Wells Rd.
[]Swine ❑ Poultry ® Cattle ❑ Horse Latitude F 3-6 """'1 • 07 4 1546 Longitude 80 ' S2 [ 15 fL
s P tDeslgn vCurrent �7.�y Deslgn Current ' Deslgtl Current
Ca actt =:P,o ulatton Poultry�� Ca actt . Po ulation::: Cattle w, - ., �Ca sell P,o "ulatton
y ®Dairy 100 68
❑ Non -Dairy
k., l .,
�1.
n Capacity° 100
'p� otaISSLW� 140,000
_a�:,..,.....w.w..., •.�a..wo.wx...rrrwo,,., -..,. -.,. .�YF��'�. �,'' •a. ,._5.} ..�.�. ,�!y.-`�k'�65 '
Number of Lagoons 0 ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
IBM]onds of' a?
Traps �1 ❑ No Liquid Waste Management System
❑ Wean to Feeder
Fes;
❑Layer
Feeder to Finish
❑Non -Layer
❑ Farrow to Wean
�` ❑Other
❑ Farrow to Feeder
-, Farrow to Finish
❑ Gilts
y A
Y �1 �� t;k 1 r I�f ��'• � s �.�; ��,6,
❑ Boars
Discharges & Stream �
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection _& Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: ......Waste..Raad..........................................................................................................
Freeboard (inches): 60
5100
❑ Yes ®No
Structure 5 Structure 6
Continued on back � �,,,h

Facility Number: 99-22 Date of Inspection 10/3/2000 Printed on: 10/3/2000
5. Are there any immediate threats to the 00ty of any of the structures observed? (ie/ tref evere erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ®Yes ❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? []Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Corn (Silage & Grain) Small Grain (Wheat, Barley, Fescue (Graze) Soybeans
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18, Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22, Fail to notify regional DWQ of emergency situations as required by General Permit'?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0; 10 yiolatit�ris;or de#iciencies were noted ....�g this. visit. . .. i.......ve no farther . .
....
about this:visit. :: :.:.:::::: :
3. Need gauged marker since operation is now permitted.
15. Lots of pigweed in fescue pasture. Did not appear to cause an overapplication of PAN.
17. WSRO received copy of permit yesterday. Operator may not have received his copy yet. He will check on this.
19. Need to start keeping freeboard readings now that facility is permitted.
IN Yes ❑ No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Dead cows are now picked up by Leaway Farms. Calves are still buried on site behind old chicken houses at owner's house.
r- - -- - - ... - - -- - - - - --- . - - . - - - - -- -- - --- --- -
Reviewer/inspector Name 'Melissa Rosebrock
Reviewer/Inspector SignatureU /,%!.f! �/Q., A►.r10 I L r Date: 1014100 1 5/O0

Facility Number: 99--22 D )f Inspection 10/3/2000 Printed on: 10/3/2000
or OdIssues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
® No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
® No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
® No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
® No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
❑ No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
5100

ivision of Water Quality
ivision of Soil and Water Conservation
0 Other Agency
(Type of Visit OtCompliance Inspection O Operation Review ()Lagoon Evaluation I
Reason for Visit l Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Hate of Visit: 1y�T ITirne: �Q Printed (on: 7/21/2000
vac
Q Not Operational 0 Below Threshold
Permitted 0 Certified © Conditionally Certified ❑ Registered Date Last Operated or Above. "Threshold
Farm Name: ....QI.q.. I i ........ 70Lr .M. 3.................................................."" County :....Y.Ab.��-1..!.V........................... .......................
Owner Name: Oti .... .gas.. .. .. ........... Phone No:.... .33. '%.!�C!... ..'.....L.s .. 0.......
Facility Contact; ..................... ' !.� 1.4.........................'hitle:.................................. ..................... Phone No: ..............
QQ^ ..n l
Nailing Address: ...5?..Pl............ .. i [S !C� • 1 IC�n...il.l.....!...r...L....... ........C..�i....°�...................
otJ.p....1........�........
...F
Onsite 1Zepresentativc: ......�.......L... I., r �� Integrator:......... ........I................................
Certified Operator: ... RoL .n.J.4..... ................... Operator Certification Number: ....... j�.tz .q..�........
H Location of arm: V
Design Current
Swine Canacitv Panulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ GUIs
❑ Boars
Design Current Design Current
Poultry_ Capacity Population " Ca tle Capacity Population
❑ Layer Dairy 1 100
❑ Non -Layer I I Non -Dairy
❑ Other
Total Design Capacity 100
Total SSLW W 0. Ono
Number of Lagoons I ❑ Subsurface Drains Present 110 Lag -ton Area 10 Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impactti
1. Is any discharge observed from any part of the operation? ❑ Yes �No
Discharge originated At: ❑ Lagoon ❑ Spray Field ❑ Other
a. II'discharge is observed, was the conveyance; man-made'? [I Yes ❑ No
h. If discharge is observed. did it reach Water nl' the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. if dischar«e is observed. what is the estimaled flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes VN o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes YNO
Waste Collection & Treatment
4. Is storage capacity (f'reeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
..Structure I tructure: 2 Structure 3 Structure 4 Structure 5 Structure 6
iclentifeet: ..VLF................................................................................................................
Freehaard (inches):
l9 �l
5100 Continued on back

Facility Number: q 9 —Rol of inspection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge Wor hPlow ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation? dm 1T) aD00.
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes -No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes )J No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or i
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes
No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ❑ No
am 32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? IT 1 a000. ❑ Yes ❑ No
tj
ode 5
�rav6l r1�t U n i r
�1
Sari n�
Pali u�.—C.
Or)4rcid-o r-
�Yls7rda i I 9 M 4• F U r OJ
V
i,eavia46, Fa,.�.. ., ChIA1XV
I
+1
5100

Facility Number: — ,2 Date of Inspection jl U U . Printed on: 7/21/2000
5. Are there any immediate threats to the9grity ol' any of the structures observed'? (iel trees, trees, severe erosion, ❑ Yes XNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? XNo
Yes
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes VNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes X No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. is there evidence of over application?
12. Crop type
13. Do the recet)
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
14. a) Does the facility lack adequate acreage for land application'?
b) Does the facility need a wettable acre determination'?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement'? (ic/ irrigation, freeboard, waste analysis & soil sample reports)
20, Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge'?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
24. Does facility require a follow-up visit by same agency'?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
Rio yiolaftgris:or de#iciencie5 v�ere noted il(rr'ing ;his:visit;-;Y;oo Will-tecgiye iio futthgr ; ;
correspondence* about: this visit:. . . . . . . .
® Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes I.No
❑ Yes %No
El Yes JNo
)q Yes Nc ___�
❑ Yes Wo
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes XNo
❑ Yes No
❑.Yes No
❑ Yes X
o
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
�
L© &PP;,>ceed [ r1 re5CuepZ-�vree no+ cow5e_
Reviewer/Inspector Name Jrje 11 5 06�Dr
Reviewer/Inspector Signature: / LAAA 1,Vz It, v k Date: 1 D 3 b o 5100

Faollity Number
Lagoon Number Lagoon Identifier
Q Active O Inactive
Waste Last'Added ....... ..._....._,.,
Determined by: ❑ owner ❑ Estimated
Surface Area (acres):
Embankment Height (feet):
Distance to Stream:
By measurement or Map?
Down gradient well within 250 feet?
Latitude
Longitude l= EJ 0
By GPS or Map? p GPS ❑ Map
GPS file number:
O <25o feet O 250 feet - 1 ovo feet O >> 000 feet
C Field Measurement ❑ Mnp
O Yes O No I �-& _ 4�
Intervening Stream? O Yes ,No
Distance to WS or HOW (miles): O < 5 O :5 - 1 r1' O > t n
overtopping from Outside Waters? Q Yes X.No () Unknown
Constructed before 1993 NRCS Standards? q Yes O No t N3 -- 11$ �-
No verification of adherence to 1993 NRCS Standards? O Yes No
Was groundwater encountered during construction? O Yes No
Depth to Groundwater:
Discharge within last 5 years? O Yes No
Within 100 year floodpinin? p Yes o
Immediate threat to the integrity of the structure? 0 yes No
Spillway O Yes Q No Adequate Marker O Yes No
Freeboard & Storm Storage Requirement (inches): .:...__......
11. Appearance of Lagoon Liquid
a. Sludge Near Surface
b. Lagoon Liquid Dark, Discolored
c. Lagoon Liquid Clear
12, Embankment Condition
a. Poorly Built, Large Trees, Erosion, Burrows, Slumping, Seepage, Tile Drains, etc.
b. Construction Specification Unknown But Dam Appears in Good Condition
c. Constructed and Maintained to Current NRCS Standards
rn
�a[L,
13. Outside Drainage Area
a. Poorly Maintained Diversions or Large Drainage Area not Addressed in Design
b. Has Drainage Area Which is Addressed in Lagoon Design
c. No Drainage Area or Diversions Well Maintained
14. Liner Status
a. High Potential for Leaking, No Liner, Sandy Soil, Rock outcrops Present, etc.
b. No Liner, Soil Appears to Have Low Permeability
c. Meets NRCS Liner Requirements
15. Application Equipment and/or Sprayfield Not Available
tF r—ti,t rn,,ld nnr tir mnde. tvirh nri-cite rcrresrrtatiVC
. -1/ go
❑ Yes ANo ❑Unknown
❑ Yes No

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
July 11, 2000
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Joe D. Douglas
Douglas Farms
5828 Wells Road
Hamptonville NC 27020
Farm Number: 99 - 22
Dear Joe D. Douglas: lad �li V,
1i
71�)71
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
/'RECEIVE- EH
i�tt �sy
N,C. L.�ei )t,-of Eill�tfi'Ci
J U t 12 2000
Winston-Saieml
Re6ional Officw '
You are hereby notified that Douglas Farms, in accordance with G.S. 143-215,10C, must apply for coverage under
an Animal Waste Operation General Permit. Upon receipt of this letter, your farm has sixty (60) days to submit the attached
application and all supporting documentation. In accordance with Chapter 626 of 1995 Session Laws (Regular Session
1996), Section 19(c)(2), any owner or operator who fails to submit an application by the date specified by the
Department SHALL NOT OPERATE the animal waste system after the specified date. Your application must be
returned within sixty (60) days of receipt of this letter. Failure to submit the application as required may also subject your
facility to a civil penalty and other enforcement actions for each day the facility is operated following the due date of the
application.
The attached application has been partially completed using information listed in your Animal Waste Management
Plan Certification Form. If any of the general or operation information listed is incorrect please make corrections as noted on
the application before returning the application package. The signed original application, one copy of the signed application,
two copies of a general location map, and two copies of the Certified Animal Waste Management Plan must be returned to
complete the application package. The completed package should be sent to the following address:
North Carolina Division of Water Quality
Water Quality Section
Non -Discharge Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
If you have any questions concerning this letter, please call Sue Homewood at [phone] extension 502 or
Melissa Rosebrock with the Winston-Salem Regional Office at [phone].
Sincerely,
for Kerr T. Stevens
cc: Permit File (w/o encl.)
Winston-Salem Regional Office (w/o encl.)
1617 Mail Service Center, Raleigh, NC 27699-1617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Facility Number
Date of Visit: 7/5/2000 Time: 11:50 Printed on: 10/2/2000
99 22
O Not O erational 0 Below Threshold
0 Permitted ® Certified © Conditionally Certified [3 Registered Date Last Operated or Above Threshold: ........
Farm Name: D.Rl7.g1a&.Earms........................................................................................... .. County: YA kill ................................... ............ W.S13.Q........
OwnerName:. meD....................................... D.O.Uglu ...................................................... Phone No: 910..46E-.4.5Q...........................................................
FacilityContact:............................................................................... Title:......................................... .Phone No:
............. .......................................................
Mailing Address: 5132A..W..911S.R tip .....................................................
Onsite Representative: RandY.D.9.14 19a.................................
Certified Operator: Randy.D............................... Amin
Location of Farm:
...... RamplQmxil!`e—AC............................................... 2.7.02,0 ..............
Integrator:......................................................................................
....................... Operator Certification Nuniber:2.13.9.6 .............................
Turn left onto Windsor Road (SRI100) off Hwy 421. Proceed South on SR1100 and then turn right onto Wells Road +
'SR1108) just after crossing the bridge. The farm is approx. 0.7 mile on the left. Shop is 0.1 mile further down Wells Rd. V
❑ Swine ❑ Poultry 0 Cattle ❑ Horse Latitude 36 ' 07 15 Longitude 80 ' S2 15
Design Current
Swine C'anarity Pnniiintinn
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity. _ Population Cattle ",Capacity,, Population
❑ Layer ® Dairy 100 96
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 100
Total SSLW 140,000
Number of Lagoons ❑ Subsurface Drains Present []Lagoon Area ❑Spray Field Area
Holding Ponds l Solid Traps' 1 ❑ Na Liquid Waste Management System . ,
....
Discharges & Stream .Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 0 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (if yes, notify D W Q) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ®No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .........................................................................................................................................................................................
.................... ..........
Freeboard (inches): 28
5100 Continued on back

Facility Number: 99-22 Date of .Inspection 7/5/2000 Printed on: 1 0/2/2000
F.
5. Are there any immediate threats to the in ty of any of the structures observed? (ie/ treetere erosion,
❑ Yes
® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
®No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
®No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
® No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
®No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12. Crop type Fescue (Hay) Small Grain (Wheat, Harley,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15, Does the receiving crop need improvement?
❑ Yes
® No
16. Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Pcmut readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
®No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
®No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
®No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) '
❑ Yes
®No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
®No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
®No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
No.yioiations;ar iieficien'cies•were'nated diiring-this; v:You;viill receive no further
correspondence about this .visit.
Use drawings faciliteto better a u e add td ' pI!g necessary
/or any recominendat' any other comments.' '
g y p( Tonal pages as necessar
[iecords look good.
Waste holding pond is at max. liquid level. Need to irrigate as soon as possible. Facility uses a third parry applicator to irrigate waste
snd the operator stated that he has had some trouble getting the applicator when he needed him.
� 16. Facility has custom applicator apply waste.
WUP will need to be revised for General Permit to include insect control, odor control, and mortality method.
_.
Reviewer/Inspector Name [Rocky Durham
Reviewee/Inspector Signature: Date: 5100

Facility Number: 99-22 D*of Inspection 7/5/2000 Printed on: 10/2/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28.. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ® No
31, Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
itiona !onts an or rawin srI, ,..� „< l ,. 9 3�, ,I r L ... mme_ _.._ _ _ ., .-, <. _ ..',... 'fir I ..� .ICJ ld f+Ir. r
5100

© Division of nd Water Conservation - Operation Rev
0 Division of Wand Water Conservation - Compliance Ins ion
0 Division of Water Quality - Compliance Inspection
0 Other Agency - Operation Review
10 Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
99 22
Date of Inspection
Facility Number G/30199
Time of Inspection 24 hr. (hh:mm)
0 Permitted ® Certified E3 Conditionally Certified 13 Registered 3 Not Operationa-11 Date Last Operated:
Farm Name: QQU9195.ti.m[t'x►s......................................................
Owner Name:bc.1?....................................... V uglo.............
Facility Contact:J.Q9.VQUg1M.................................................... Title:
Mailing Address: 5112,A..W. A5.Kuril......................................................
County: YAdkia.............................................. W,S17A........
Phone No: 910-4.68.:459.3........
... ............................ I................... Phone No:............................. ......................
1bmt 1wx,tlEtw..NC.............................................. 2.7.020 .............
OnsiteRepresentative:.Ion.Douglas................................................................................. Integrator:.............................................................. ........................
Certified Operator: Randy. ,D................................ L?(tul 05............................................ Operator Certification Number: 213,9,fi.............................
Location of Farm:
TIAl;la.lift.ontto.WindsQx.Road..(SR,I1QQI.af.Rwy.42L .... PXac.Best.SQukh.Qzt.SR11UQ.and.thecaa.>uxn.rfight.atala.N'ells.Rn d................
Latitude 36 • U7 6 1564 Longitude 80 ' S2 i 1S64
Design Current
Swine Canacitv Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ®:Dairy 100 100
❑ Non -Layer 10 Non -Dairy
❑ Other
Total Design Capacity 100
Total SSLW 140,0ao
Number of Lagoons IO Subsurface Drains Presentjl❑ Lagoon Area 1❑ Spray Field Area
Holding Ponds 1 Solid Traps I ❑ No Liquid Waste Management System
Discharges & Sirgjim Impagts
1. Is any discharge observed from any part of the operation?
Discharge originated at:. ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? , ❑ Yes CMNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste ll cti & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate'? ❑ Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): .............. '}$................. .......................................................................................................... ......................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes ® No
Continued on back

Facility Number: 99-22 1 0 l) f Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a wa a management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11, Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type Fescue (Graze)
6/3fl199
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement'?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)
20, Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
�10 yR) A ions:or deficie666.were:nbted d jfhig•this v A ..Ydu.Wi.1 receive•nti•fgrther• ;
cnrresnnndenee. ahnnti this .visit.
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
[]Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
3/23/99

Facility Number: 99--22 *)f Inspection 6130/99
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ® No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ❑ No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ❑ No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
onalMommen an or .a Ing
3/23/99
3/23/99

10 Routine 40 Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Facility Number 99 22 Date of Inspection 11/25/98
Time of Inspection 24 hr. (hh:mm}
13 Registered ® Certified © Applied for Permit © Permitted Not O erational Date Last Operated:
FarmName: Dmuglaa.> Artuta.............................................................................................. County: YAdkin .............................................. W..S.>rifl........
Owner Name: dme.1Q....................................... ddQ.Uglas....................................................... Prone No: 2.10.461-.4593..........................................................
FacilityContact: dme.dajApJas..................................................... Title:................................................................ Phone No: aaame ......................................
Mailing Address: 5M.1?I.01%.liaad.................................................................................. HIMP10jaxALCAC ............................................... 27..0.20.............
Onsite Representative:,IucdlmuglAta................................................................................. Integrator:......................................................................................
Certified Operator: R=Wy..id,.............................. Dmutgltta............................................ Operator Certification Number:2.U9.6 .............................
Location of Farm:
C>atta.i>"fk.Rluka.3'�itudanxlimtuti.(il>IOJ..H�xy..4d....IQxm�e��l.nuxb.ata.SR)<dQQ.a�ar�.xlreat.t�uxta.x[gbtx.a�tka.W�Aa.Iiamsl..................... `
S.ki.1.I.Q�J.juxt.after:.er�ssan�.xl�e.l�Xistge,..Tb�J'a>:na.is..apprnx..0�7..�a�ilrr. au.ktt�.Icft,,..S�b�ap.ia. Q.1.aaiAe.fuxitb�ex.�nnt�.V�!ell�..l�tl�.............. .
Latitude 36 ' 07 —15­146 Longitude 80 •F 52 15
General
1. Are there any buffers that need maintenance/improvement? © Yes ® No
2. Is any discharge observed from any part of the operation? ❑ Yes H No
Discharge originated at: [] Lagoon M Spray Field ❑ (7tlrer
a. If discharge is observed, was the conveyance man-made'? ❑ Yes No
b. If discharge is observed, did it reach Surface Water'? (If yes, notify DWQ) [:]Yes [] No
c. If discharge is observed, what is the estimated flow in gal/nun`?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) © Yes © No
3. Is there evidence of past discharge from any part of the operation'? []Yes CR No
4. Were there any adverse impacts to the waters of the State other than from a discharge'? [] Yes 9 No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes 0 No
maintenmrce/irnprovement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design'? ❑ Yes ® No
7. Did the facility fail to have a certified operator in responsible charge'? [] Yes ]A No
7/25/97

Facility Number: 99-22 Date espection 11/25/98 •
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes ® No
Structures (La2oons.Holdinz Ponds,Flush Pits, etc.)
9. Is storage capacity (freeboard plus stonn storage) less than adequate? ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(ft): ...................................................................................................................................................................................................................
10. Is seepage observed from any of the structures? ❑ Yes ® No
11. Is erosion, or any other threats to the integrity of any of the structures observed'? ❑ Yes 0 No
12. Do any of the structures need maintena:ice/improvement? ❑ Yes X No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers? ❑ Yes ® No
Waste Application
14. Is there physical evidence of over application'? ❑ Yes ® No
(If in excess of 'AMP, or runoff entering waters of the State, notify DWQ)
15. Crop type .......................E%znu........................................................................................................................................................................................................
l6. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes ❑ No
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement'?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency'?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of die Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
M •No.Wolatibtls' a�r'd'eP�ieneieS i�v�r'e' ote'd'dura>ng� rt4is•visit.' You M11'rucive wo forther'
:Cbiris�6> deiic�ahok!his;v sat: '
❑ Yes ®No
❑ Yes ® No
❑ Yes CM No
❑ Yes ® No
❑ Yes ® No
❑ Yes 0 No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes IM No
M7.... i'9 ii{N 1N'-
r :k t r
lV1it 'ttiscillt.:}W::E>!0F>t� �iAEtlt�lfttattrs 'a:att�dltto =1xlE=iid ,#:eq z;.:.
..t..t:.........:.,..........................._.................,............,..,..,.,,..,.,...,..,,.,,......,
Certified operator unavailabl.,..,
- e during inspection, but sampling and record keeping requirements apparently being met based on
AL
conversation with owner.
- Storaage pond to be pumped by contractor in near future.
Reviewer/Inspector Name
T
Reviewer/Inspector Signature: Date:

Division of Soil'Wd Water Conservation 0 Other AVRey r
vision of Water Quality yY.
10 Routine 411 Complaint O Follow-up of DWO inspection O Follow-up of DSWC review O Other 1
Date of Inspection
Facility Number
Time of Inspection fff= 24 hr. (hh:mm)
0 Registered Mfertified Applied f�ermit © Permitted 113Not0perational Date L38 Operated :..............
Farm Name:....J""" .. .tom....... ............................................. County:... ,15,.1..a ...................
Owner Names .......E,,.......................... ....... aPhone No. .. i).:./..i?5..... ..,��..���
Facility Contact: ! ., ,
..........��s�........................�--.................... `I"itle:........................................................... Phone No: �....................
Mailing Address:... ........!(l /....................r......................... .. 1�% �%..11e.....��..... 1G1 �
Onsite Representative:... Q............ .................................................................. .. Integrator:...................................................................................... Certified Operator, ...-� .... ........................ ......� ............. Operator Certification Number:...................
......
Location of Farm:
'. Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Subsurface Drains Present II❑ Lagoon Area I❑ Spray Field Area
No Liouid Waste
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes ANo
2. Is any discharge observed from any part of the operation? ❑ Yes PIo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. if discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes ❑ No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes IgNo
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes VNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ;J'No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ;OINo
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes 1VNo
7/25/97

Facility Number: —
8.JAre there lagoons or storage ponds on site which need to be properly closed? ❑ Yes �RNo
Ntructures (Lagoons:Holding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes /W No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(ft):......................................................................................................................................................................................................................
10. Is seepage observed from any of the structures? ❑ Yes WNO
11. is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes )ZNO
12. Do any of the structures need maintenance/improvement? ❑ Yes )VNo
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers? ❑ Yes CRONo
Waste Application /
14. Is there physical evidence of over application? ❑ Yes ANo
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
r
15. Crap type r......Ic..«.,111;7.................................. :................. ......................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes ❑ No '
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes No
18. Does the receiving crop need improvement? ❑ Yes No
19. Is there a lack of available waste application equipment? ❑ Yes I'No
20. Does facility require a follow-up visit by same agency? ❑ Yes )'No
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative? ❑ Yes 9No
22. Does record keeping need improvement? ❑ Yes ❑ No
For Certified or_Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes . ❑ No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes )ja No
25. We y additional problems noted which cause noncompliance of the Permit? ❑ Yes JRNo
o.violationsor defcient:ies.were,noted.iiuring this .'visit:�.You*ill receive-n6lurth:er,:
eoeres040dehO dhout -this: visit: ...:. : .
ellwelal
0Ole
7/25197
I Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:

I* Koutine 0 uumptaint 0 ronow-up or uwy Inspecrton 0 ronow-up or uNwt- review 0 Vtner
Date of Inspection 10-24-97
Facility Number
Time of Inspection ® 24 hr. (hh:mm)
p Registered M Certified p Applied for Permit p Permitted in Not 0perattona Date Last Operated:
Farm Name: Miaglas,.Farms............................................................ .................................. County: Yadkin WSRO
Owner Name: Jon—l..................................... Dau.glas......................... ............................. Phone No:49.t0.).46R4593 ........................................................
Facility Contact: ...............................................................................Title:............... ... Phone No:
Mailing Address: 5$28..Wel1s.EWad.................................................................................. Hamptanville...NC............................................... MIR ..............
OnsiteRepresentative: JoeM.uglas................................................................................. Integrator:.......................................................................................
Certified Operator:Ramdy..................................... no.ughost........................................... Operator Certification Number: .........................................
Location of Farm:
.Latitude ®� ®° ©°� Longitude
d itgn,
urren F es>gn urren € .
esign ,3. ' urren
Swine
Canaeity ,Population Poultry : Cap9ae ty Popis3latton Cattle
Capacity Population , .v
i,: ® airy
€t" }
on -Dairy
=❑ y
'.;
`n Capacity"TOO
otai SSLW
140,000
3,sAP-. ..... .......
.....................
BS i" -. Y 3 G &' E 8 i �! a p
Num bjer, of4�I:a go ors l�HoldtngEPonds'� ❑Subsurface
rains Present❑ Lagoon Area
ii
❑ pray ie rep
}1.I 3fl
�iif ...........
(7
Q 1 i
........ ..... ......... .........
as e ana emen 5 em
Y i3
_Fi:�
❑ `lu
�
�
can to ee er
❑ Layer
e er to m�s
F3arrow
p Non -Layer
to can
'
❑ arrow to Feeder
❑ Farrow to Finish
F
❑ ter
d 1 i
Total Desig
' T
€
2 i
p Gilts
❑ Boars
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes g No
2. Is any discharge observed from any part of the operation? p Yes g No
Discharge originated at: ❑ Lagoon p Spray Field ❑ Other
a, If discharge is observed, was the conveyance man -trade? ❑ Yes ❑ No
b. If discharge is observed, did it reach Surface Water`' (Il'yes, notify DWQ) ❑ Yes ❑ No
e. lfdischarge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes g No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes ®No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ®No
maintenance/improvement?
6. Is facility not•in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes g No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes g No
7/25/97

Facility Number: 99_22
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons,14olding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Freeboard (ft): .............AIL................................................
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
p Yes ® No
p Yes N No
Structure 5 Structure 6
15. Crop type ....................... F..assw=...................... ....... CO.M.(S1lage.&.Graixt).................................................
................. ....................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did ReviewerlInspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
.. o:via tions.or crencies•were.n� a •uring is visit.. You- will.receive no' ur er . • .
..:.:..
... s..... abut :ttiiS•yiS�jt:....:....... ........
..
...............................
Yes
® No
p Yes
® No
p Yes
®No
p Yes
p No
p Yes
.......................................
®No
p Yes p No
p Yes ® No
p Yes ® No
p Yes ®No
I7 Yes ®No
p Yes ®No
p Yes p No
p Yes p No
[]Yes p No
p Yes p No
otiitiiehdatioits o any otl-e`e, commie&nto
•osriitients (re errfb qu'estitin #): Ezpla�n any YIES iinswers still/or°any�es
Use drawings of facility to better explain situatiaus. (use additional pas necessary):
Facility appears to be well managed. No water quality problems observed. Apparently the farm is now certified (+Joe Douglas
C
was not familiar with the plan. Randy (son} deals with the certification aspects, but he was not present). Assume maximum level
marker speciFed by plan.
7125/97
ReviewerlInspector Name Mike Mickey
Reviewer/Inspector Signature: Date:

State of North Carol Pla
Department of Environment,
a Health and Natural Resources • 0
Mooresville Regional Office
James B. Hunt, Jr., Governor p � � � R
Jonathan B. Howes, Secretary
DIVISION OF SOIL AND WATER CONSERVATION
May 27, 1997 N.C. Dept. of EHNR
MAY 2 9 1997
Mr. Joe Douglas
5828 Wells Road Winston-Salem
Hamptonville, North Carolina 27020 Regional Office
SUBJECT: Operation Review Corrective Action Recommendation
Douglas Farms
Facility No. 99-22
Yadkin County
Dear Mr. Douglas:
On May 13, an Operation Review was conducted of Douglas Farms, facility no. 99-22. This Review,
undertaken in accordance with G.S. 143-215.10D, is one of two visits scheduled for all registered livestock
operations during the 1997 calendar year. The Division of Water Quality will conduct a second site inspection.
During the Review, it was determined that waste was not being discharged to the waters of the State,
and the animal waste collection, treatment, storage and disposal systems were properly maintained and
operated under the responsible charge of a designated operator. However, the following management
deficiency was discovered and noted for corrective action: failure to install start pumping markers within the
pond. This management deficiency needs to be addressed and corrected. You are encouraged to contact your
certified technical specialist if additional assistance is needed. During ensuing reviews, this same deficiency will
be re-examined to determine if corrective actions were implemented.
In order for your facility to remain in compliance with environmental regulations, animal waste cgor of be
discharged into the waters of the State, and the animal waste collection, treatment, storage and disposal
systems must be properly maintained and operated under the responsible charge of a certified operator.
Please remember that you are required to obtain and implement an approved animal waste
management plan by the end of this year and have a certified operator. The plan must be certified by either a
designated technical specialist or a professional engineer. For additional assistance with the plan or the
certification course, please contact your local Soil and Water Conservation District Office or local Cooperative
Extension Service Office.
919 North Main Street, ,Ny
Mooresville, North Carolina 28115 �� FAX [phone]
CAn Equal Opportunity/Affirmative Action Employer
Voice 704-663-1699 5C% recycled/ 10°,G post -consumer paper

0
Mr. Joe Douglas
May 27, 1997
Page Two
The Division of Soil and Water Conservation appreciates your cooperation with this Operation Review.
Please do not hesitate to call me at 704/663-1699 ext. 277 if you have any questions, concerns or need
additional information.
Sincerely,
Je'seph C. Zimmean
nvironmental rmEngineer I
cc: Yadkin Soil and Water Conservation District
P3as-Rn"er DW— t peci�YadKK
DSWC Regional Files

Routine O Complaint O Follow-up of DWQ ins ectii
Facility Number 99 22
Farm Status: Regislercid.........................................................
Farm Name:URulghs.FArms............................................................
Owner name:Jot ........................................... D.Quras...................
llow-up of DSWC review O Other
Date of Inspection 5113197
Time of Inspection 12:53= 24 hr. (hh:mm)
Total Time (in fraction of hours
(ex:1.25 for 1 hr 15 min)) Spent on Review 2,25
or Inspection (includes travel and prdcessing)
County: Yadkip............................................... W.SHQ........
Phone No: 4611-.4593.........................................................
:Nailing Address: 58.Z8.W.eMRQ d.................................................................................. HmptmltvUlie...N.C............................................... Z20.20..............
OnsiteRepresentative: Randy..Dmugla,5.......................................................................... Integrator: .................................................................... I...................
Certified Operator: ................................................... ............................................................. Operator Certification Number:
Location of Farm:
, �1Q8..-. i,aa,.affXa�ds�.Hd�;i�d�;Ga�at�a�urni?�?:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: . .
Latitude 36 • 07 15 Longitude 80 • 52 6 15 1,
113 Not Operational Date Last Operated:...............................................................................
Type of Operation and Design Capacity
Swine
Number
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
Lj Farrow to Feeder
Farrow to FFESE
Poultry Number Cattle Number
❑ Layer I JIM Dairy 100
❑ Non -Layer 1 1 10 Non -Dairy
❑ Other
Number of Lagoons 1 Holding Ponds 1 " ❑ Subsurface Drains Present
❑ Lagoon Area ❑ Spray Field Area
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes ®No
2. Is any discharge observed from any part of the operation? ❑ Yes OR No
a. If discharge is observed, was the conveyance man-made? ❑ Yes ®No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes ® No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes ®No
3. is there evidence of past discharge from any part of the operation? ❑ Yes ®No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes ® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ® No
maintenance/improvement?
Continued on back

6. Is facility not in compliance with any applic ble setback criteria?
7. Did the facility fail to have a certified o. bin responsible charge (if inspection after 1/116
❑ Yes ® No
❑ Yes ®No
8. Are there lagoons or storage ponds on site which need to be properly closed?
1 Structures fl,asoons and/or Holding Ponds)
9. Is structural freeboard less than adequate?
Freeboard (ft): ' Lagoon] Lagoon 2
...................1.........................................................
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
Lagoon
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adquate markers to identify start and stop pumping levels?
Waste Application
14, Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ............................. ymtuc ............................. ............... ...............
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the cover crop need improvement?
19. Is there a lack of available irrigation equipment?
For Certified Facilities Unly
20, Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal Waste Management Plan in any way?
22. Does record keeping need improvement?
23. Does facility require a follow-up visit by same agency?
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
❑ Yes ® No
❑ Yes ® No
Lagoon 4
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
Comments (refer to question #): Explain any YES answers and/or any recommendations:or any other comments. 99-22
Use drawings of facility to better explain situations; ,(use additional. pages as. necessary):
Question 13: Pond needs level marker to indicate start pumping ( maximum) level.
Question 19: Facility contracts out waste hauling
Facility milks between 70 & 80 cows and is in the porcess of being certified. There is some minor rodent damage along one side of
the pond but it is not significant. Opreation plans to continue with certification process.
Reviewer/Inspector Name '3osex
Reviewer/Inspector Signature:
Zmniermw i..
Date: S / .'/e"
cc: Division of Water Quality, Water Qud#ty .Section, Facility Assessment Unit ' 11/14/96

r OPERATIONS BRANCH -- WQ Fax: J ul 20 '95 11.05 P.16/18
r
SAa rtqulres immeo':Ig;dlpnfm
• F3c!Zy numEsr ��
SiT5IMITATION RECORD
Data: c, 199a
Ccu tj: 1
Agam'AsIng Site: 5,� $ C Icy, —� �.� _ r ct p: _AL--.9 s
Phcne: _
Physical �•odres3' - - ,_____• ,-
{Mailing—.-
7we of C'cGsuvi,. Swine Poultry ,--6A!ge
past; Cqw! : _ 4 _ NUMOV of Nows on Si`.a:
Circe Yes or No
a yIt I-ac 1 In�.� l ii . �J 5 Y t, Sve
.i,� i�3 �yGG;i {�a;E Slii11..,.G��; EeC'�3f.�� p' � 2. 'fAc �- ",,Ui :[C�Ti IlI
ate
inches
12C:€IN 'n h mare than cre 1 ocn, Chase Ames the k er € igms MWEd'undar be
,,_ me, tS SecucM.
MS sny Se_Page Mamed `rom 1a iagt.0 (SP Yes 4r � 7
Wes trip amsicn cf the dais? Ys3
€3 ww!'a` t Q i�'alt�bi r�; lai. i 3 r:�iCa Jfl' �ES� Cr iNc
;? :i'E C�;eC _•'Q: a�flyU31@ias yr `4r0
5#Mvs !'Agent
F,2x..^ 13) 713-3$-'