790003_INSPECTIONS_20171231

Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: it Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access n
Date of Visit: I1 ( Arrival Time: lL' Departure Time: I q County:vp %111V111 Region:WSl_ll
Farm Name: Ph I I f-DI') --n f m Owner Email:
Owner Name:.Q,YrI� �1,n�1'� Phone:
Mailing Address: 5� �� I L '\I I rb 0 6 i g��� 6 + �J n 12L 1
Physical Address: a25 1^ zn V_ L^ �Vi k e, � G ^�?) C) o
FacilityContact: n I,, UI I U KTit �1
(znhl✓► Title: Phone:
Onsite Representative: U Integrator: ru Y, 5
,rr" I1K YlP2 QC
Certified Operator: Certification Number:
Back-up Operator: �n e 1 tdIy Certification Number:
Location of Farm: Latitude: Longitude:
ILA C usaq -�> bus "q
Cali D ntZd.
r-A az 1EIrn 0,1rove, Ch.
M2izah Ch. •
Swine
Wean to Finish
Design
Capacity
Csurrcnt
Pop.
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Cattle
Dairy Cow
Design
C**opacity
Current
Pup.
Wean to Feeder
I
INon-Layer
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
I)r, P,oultr,
La ers
Design
Ca acit
Current
P,o
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
PulletsI
113eefl3rood Cow
Other
Other
Turke s
Turke PuuIts
Other
Discharges and Stream Impacts
I. 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 DWR)
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 DWR)
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
I No
�❑
❑ 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 21412015 Continued

Facili Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes )PQ 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: PpV_ IANEL
Spillway?: �P l�¢�
Designed Freeboard (in):
Observed Freeboard (in): y_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
5Q 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
54 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 DWR
7. Do any of the structures need maintenance or improvement?
(4 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): So � n t y� h e+
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
t�
X� No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[AN o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
Yes
Wil No
NA
NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the 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 ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes R YNo
Waste Application DQ Weekly Freeboard Waste Analysis Soil Analysis ❑-WRAO FRnsfefs`�
Rainfall XStocking tACrop Yield [A 120 Minute Inspections Monthly and I" Rainfall Inspection
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 2kNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
Page 2 of 3
❑NA ❑NE
Weather Code
❑�y�o1q
❑ NA ❑ NE
(DNA ❑NE
21412015 Continued

Facility Number:'jDate of Inspection:
24. Did the facility fail to calibrate waste appon equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No
the appropriate box(es) below. VW
❑ 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:
❑ NA ❑ NE
❑ NA ❑ NE
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes MNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No X NA ❑ NE
Other Issues jy'�
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes Y4 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
No
❑ 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
❑ Yes
No
tA
❑ 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
MAILANo❑
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
EA No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawines of facility to better explain situations (use additional paues as necessarv).
-
C4�AClL CU\Idi4�cr of wvtbGnlcwlevVlS— C6YIhPuQI ek�oY+S m inner @.tnbGrlKwkA4
Plecist, re rYiove,, lar(y -I-eeeS ov, inside
C4t�eK Y>1GrY�+'- incliCCt+Drspre Se wl ' JvuvKx looks Or--vfsp'r .
t�we�• �s du +�ar�l
c0Gig- imGJGO-1M rAesi nl Wt
e_ 1ple, UC�cbp�• \rit-l�rtb le oCXe0.9( S�rec�6�^QF�I dp�� 1o4K-S
)d\1GSUrt, i'10UAXA - O•q�" in ;10I b . _ U•a1 "on 5eOC�, APpbC0chzv' reprz �
M vv" wAs4-C, Vlaa WSQ0 recte"ea C_PL�
Soil dull in 20Iq. Lasl-C)W%e� 1\1Iq/I6
,. ��V Cta I i bra-16Y)' C6 n plmkd Ian} tJ, oa
1*y AWI,-(l`xf'6y\ Should use I•�I rJ anal�ls.
Cnrna I t' Mi n eve +S M issi n� i n i+tuls _
Reviewer/Inspector
Reviewer/Inspector
r
-7/IVlb- Due atIa-n (9-015
No eoricern over o �uea-4^ avu
- q-1 05-
Date:
21412015
Page 3 of 3

Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: X Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Timer County: C-,0mWGj M Region: ktjSP_C)
Farm Name: i-11L1_--0? �_W Owner Email:
Owner Name: _ gm A"U Phone: )p-M rsD-1 8915
Mailing Address: t SIto3 H0 160E, BkOWkr 3vrwliTS NC %a1if
Physical Address: 0- 5 eca-rou RIP-, R0DSVI LL6 . NC Pa 30
Facility Contact: Rw3IN co?( Title: Phone: p ryHi� l �iup U S58
Onsite Representative:
Certified Operator: -) QRI o P "
Back-up Operator:
Location of Farm:
Latitude:
Integrator: P Ligm $
Certification Number:
Certification Number:
Longitude:
Swine
Wean to Finish
Design
Capacity
a-600
Curren[
Pop.
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pup.
Dai Cow
Wean to Feeder
Non -Layer
�
Dai Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
F1 1A0
o4
Dr, P.oultr.
Layers
Design
Ca aclt
li
Current
P.op
Dai Heifer
D Cow
ai
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
jBeef Brood Cow#_
Other
Other
Turkeys
Turkey Pouets
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 DW R)
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 DW R)
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 ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Y gNo ❑ NA ❑ NE
Page 1 of 21412015 Continued

Facility Number: 74K - C • Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Ej No
❑ 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: kip PGlZ L-0"a
Spillway?: YES
Designed Freeboard (in): `-F4•J
Observed Freeboard (in): 4t_
5. Are there any immediate threats to the integrity of any of the structures observed?
[—]Yes
[K 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
[vrNo
❑ 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 DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
[A 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 2fNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes E6 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): t U{ IRCAt,)5 , IAJKt.R
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 6 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [6 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [6No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
t No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
t No
❑ NA
❑ NE
Required
19.
Records & Documents
Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[6 No
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
CErNo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑Other:
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
❑ NE
El
Waste�n -E3-WFe TyT ei'LeUo—R t ❑ wastcT rft ws E;S '�Sris Q WAsts Trens€ers
_u"Is ^ -r �a AE3 444 &u tc �c
all Ins ections
ri
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
6 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
KNA
❑ NE
Page 2 of 3 21412015 Continued

[Facility Number: CO f5ate of Inspection,
24. Did the facility fail to calibrate waste appliL�ation equipment as required by the permit? ❑ Yes [—]No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Pj 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 provide documentation of an actively certified operator in charge? ❑ Yes 19 No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
•
NA ❑ NE
NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
�,�{
l.� 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
Cd No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
[KNo
❑ NA
'Ni30.
❑ 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:
0
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?
❑ NA
❑ NE
34. Does the facility reouire a follow-on visit by the same aaencv? IM
_]Yes
Yes
1No
No
I—1 NA
I —I 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). his g
—C"6-M c>Pt;RA-Tok (DRTt1-taPOIA 6AAD No7 Lv5l-&O oQ PA01 (ZeC&NY f�)iQ- S Pft+6
— kPIA"60T V i C-61 rpmo u Mk%U5KE0 o'u 6^N%wK M6W\ s ? \i&S L°G15 6-wP ,,� FATE!= Ct 3s1
sort t�t�ysts wcwow� t kCu ES w 3 A�nLtcnat �u \d0 pit
�0,6 C °h` ao Psl @
'�O\6 (J��I(3MttotS �f.�s� t+rtV6 w6TC�D D%tu�(JVXonLb 8E W)MCzz_LC = 0,91'1 (2C1sL
2 c7 �6 St vo 6b SW-W( Mcn Puc- u ml. 3-bkq ste,�, 3 \(c\Nz C'auw (=ttA. TEO
"s PSRmtTEE ! tS ApPU4 � f�-ftMorj co W.U_P.2 up DR--T6-P LRWM(� IS ('sNQJW�
Arco"Rp-Ttau (=os- FE&D6P- PW15H oP4ftfr`(7aN
WtoI& lWRt,`ISIS 2o�Sllc� Vts
(ppuctFnolJS ; n�ARCh �°tb, 3u44E 304, "Z41 2-•te
L_6"R ALS
LotrsGK AtS-1
wWA NLS;
Reviewer/Inspector Name:
►.)= b.11t lbll000 6RL
N= �.F14 \bll000 Gfrl
1J = )66 \hlto�o G�
Reviewer/Inspector Signattu
Page 3 of 3
W\64_1
Cout_D use LE��
1.� l cf�RS
OO
Ate: o;
Phone:[phone]aa3
Date: W
21412015

III
Operation Review O Structure Evaluation O Technical Assistance
for Visit: (h Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied
Date of Visit: ' 'II Z 3 b Arrival Time: Departure Time:/ 'Q County: (2at�blph Region: IusP_O
Farm Name: t'(' I TOP arm Owner Email:
Owner Name: fPX-r- �P P I e' /� Phone: Sea- r' �CE I I) 38 a-' /- S-5 41.
Mailing Address: tia_3 14wy� �>roton 5ummi � 1 NC- a7 +ZI7
Physical Address: R a.S
C
Ph
-li S
Facility Contact: 4 f i n1VI�uiCO )C Title:
Onsite Representative:
Certified Operator: TP_U'ry A P P Ie_-
Back-up Operator:
Location of Farm:
viIle- I NC, R7a30
1'eoioin-i5-d1- 1758
Phone: Phi li 0 II.SI - 9317
Integrator: L, r V
Certification Number:
Certification Number:
Latitude: 3(o ° 161 3-2 t Longitude:
79° 37' oar/
2- 0F/ u5a9 1 t3as a
n(, 121 61m Grove- Ch. (� •� izpcLh
Cho
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Wet Poultry
Layer
Non -Layer
�%
Dr. P.oult .
Design
Capacity
Design
Ca aci
Current
Pop.
Current
P,o .
Cattle
Dai Cow
Dai Calf
Dai Heifer
D Cow
Non-Dai
Design
Capacity
Current
Pap.
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La ers
Pullets
Beef Feeder
lBeefBroodCow
Boars
Qther
Other
Turkeys
Turke Poults
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 DWR)
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 DWR)
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
❑ Yes
,IVNo
❑ Yes
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
Page I of 3 21412014 Continued

Facility Number: -7 4o - 3 / • jDate of Inspection: /;12ni
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �gNo
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4
Identifier: U .tom OL_0e _
Spillway?: V95
Designed Freeboard (in): T
Observed Freeboard (in):
fit:► . FT; IV
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 which are not properly addressed and/or managed through a
waste management or closure plan?
❑NA ❑NE
❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes T1 No ❑ NA ❑ NE
❑ Yes I XI No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
(t,
threat, notify DWR
7. Do any of the structures need maintenance or improvement? A Yes *No U 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) 77-``
9. Does any part of the waste management system other than the waste structures require ❑ Yes �f No ❑ NA ❑ NE
maintenance or improvement? T'
Waste Application �(
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes pal No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes O�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):
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? o- re'e-V S
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 JM No ❑ NA ❑ NE
❑ Yes 9No ❑ NA ❑ NE
❑ Yes 9�No ❑ NA ❑ NE
❑ Yes oNo
❑ Yes A No
❑ Yes ]ZfNo
❑ Yes 5eNo
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other: nn��-,,,,,CCCC
21 Does record keeping need ' provement? If yes, check a appropriate box below. ❑ Yes R M No KSludgee
❑ NE
aste Applic ion �eekly Freeboar Waste Analysis E3/Soil Analysis �er Code
Rainfall Stocking Crop Yield 120 Minute Inspections [ Ivtonthly and I" Rainfall Inspections urvey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes /5No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [:]No 0 NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: -1 - 0710 1 Date of Inspection: J' S
24. Did the facility fail to calibrate waste application equipment as required.by the permit?
❑ Yes No
❑ 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 PDA for sludge
levels
❑ Non -compliant sludge levels in any lagoon
h0 U
List structure(s) and date of first survey indicating non-compliance:
SU I t/ .2613 u
P P e-
26. Did the facility fail to provide documentation of an actively certified operator in charge?
—/-
❑ Yes �,{ No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes )j7`j'�[+j 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?
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:
[:]Yes P(No
❑ Yes '7I X`No
❑ Yes ONo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? YeeJ 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 CKNo ❑ NA ❑ NE
Comments (refer to question 0): 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).
'7 En.bavk K t+nPv�k Se"edi 0V)
a so�I es+s due- dol(o/ incl. C,op(�r d-zitic, , ©�da�m b�kuee� tJPperw Low
PC5M a.o liked }av-upPp�- lo�goon; I4V_k, t
weJ Ikea d l a mekle r d �1te v m i hJJe�i �° r " Ali brc> F%o r� ? NaF {a ! �PQ� ;701
. aoly�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: 171p —Q(09 I
Date: ) a131 ROTS
Page 3 of 3 21412014

for Visit: W Routine () Complaint O Follow-up O Referral p Emergency p Other p Denied Access
Date of Visit: 9 4rrival Time: Departure Time: Caunty: jew ttq 2 gion: j,J$ �
Farm Name:�ll T0,Q FoxrY) -- t��
Owner Name: SAYV-U I
Mailing Address:
Physical Address:
Owner Email:
Phone:3/8a-8915
dMlt �l)�.�70;21
Pni4nvi P_n , _ P.eids it; tle- .ABC a7 a30
Ph
I�,j�J KU0" '
Facility Contact: I /gyp .b i rL to }G Title:
Onsite Representative: P,Dnn I 0 U
Certified Operator: SPA r U f+P P 1 �
Back-up Operator:
Location of Farm:
Latitude:
Po b )n 5 o - c
Phone: ph-, I i 0
%S 1 —9 317
Integrator: �U r U i5
Certification Number:
Certification Number:
Longitude:
=-q0 E, US ,29N I GUS 39 t i? Elm !'rove, Gh • 1?14.1
C h . Ado I"_o on
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
La er
Design
Capacity
Current
Pop.
Cattle
Dai Caw
Design Current
Capacity Pop.
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
Dai Heifer
Farrow [o Wean
Farrow to Feeder
Farrow to Finish
Q
Design
Current
D Cow
Non -Dairy
1 Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
I Beef Brood Cow
Other
Other
Turke s
Turke Points
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 D WQ)
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 IN No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ONE
Page 1 of 21412011 Continued

Facili Number: Date of Inspection a O I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes WNo ❑ 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: QI{Lt0✓1 l�1) — �--
I S Spillway?:
Desij(h&d Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
D�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
[V 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 DWR
7. Do any of the structures need maintenance or improvement?
QQ Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
g] 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
W'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, et .)
❑ 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): �JO�L/� XAA1 4 /Q� A 00 0, ip11 n / l y...�_,A /
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 OrNo
❑ Yes Zo
❑ Yes N-110
❑ Yes 'M'No
❑ Yes X No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
Nr�o
❑ NA
❑ NE
❑ Yes
Wo
❑ NA
❑ NE
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements []Other:
21, es record keeping need improvement? If yes, check he appropriate box bet ❑ Yes No ❑ N ❑ NE
aste Application ❑ eekly Freeboar [Waste Analysis Soil Analysis �e s �ather Code
FR�Rainfall r;�' tocking El
Yield CId20 Minute Inspections [Monthly and V Rainfall Inspections Q Iudge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ZNo ❑ 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 21412014 Continued

Facili Number: Iq Date of Inspection: ao( ZV
24. Did the facility fail to calibrate waste ap tcation equipment as required by the permit? ❑ Yes [NKo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check kes ❑ 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: jol 201-3
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes Nr&o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �rNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes �j No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
JX
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes p(J No
)
❑ 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
❑ Yes No
. ❑ 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 >rNo
❑ 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).
al 5oi( 4'e5-f-aue�a016l 'Iv1cl. coppeff-+Zinc.
S PD19 Coi4l _" �01- UPP2r ? MaVe ll t 56M PO(A, 5vbrW'+.
6rCo.d tea-Ve5/Ueni✓C41ovt C.on.�-rb I e-a o 11 Clauk- b e} we en U w t- ?
0 b-Iibro-honCo"Ie-t'0_4 do13ea014,A1"-0wasurz wa-kteJ
ao�+-3.2 er g by Pu 11 in u--)u P
q 8 I`fo It✓ rafa i reA 7
Ple.a.5e. Se.ed� e.�wlnotv��-Q.v�l� �WiiS' �'al Ip
a Li►-WAeA.ei.44 A! aff&j t6 Wj�g� ?
b IVAed -5 u,/ W u P — PvI( Sdov�'�
LJ&5+e.Ad1 11 51.s = Aka-+4
3(lbla014 lolqa.013
` lA319,o14 = W91 165./U//000 Sae . L
Reviewer/Inspector Nam
Reviewer/Inspector Sign
Page 3 of 3
Phone: - 1 1 1
Date: —1 1 jL_, Lf
21412014
VS', WA Wort'-Shee-i;

OnsiteRepresentative: pklolYl
Certified Operator: SeXr- U PW
Back-up Operator:
Location of Farm:
II ype of visit: U compliance inspection U Operation Keview U structure Evaluation U I echnical Assistance
Reason for Visit: O Routine O Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: Arrival Time: ® Departure Time: �County: Region: WI
Farm Name: Top
(n fir M Owner Email:
Owner Name: SQ�r►^ V Id A P P. Phone: J 1" r 'T9 1-T
Mailing Address: -`U 3 W4,-..3 1 S0 (5 t 8 rOw n Sumin.i ti- r tic, 01 7 2' 1 7
Physical Address: a- a 5- N L aZ eZ Q
MPLY Pzb!n -1-7 5-e
Facility Contact: kI Ltd 5 jy, Title: Phone: I I - $ `e
Integrator: ,.Pu r v fl 51 -01317C
Certification Number:
Certification Number:
Latitude: Longitude:
us a9 N 'SUS. a9 N 166D E�Iw-\ eprove C.� old• , N(tZp�ih
ga ova 3 ,
Swine
Design
Capacity
ll
Pop.
ij Design
Wet Poultry Capacity
Current
Pop.
Cattle
Design Current
Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
I INon-Layer I
Dairy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design
Dr, • P,oultr. Ca aci
La ers
Current
P,o P.
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
I
I
I
lBeefBrood Cow
Other
01 Other
Turke s
Turke Poults
10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
0 No
❑ NA
❑ NE
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
[g No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
❑ NA
❑ NE
of the State other than from a discharge?
TT
Page 1 of 21412011 Continued

Facility Number: Date of Inspection: Q
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ 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
SIdentifier: �4t2 tr
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes 0 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 KNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes N 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 CP�iJo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes XNo
❑ NA
❑ NE
❑ Excessive Pending ❑ 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):
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
❑ Yes 'Na No
❑ Yes jS'No
❑ Yes ;P0
❑ Yes V No
❑ Yes XNo
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? JgYes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes jDallo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements []Other:
21. Does record keeping need improvement. riate batz_ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application �eekly Freeboard ❑ Waste Analysis Soil Analysi [V�Waste Transfers Weather Code
[a Rainfall []Stocking [Crop Yield [9120 Minute Inspections ❑d0%nthly and I" Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 10 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [:]No NNA ❑ NE
Page 2 of 3 21412011 Continued

[Facility Number: 03 1 Date of Inspection: 0
24. Did the facility fail to calibrate waste #aication equipment as required by the permit. ❑ Yes [� No ❑ 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 PDA for sludge levels
XNon-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance: ] u I t/ cZU 13 1JPD2�
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes XNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [�LNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 0 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
No
❑ 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
❑ Yes
No
❑ 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
XNo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
X 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
NrNo
❑ NA
❑ NE
of facility to better eaDlain situations (use additional naves as
&� hole r`.e,Pot'trt?d ? �btye�. Cornero; �SQ,�-aded d e
+o r al v) VJ1A�► f to
o 3 A t^.r ease r)o% y �+ . See, i Sfi °
I. Los+ Soil fiest da i call. aofaAravtc Coh�,plefej. Need-Fo
f,OL-1 y Z 7 vac � 1 s o �J off,,,.. a o i 6.
Cal' b.ro�ion due- ablif. /I /aa13
S, POR For upp.P-r
�5� Q — 90 DAYS h be. o,orvtplef'ed
101gi113 = 1• qg-
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
&1"113 = I.4o
ee/(a/I;z 1. SI
a• 87 141-71ia=
Phone: -711—sag7
Date: 0,11,1901 3_
21412011

for Visit: M Routine
Referral
Other O Denied Access
Date of Visit: ii l Arrival Time: Departure Time: 00 County: � W t< Region: i asi26
Farm Name: lop F ar >v�. Owner Email: Owner Name: TP p e Phone: _Ter r/
e10 38� — Sq IS
Mailing Address: 5463 4 N 150CQ5F a-zalY
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: —Tex r U Ff PP t P_
Back-up Operator:
Location of Farm:
Phone: Phi 111 D/C%:. $q 1-5
puryi5
Certification Number:
Certification Number:
Latitude:_3 (0 16 3 2 Longitude: % I 57 Q ;L
o E }o US aq N !a u5"• Aq N I E(M Grove c.h. ,� R
M i z POL d
Design
i wine Capacity
Current
Pop.
Design
Wet Poultry Capacity
Current
Pop.
Cattle
Design Current
Capacity Pop.
Wean to Finish
I
ILayer I
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design
Da P,oultr. i (?a eci
La ers
Current
P,o
Dairy Heifer
Dry Cow
Non -Doi
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
I Beef Brood Cow
OtherI
11 Other
I
Turkeys
ITurkeyPoults
10ther
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 0 No ❑ NA ❑ NE
❑ Yes ❑ No
[:]Yes [:]No
[:]Yes ❑ No
❑ Yes//No
❑ Yes I �JNO
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
Structure l
Structure 2 Structure 3
Identifier:
I )n
LdLA;
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
❑ NA ❑ NE
❑NA ❑NE
Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
❑ Yes 07No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes We ❑ 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 �Vo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes �Po ❑ 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 o ❑ 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 Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, et))
❑ 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): �[
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes p(1 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes C�No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes �Po ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes tVo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the 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 ❑ Lease Agreements ❑Other:
21. oes record keeping need i provement? d€ ecrcl topriate box( ❑ Yes 9 No ❑ NA ❑ NE
ste Application Weekly Freeboard Waste Analysis �❑ Sod Analysis [+astea+:sferS Weather Code
Rainfall [+Stocking ❑ Crop Yield 3120 Minute Inspections ❑ Monthly and V Rainfall Inspections [EKludge Survey
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 J lA ❑ NE
Pagel of 21412011 Continued

Facili Number: Date of inspection: Q
24. Did the facility fail to calibrate waste app (cation equipment as required by the permit? ❑Yes �No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes tZo ❑ 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 to provide documentation of an actively certified operator in charge? ❑ Yes IN ' ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 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 �No ❑ 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)
❑ Yes [g No ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
Cg/No ❑ NA ❑ NE
WIMJ o ❑NA ❑NE
NNo ❑ NA ❑ NE
j(No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recoenckations or any other comment .
Usedrawines of facility to better exolain situations (use additional Dazes as hecessar�ktl Nl:l'$S! A " ?` �`.
a a0101aiDll 1 ,101)- SOII ��eSt 5 ? 3/10`a01/4, .;2/27/2ob (;cog
'� ao(a (°A1'�b�liovl ? des . �i�n►e�er A7
one,500�D V
S PON for up P-er 0.1% v l PoPwSe -
/veed SluNCeanou� r-raa�iioo.v
�
Plaho
0.+3a. Ac etc lis iv\ wuQ bj Pull?
9'. West eu�d 65 s tvtl5si h 9 i pia+ >lovs e — hole in cov►�re
12U5� e-hec.U- �ndM-e�al ro
411 ia =
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
a. 3 1 �5, N / loco .
Phone: -/1 I- 5-agq
Date:�-
214/2011
`A

Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 2Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: S Departure Time: County: cy-I M6 : LlSRo
Farm Name:—bh 117_60 Farm Owner Email:
Owner Name: `' cr Phone: ap'-rsi aE.I.I)
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: f� PP I e—
Back-up Operator: P�1 I ( t 1 V` V IS
Location of Farm:
as-fs n
Integrator: I' U f- V 1 :5
Certification Number:
Certification Number:
Latitude: ";[n I � 3a Longitude: _79 3 7 o ;)—
4o E 40L6 alN• � a u5- ,2qN., ®°nto El Al (oro(IL Calure--k
t3
K.) nin MI.% t\/lk /th,IrYIn 62A•i ZJ� nn-tn el-J-kAn PA.
Wean to F
Feederto
Farrow to
Farrow to
Farrow to
Gilts
Boars
Poults
Discharges and Stream Impacts
I. 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?
Beef Brood Cow
[-]Yes W No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes []No
❑ Yes � No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 21412011 Continued

Facility Number: 1 - Q Date of Ins ection:
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 j�J No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: �.Ol
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
(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 en vi onmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? es ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes P(No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) y(
9. Does any part of the waste management system other than the waste structures require ❑ Yes I XI No ❑ NA ❑ NE
maintenance or improvement? T
Waste Apnlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes P�No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 5(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):
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 ox.
WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
,,2��1,,��. oes record keeping need i rovement? I
Vste Application ;� ekly Freeboard Waste Analysis bityand
alysis
amfall L�Id/tocking,L�1JCrop Yield 120 Minute Inspections ont V'
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?
Page 2 of 3
❑ Yes
[KNo
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
q No
❑ NA
❑ NE
❑ Yes 1$No ❑ NA ❑ NE
❑ Yes 10 No ❑ NA ❑ NE
❑ Yes
Rainfall
0 No
❑ NA
❑ NE
PYes
❑ No
❑ NA
❑ NE
❑Other:
C!ryes
❑ No
❑ NA
❑ NE
D (Waste nnsfersfers
Bather Code
Inspections
\ Sludge Survey
❑ Yes
tj No
TT❑"-
❑ NA
❑ NE
❑ Yes
No
X NA
❑ NE
21412011 Candnued

[Facility Number: Date of Inspection:
24. Did the facility fail to calibrate waste app tion equipment as required by the permit?
❑ Yes
d, NNo ❑ 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 PDA 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
W No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
P No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
ONo ❑ 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
No ❑ 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 ❑ Yes [�No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application) TO
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes j No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other: T
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? I N Yes ❑ No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes lNo ❑ 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;�tawings of facility to better explain situations (use additional pages'as necessary): ' .`l°;' , ` `I Ft,) asi?)°,!
P re s5 ur2. QV 4 et _ ? C/t' & .
?VN o, ao i f� S i o S.tx-�'�►t-� a°! o bb
a� aolD �eelibr Jion? �(�S DvP� a�n in aola
51 ud Q p0 H 1 7 B04+ �rve�scipnY+ a 10C, a,ot l� 4uPP� Ia tso
a ? ,kffd � 4 � . (U`� l � w up) e i r�o � A 6 o o n/V 0 -d
n o ke.+w�� �P l -�a� . /� C.�-te�-t-lJ td IA a
Wi5ajdG#6 - nt I_1Lt_tCA_Cc LtdU g
e*C�'io��
QAust M6LO � l�etw� Epp ' lower 1c�I�pc�ons
(�.5 Soon aS �SS i lol _— sau7 �o (i ve I-ound l� s .
0 Lrnt-r = a.-7 110-5 N/iocoj ' - 3/30/a0t/
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: —
Date: cj 11&
214611

3
Type of Visit (Compliance Inspection 0 Operation Review . 0 Structure Evaluation 0 Technical Assistance
Reason for Visit XRoutine O Complaint 0 Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: OS 0 Arrival Time: Departure'rime: �/ County: t ` 5t Region: 6 0
Farm Name: ^� - ' °'o 'F—cu-M �//�� Owner Email:
Owner Name: f / rTDOI L / 77 Phone: 3 �L Z
Mailing Address: 5qD r pjIwlsi %� Geit� I�pfown ,5LIMM14- �6 2 V
Physical Address: 225— Ge'�h RdA1 f Lj A'rLJ 11 G iJ G 2, 723 0
rr Rob Z
Facility Contact =��G M.�l%s 0/Q FDl7 n Title:
— S2�_2 � Phone No:VR;//.ga)7-3T2--,?9lf
Onsite Representative:
Integrator:
Certified Operator. A,r 'r MHk� lr Operator Certification Number:
.
Back-up Operator: �l_ Back-up Certification Number:
Location of Farm: Latitude: ©° ®� 32 �� Longitude:
/f(,7 E. -j, (I f 'L% fj, -)Ia
6cff. 2-9 Al, Elm 6rove
.C&) Al /,fx
CA, tU.,
R 6,40', g':.
IV
Design Current
Design Current
I csign Current
Swine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ La er
E]Dairy Cow
❑ Wean to Feeder
11
ILI Non -Layer I
❑ Dairy Calf
❑ eeder to Finish
E]Dairy Heifer
Farrow to Wean O
Dry Poultry
E]Dry Cow
Farrow to Feeder
La ers
❑ Non -Dairy
Farrow to Finish
El❑
❑Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑Beef Brood Cow
El Turkeys
70ther
❑Turke Poults
❑ Other
Number of Structures:
Discharges & Stream Impacts 4—Nov �— PC — 0 6 6
1. Is any discharge observed from any part of the operation? ❑ Yes No ❑ NA ❑ NE
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
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 War S o Stateother than from a discharge? \,��pV"
gel of
)
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yies ❑ No
❑ Yes YNo
❑ Yes �No
12128104
El NA El NE
❑ NA ❑ NE
❑ NA ❑ NE
Continued

Facility Number: '' — ©3 • Date of Inspection Eptpe
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: fi A c
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): j _ 0
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 XNo ❑ 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 0No ❑ 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 L1A 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/improvement? / `
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes &(No ❑ NA ❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Croptype(s) SMa11 o-r-a
13. Soil type(s)
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
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?
'R,Yes
❑ No ❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers apd/or,anyrrecdmmendationsor, any other,comments:;
Use drawings of facilityYo better explain situations. (use additional pages as necessary):
,!
b z
k.
La,8med
S,*.C/9tuNOor
h r/>°tsur'C- q ai�gG/ far 1r'14) 4,bn sn. ^
N1�`� %✓(/er ;6-� eti� ✓ aver?Catfinue- eCf'or}s -im mowJSPrQu
. weeds pin dam beiwgeh 1 �. �I,
10ACUC N t,00lZg meat Sb far.
Reviewer/Inspector Nam Fr; Fty',Af� r? Phone
Reviewer/Inspector Signature. Date: Qi 2G /t7 VLSI
Page 2 of 3 12128104 Continued
7

Facility Number: — 3 0 of Inspection OS •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? Yes ElNo ElNA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ YesIVo ElNA El NE
the appropriate box. ❑ WUP ❑ Checklists El Design ❑Maps El Other
21. Doe record keeping need im o/vement? X2O
Yes ❑ No ❑ NA ❑ NE
Waste Applic lionWjkly Freeboard aste Analysis ❑ soil Anal is[Lainfall[ocking Crop Yield �inute Inspections on[hly and l" Rain Inspections Bather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 'No ❑ N ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [I Yes El No K �K`A ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ YesNo ElNA ElNE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes XNo ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes 9 o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes p�No [I NA El NE
Otherlssues d_
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 Id 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 rko ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes �4lo ❑ NA ❑ NE
tddi onal Comment .and/or Drawings: r
-f
2S aA d slh Geanaat on #1 d� 4� zao9 ?Tech 5 IGL ISf �SFmCo
0
D /1W /Y'�ya c �h w�
IPIL/O/� br s/Jrr`^'f OV/��
4,1Q5�,
W
e
WWI P I W,t�',�: i� 0K
��' �; i

Type of Visit aD C mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visittt Routine 0 Compl4mt 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: o Departure Time: County: L ion:
Farm Name: O 'E E4 Owner Email:
Phone: �Q Owner Name: - � - U AL Y to
Mailing Address: �t%0� t� S� t' 1. J��t% i tD i� S U 11 M / -� , t0C a 7d—1
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
' a' Pu Integrator: r V IS
Operator Certification Number:
Back-up Certification Number:
Latitude: F� o 0• Longitude: „ o I J 11 I tJGy.••
_- 4o6 4-a u5a9 N u-�)
�L9N
4p¢m
Vl'I CProve. C��
�'
•
oin+-C Mi z p0.h
I^_h
ap MCv#eti /U.
-
Design Current
Design
Current
Design Current
Swine Capacity Population
Wet Poultry
Capacity
Population
Cattle
Capacity Population
❑ Wean [o Finish
❑ La er I
❑ Dairy Cow
❑ Wean to Feeder
❑ Non -Layer
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
Farrow to Wean
Dry Poultry
❑ Dry Cow
Farrow to Feeder
❑ La ers
❑ Non -Dairy
❑ Farrow [o Finish
El Beef Stocker
❑ Gilts
❑ Non -Layers
❑Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cow
❑ Turkeys
Other
❑ Turkey Poults
❑ Other
❑ Other
Number of Structures:
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)
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 I of 3
❑ Yes '§�No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes ko []NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
12128104 Continued

Facility Number: — • Date of Inspection .
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: ).(' C�i�CLaAX�
Spillway?: �r
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes Cj(No
❑ Yes ❑ No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
❑ Yes $No ❑ NA ❑ NE
❑ Yes WNo ❑ NA ❑ 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? WYes ❑❑ No [I NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? El 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 El Yes o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [tNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes O�No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑. vidence of Wind Drift El Application Outside of 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?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? El Yes
17. Does the facility lack adequate acreage for land application? { ❑ Yes
18. Is there a lack of properly operating waste application equipment? WYes
❑No El NA ❑NE
0 No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
_�No ❑NA El NE
El 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):
c'X e �0'w Uppe,✓
welt lu�oon?
M�(,�-ter d ram► �� ?
s� 1 Need .
t N��d resSVJe
o� 'lv'r' a�lion vne
Reviewer/Inspector Name IPhone:
Reviewer/Inspector Signature:'
Date:
Page 2 of 3 12128104 Continued
�� °� a �3a NcIW as 5(,a, alto

Facility Number: — Q
Date of Inspection 1t�
0
I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes AIo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP eat ily available? If yes, check 2 yes ElNo [INA ❑ NE
the appropriate box. ❑ WUP ❑Checklists es n El Maps El Other g
21. Dos record keeping need imp ement? If 7es a ante bex-belew, ❑ Yes �No ❑ NA ❑ NE
L^�IWaste Applicati eekly Freeboard Waste Analysis ❑ Soil An lysis n "' T ,, jai ccrt7icatigrr
Rainfall Stocking rop Yield [),120 Minute Inspections L�YMonthly and V 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 ❑ NA ❑ NE
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
❑ Yes o
El NA
El NE
El Yes
tNo
❑ NA
❑ NE
ElYeso
❑ NA
❑ NE
❑ Yes ANo
❑ 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 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?
a
06
Comments and/or
oco S0(I -Feel e
mowi
❑ Yes D No ❑ NA ❑ NE
❑ Yes �jNo ❑ NA [3 NE
El Yes ((No ❑ NA ❑ NE
❑ Yes )§ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes T&No ❑ NA ❑ NE
aC0$ 5 (UI Ca2 S v r tl�
% 1 i b ration oo wtite-d I , a oo4.
�I .. �I 1il /II I
t
�) A
Page 3 of 3
12128104

Facility Number
Type of Visit Coml
Reason for Visit YRC
Date of Visit:
Farm Name:
Division of Water Qualit
Division of Soil and Water ouservation q . 5o
O Other Agency
nce Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
is O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Arrival Time: �,1, 1 h hayyt
FORS Departure Time: County: •• fl
FOR Farm Owner Email:
Owner Name:, j Phone:
le F- 34a-ila
Mailing Address: . 3 L4 I /N'wo.q 15o�F,�as-,L T
Physical Address: a aI S/n� MCotton t`-u-- , p
Facility Contact: ` 1 Y t tl u t lls {� Title:
WS 6
" JumnarM . !,)C_ -L7,I1T
U! Ile— I N ('
Phone Na: T2Yf C 3`6 a —
Fo 131 h UA/-
Onsite Representative: ''``
Certified Operator: I t B IIL�S
Back-up Operator: rr N lam.
LAI
Integrator: r u r V 15
Operator Certification Number: o2t7_
Back-up Certification Number:
Location of Farm: Latitude: ® 0 UP I M:_ Longitude: 7 0 I�
L - qbE v 5 a q N . -b Bus 1A, 4 a . or%E E/m isrove G • ►� �� -
br o• Mizph a. ed. pi . oto (oElai I4-
Swine
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feedei
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La cr
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Cattle
Design Current
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
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)?
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 jNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes )< o
❑ NA
❑ NE
El Yes No
❑ NA
❑ NE
12128104 Continued

Facility Number: — " . Date of Inspection
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?
❑ Yes No
❑ Yes 1111110
______No
❑NA ❑NE
❑ NA ❑ NE
,Structure I Structure 2 I Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ro mam
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ' Ole 4-
�� y
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.) 1
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes J�(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 threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Owes ❑,(' No ❑ NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes I Ii.No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) T
9. Does any part of the waste management system other than the waste structures require ❑ YesNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ yes )rNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes f�No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN> 10%or 10lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drill ❑ Application Outside of Area
12. Crop type(s) :s6 i4beAns , is e-a_+
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 R No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
,KNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
qNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
> No
❑ NA
❑ NE
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
mat
` S We- a14 ,a OF frM
Reviewer/Inspeitor Name
Reviewer/Inspector Signature:
it
L44
rnune- rI L—a-c
Date: Q
1 4 Co=tie
o.
n

Facility Number: — 41ate of Inspection 1 /mod Y� •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
❑ Yes ONo ❑ NA ❑ NE
❑ Yes X No ❑ NA ❑ NE
21. Doe record keeping need impr vement? If yes, chec he appropriate box b ow. ❑ Yes ❑ No ❑ NA ❑ NE
W to Applicati n ek Freeboard, �NJ Waste Analysis Soiil A/n�lysis Waste Transfers L3i}Uff
Rainfall tocking Crop Yield L►d'120 Minute Inspections LSMonthly and l" Rain Inspections Bather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes El No
'b%je_ o'I QV-.j
4 24.
Did the facility fail to calibrate waste application equipment as required bythepermit?
V's ' ❑ Yes
)dNo
*25.
Did the facility fail to conduct a sludge survey as required by the permit? { , ��
1— -r ❑ Yes
)(No
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
t]� No
/❑
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ yes No
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
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 ❑YesNo
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes o
33. Does facility require a follow-up visit by same agency? ❑ YesNo
❑ NA ❑ NE
;<NA El NE
❑ NA ❑ NE
❑NA ONE
El NA ONE
MM
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA El NE
❑ NA ❑ NE
Additional Comments and/or Drawings:
goo& somas? Xoo`? soils ?�
dS• SQ{JV �S UPVi-i Go0v+Le.+esQ s-tr Dm-7a LbCUPX GD71 IYL" to eA
a�. Cal�brtlod� dv� c�e�\0 4 p
al 1r.►as� 1a�1�1�O1 _3.`6
ro
11118104

Division of Water QualitW
Facility Number Division of Soil and Water Conservation a 3 pry)
0 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
0
Date of Visit: rj Arrival Time: U.�=L. �--i Departure Time: L 1 • }'7 I County: letMl at" R gion: U26 P 0
Farm Name: ((IO P Rn Y Owner Emai l
Owner Name: 'e- Phone: �,/
Mailing Address: I� t��l I Sa Ea5f_R r0 Lt.)r) SU M M l+ NC a. %
Physical Address: A In 0 q U y) 9 d � 611, V I e rj L
D 1
Facility Contact: I 1' Title: Phone No'�r�
bin C oX a - a58
Onsite Representative: AA AA integrator: PI) r V l 5
Certified Operator: : V `V S Operator Certification Number:
Back-up Operator: P tr r�i P P I e Back-up Certification Number:
Location of Farm: Latitude: ®e au I a�!„ Longitude: M e ©. p�J
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
I, ❑ Non -La et
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?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stockei
❑ Beef Feeder
❑ Beef Brood Co
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)?
Number of Structures: Fy�,
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 LJQ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
xio
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Facility Number: — • Date of Inspection
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?
tructure I Structure 2 Structure 3 Structure 4
Identifier: Vri M"'4 Coneiy!E
Spillway?: /
Designed Freeboard (in):
Observed Freeboard (in): 1
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, 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
❑ Yes ❑ No
Structure 5
El NA El NE
❑ NA ❑ NE
Structure 6
.SI Yes ❑ No ❑ NA ❑ NE
❑ Yes N No ❑ NA ❑ 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? ITd Yes ❑ No ❑ NA ❑ NE
8. Do any of the stucmres lack adequate markers as required by the permit? T 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 [INA ElNE
maintenance or improvement?
Waste Application
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. El Yes J! 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
[IEvidence of Wind Drill ElApplication Outside of Area
12. Crop type(s)
13. Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
gNo
❑ 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
_% TINo
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
No
El NA
El NE
18.
Is there a lack of properly operating waste application equipment?
El Yes
Jj.�MNo
❑ 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): At v 5T J
"'W\ f j.
'Bro" Ie,4 weeds o�12mkgvA K me vlt ? 5P� w rc=Seed his FgII
C=C1L hem vlsl -�-N
mat eel ? IA 1� d�
(M�rV,er fixed In lower 1a�oon? �J° CAC _
Reviewer/Inspector Name
Reviewer/Inspector Signal
Phone:
Date: g,�v

Facility Number: — Q 4te of Inspection •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Ye 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 appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other ,�,�
21. Do record keeping need imm ovement? repriet ew— ❑ Yes [VNo ❑ NA ❑ NE
�Raste Applica on UV W kly Freeboard Waste Analysis Soil A lysis �j Waste Transfers rlrfiC2Ytb3i
ainfal] Stocking LI Crop Yield 120 Minute Inspections IyMonthly and I" Rain Inspections Bather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [I NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 9No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes 9No ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes 9No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No ) j NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ;No
❑ NA El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑yes ❑ 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 N ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes No ❑ NA ❑ NE
Ad ' al Comments and/or Drawings:
aool Sot u«S?I K)O+ en SX e- ©nbme-
a5. sludge suYv � a �ve%e_}i?o�a00l e ompletec6.
�� due
Ca�i�re��idh ao0(Q C'oQrJl2�eQ o V•�o�' p��ai✓l
vn-V; }. a00%O
a Sma�I 8rayn Crop yI2id? ;ta0loodz. e- uk. 2007meyc, vi
r
a h en d c ao�� w u P-zq
e
12/28/04

•
•
NCDA fcCS Agronomic Division Phone: [phone] Web Site: www.nmg.com/agrononil/
Report No: 36528.
'
Grower:
Apple, Jerry
Copies To:
5401 Hwy 150 East
•.
oil Test Report
Brown Stuvtnit, NC 27214
Parm 7143
5/14/2007
SERVING N.C. RESWENTS FOR OVER 60 YEARS
Rockingham County
Agronomist Comments
A - 3
Field information
Applied lime
Recommendations
Sample No. Last
Mo Yr T/A
Crop or Year
Lime
N P205 K20
Mg
S
Ca
Za
B
Mn
See Note
1
1st Crop: Small Grains
0
80.100 0 0
0
15-20
0
0
.0
0
3
2nd Crop: Soybeans
0
0 0 0
0
15-20
0
0
0
3
Test Results
SoUCUU 1M%
W/Y CBC BS% Ae pH P-I K-1
Ca% Mg%
Mn-I Mo-Af(1) Mx-AI(2)
Ind Za-A[
Cu-1
SI
SS/
NO3-N AN4-N
No
MIN 0,36
1.17 6.7 85.0 LO 6.4 log 141
49.0 25.0
1533 924 924
157
157
89
23
0.1
Field information
Applied Lime
Recommendations
Sample No. Last
Mo Yr T/A
Crop or Year
Lime
N P205 K20
Mg
S
Ca
Za
B
Ma
See Note
2
1st crop: Small Grains
0
80-100 0 0
0
0
0
0
.0
0
3
2nd Crop: Soybeans
- 0
0 0 0
0
0
0
0
0
3
Test Results
Sou Class IL51%
W/V CBC BS% Ac pH P-I K-I
Ca% A(g%
Ma-1 Mn-AI(1) Mn-AI(2)
Za-I Zn-AI
Ca-1
Sd
SS-1
NO3-N NH4-N
Na
MIN 0.27
1.22 6.6 85.0 1.0 6.2 67 172
46.0 26.0
1412 854 854
94
94
81
44
0.1

•
NOAKS Agronomic Division Phone: [phone] Web Site: www.acaff.com/agmomi/
Report No: 05978
Croaxr
Apple, Jerry
Copes To
S"ilT'St
5403 Hwy 150 EastBroom Summil, NC 27214
Report
Parma
lo/6/20o6
SERVING N.C. RESIDENTS FOR OVER 60 YEARS
Rockingham County
Agronomist Comments
A -*3
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Ltme
N P203 Kz0
Mg S
Ca
Zu B
Mn
See Note
1
1st Crop: Small Grains
0
80-100 80-100 0
0 0
0
0 .0
0
3
2nd Crop:
0
Test Results
Soil Class fim
W/Y C8C BS% Ae pu P-/ K-I
Ca% Mg%
Mn-1 Mn-AL(1) Mn-AI(2)
Zal Za-Al
co-1
S-/
SS -I
NO3-N AW74-N Na
MIN 0.32
1.18 93 88.0 1.1 6,1 20 101
56.0 27.0
182 118
108 108
42
79
0.2
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Line
N P303 K20
Mg S
Cu
Zn B
Mn
See Note
2
WOW: Small Grains
0
80-100 130-150 0
0 0
2
0 .0
0
3
2nd Crop:
0
Test Resits
Soo Class BM%
W/Y CBC AS% Ac pd P-/ K/
Co% Mg%
Ma-/ Mn-A1(1) Mn-AI(2)
ZwI Zn-Al
Ca-/
S-I
SS-1
NO3-N NH4-N Na
MIN 0.36
L15 8.6 90.0 1.7 5.9 3 95
47.0 27.0
246 159
52 52
21
62
0.1

CI
•
•NCDABCS Agronomic Division Phone: [phone] Web Site: www.naigr.conx/agronomi/
Report No: 24537
Grower .•
Apple, Jerry
Copies.To:
5401 Hwy 150 East
•
oil Test Report
Brown Summit, NC 27214
Parma
3/16/2006
SEINING N.C. RESIDENTS FOR OVER 60 YEARS
Rockingham County
Agronomist Comments
A - 3,1
Field information
Applied Lime
Recommendations
Smote No. Last Crop
Mo Yr T/A
Crop or Year
LLme
P205 %20
Mg S
Cu
Zn B
Mn
See Note
t
ls1 Crop: Small Grains
0
80-100 0 0
0 15-20
0
0 .0
pH$
3
2nd Crop:
15-20
Test Results
SOU Class BM%
W/Y CHC BS% Ac pd P-I K-1
Ca% Mg%
Mu-1 Mn-AI(]) Mn-Af(2)
Zn-/ Za-Al
Cu-I
S-I
SS/
NO3-N AM*N Na
MIN 0.51
1.22 7.1 90.0 0.7 6.8 66 108
54.0 29.0
1119 669
181 181
93
21
0.0
Field Information
Recommendations
Sample No. Last Crop
Crop or Year
Lime
NP203 K20
Mg S
Ca
Za B
Mu
See Note
2
7Y/A
1n Crop: Small Grains
0
80-100 0-20 0
0 0
0
0 •0
0
3
2nd Crop:
0
Test Results
SoBClass BM
W/Y CBC BS% Ac pH P-L K-I
Ca% Aug%
Ma -I Mn-A/(1) Mn-AI(2)
Zn-I Za-AL
Cu-1
S-I
SS -I
M03-N NH4-N Na
MIN 0.41
1.11 7.8 83.0 1.3 6.2 59 176
44.0 28.0
446 275
76 76
96
49
0.1

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 790003
Facility Status: Active Permit:
AWS790003 ❑ Denied Access
Inspection Type: Compliance Inspection
Inactive or Closed Date:
Reason for Visit: Routine
County: Rockingham
Region: Winston-Salem
Date of Visit: 09/14/2006
Entry Time:09:20 AM Exit Time: 11:15 AM
Incident #:
Farm Name: Hill Too Farm
Owner Email:
Owner: _ferry Aoole
Phone: [phone]
Mailing Address: 5403 Hwy 150
E _ Brown Summit
NC 27214
Physical Address:
Facility Status: ❑ Compliant
❑ Not Compliant Integrator:
'
Location of Farm:
Latitude: 36°16'32"
Longitude: 79°37'02"
1-40 east to GSO. Hwy 29 north to Bus. Hwy 29 north. Right onto Elm Grove Church Road. Right onto Mizpah Church Rd. Right onto
Cotten Rd. Farm is at the end of the road. Farm address is 225 Cotton Rd.
Question Areas:
Discharges & Stream Impacts
Waste Collection & Treatment
Waste Application
Records and Documents
Other Issues
Certified Operator: Philip T Mullis
Operator Certification Number: 20387
Secondary OIC(s):
On -Site Representative(s): Name Title
Phone
On -site representative
Philip Mullis
Phone:
24 hour contact name
Robin Cox
Phone:
Primary Inspector: Mel's a Rosebrock
n
���id ONh
Phone:
i
Date:
Inspector Signature:
—�
Secondary Inspector(s):
-
Inspection Summary:
5. & 7. Owner has engineering design dated 3/9106 to begin repair on spill pipe this Fall.
7. Dam looks better. Suggest spraying to control broadleaf weeds.
20. Irrigation plan is not on site... again.
21. Don't forget to obtain 2006 soil test results.
21. Need to keep waste level records for upper lagoon until spill pipe repairs are completed.
24. & 25. Don't forget to obtain calibration & sludge survey for 2006.
28. Need to add application months to WUP for soybeans.
8/7/06 waste analysis: 3.71 lbs. N/1000 gal.
Page: 1

Pernilt: AWS790003 Owner -Facility: Jerry Apple Facility Number: 790003
Inspection Date: 09/1412006 Inspection Type: Compliance Inspection Reason for Visit: Roullne
Regulated Operations Design Capacity Current Population
Swine
O Swine - Farrow to Wean 1,140 834
Total Design Capacity: 1,140
Total SSLW: 493,620
Type
Identifier
Closed Date Start Date Designed Freeboard
Observed Freeboard
agoon
PRIMARY
18.00
agoon
SECONDARY
36.00
48.00
Page:2

Permit: AWS790003 Owner -Facility: Jerry Apple
Inspection Date: 09/14/2006 Inspection Type: Compliance Inspection
Facility Number: 790003
Reason for Visit: Routine
Discharges 8 Stream Impacts
Yea
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?
1101111
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? -
❑
■ 0
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a
❑
■ ❑
❑
discharge?
Waste Collection, Storage & Treatment
Yea
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 (Le./ large trees, severe
❑
■
❑
❑
erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a waste management
❑
01111
or closure plan?
7. Do any of the structures need maintenance or improvement?
■
❑
❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Notapplicable 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 Yea
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?
❑
■
❑
❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
Page: 3

0
- Pernit:'AWS790003 Owner -Facility: Jerry Apple
Facility Number:
790003
Inspection Date: 09/14/2006 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Waste Application
Yoe No
NA
NE
PAN?
❑
Is PAN > 10%/10 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
Small Grain
(Wheat,
Barley,
Oats)
Crop Type 2
Soybeans
Crop Type 3•
.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?
❑ ■
❑
❑
18. Is there a lack of properly operating waste application equipment?
❑ ■
❑
❑
Records and Documents
Yoe 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?
Cl ■
❑
Cl
If yes, check the appropriate box below.
WUP?
❑
Page: 4

Permit: AWS790003 Owner- Facility: Jerry Apple Facility Number:.790003
Inspection Date: 09/14/2006 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? Cl ❑ ❑
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?
❑
0 ❑ ❑
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
Yea
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

Permit: AWS790003 Owner- Facility: Jerry Apple
Facility Number: 790003
Inspection Date: 09/14/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Otherissues Yea 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?
❑ ■ ❑ ❑
I1111RE]•IIIIII
❑ ■ ❑ ❑
Page: 6

Division of Water Qualityop v
Facility Number: Division of Soil and Water Conservation zn
— — — -- 0 Other Agency ✓v
Type of Visit ,�C[[ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Via (ju Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit:
Arrival Time:
� eparture Time:
County:
oe.u-i nq ha IllRegion: 0 "
I
Farm Name:
O
1rm
Owner Email:
4 o oZ Fot r►I'J
Owner Name: Jerrsl
le
Phone:
, f
Mailing Address: ST03 UWV
IS0 l/�S+�8rotl->r)SuMM'I
v
/w
T
Physical Address: aas C4461
'I n f
�r?1�5l�
/
le NJ
n
Facility Contact: Pkdji.D
Mullis
(�t`-t11,--t
or ICOWIIjitI ,QK
Phone No:aerr � 3s;l- gql
Onsite Representative:
p
6111 t O):
$4211—
Integrator:
pury i5 S
PhiCertified Operator:
I
U
l iS
Operator Certification Number: 2 O 38 7
Back-up Operator: v I ie, Back-up Certification Number:
Location of Farm: Latitude: ®o ®, r-3--T Longitude: M o 0 • I ..
_T-yo EO-5+*)CGSD. US t yy a-q N BU5 y aq N. A-F -onfo
Elry1 e rove_ a). lid • W_ bn-b N 12-190 Ch • � . 2t- onto CQt�n
Design Current
Other
❑ Other
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
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
❑ Dairy Cow
❑ Dairy Calf
11
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: J
❑ Yes I�No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
0
d. Does 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 *No El NA [I NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State []Yes �No ❑ NA ❑ NE
other than from a discharge?
Page I of 12128104 Continued

Facility Number: — • Date of Inspection Mfttya
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes �{No
El NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes (❑ No
❑ NA
❑ NE
I Structure 2 Structure 3 Structure 4
�
Structure 5
Structure 6
Identifier:
�Structure
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �q } I OL
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 )qNo
❑ 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? K Yes ���,,,,,❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes IEI No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)/T.,�,/
9. Does any part of the waste management system other than the waste structures require ❑ Yes �A No ❑ NA [I NE
maintenance or improvement? 17C
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes o ❑ 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 10 Ibs ❑ 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)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
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
❑ No ❑ NA ❑ NE
o ❑NA ❑NE
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):
s Sp l t l p p e. ? on Aa.vvL beh,_w_"
1 °4- a° ?
'
cle�
44-1
Reviewer/Inspector Name r SC 77MAL
I o e: 1 a$
Reviewer/Inspector Signatu e:
Date:
Page 2 of 3 1 " 12128104 Continued

Facility Number: — a�nspection ,
Required Records & Documents /
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes I]p No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes pp No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ ❑ Design ❑Maps ❑Other Checklists /-
21. Doe ecord keeping need im ovement? If yes, the the appropriate box below. P Yes ❑ No ❑ NA ❑ NE
Waste App��lica��tion Weekly Freeboard Waste Analysis Soil A ly ��—;nsn '
Rainfall @'Stocking [� Crop Yield -gf20 Minute Inspections Monthly and 1" Rain Inspections We
( ather Co
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes IXI No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes El No O(NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permOC'1: • I El Yes *o El NA ❑ NE
it?
25. Did the facility fail to conduct a sludge survey as required by the permit? oZcc(o ❑ Yes No ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes �No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No 1XNA ❑ NE
Other Issues , ,(
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes I)(l 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 X No ElNA [INE
33. Does facility require a follow-up visit by same agency? El Yes No ❑ NA ❑ NE
Uditional Comments and/or Drawings:
a005 5011 +eb+ ►-esu46 ? a OOG ? •
K r a_W 31((o Info A-00A ?
• MOV'
MA
C / `i .1 ClotPI
f/2006 • w•
1 �
10 1212810.

•
Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 790003 Facility Status: Active Permit: AWS790003 ❑ Denied Access
Inspection Type: Comnllanre Inspection Inactive or Closed Date:
Reason for Visit: Routine County: Rockingham Region: Winston-Salem
Date of Visit: 03/11/2005 Entry Time: 09:35 AM Exit Time: 11:35 PM Incident #:
Farm Name: Hill Tao Farm Owner Email:
Owner: wry Apple Phone: [phone]
Mailing Address: 5403 HW 150 I= Brown Summit NC 27214
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 36°16'32" Longitude: 79°37'02"
1-40 east to GSO. Hwy 29 north to Bus. Hwy 29 north. Right onto Elm Grove Church Road. Right onto Mizpah Church Rd. Right
onto Cotten Rd. Farm is at the end of the road. Farm address is 225 Cotton Rd.
Question Areas:
Discharges & Stream Impacts Waste Collection & Treatment Waste Application
Records and Documents Other Issues
Certified Operator: Philip T Mullis
Secondary OIC(s):
On -Site Representative(s): Name
On -site representative Robin Cox
24 hour contact name Robin Cox
Operator Certification Number: 20387
Title Phone
Phone:
Phone:
Primary Inspector: Meelissa/MRoseb k I I ►, Phone: [phone]
�IA1r9/WY 6N` Ext.38 ^�
Inspector Signature•II�Date: 1.L7
Secondary Inspector(s):
Phone:
Phone:
Inspection Summary:
5. and 7. MUST repair spill pipe and establish grass on dam between upper and lower lagoons as soon as possible.
11. New irrigation went in after November 2004 so new waste plan dated 3/26/02 Just went into effect after the october 2004
applications. Approximately 10 plbs. overapplication due to the PAN and acreages changing from the old waste plan to the new one.
20. Must obtain irrigation design to keep on site.
21. Went over the new permit requirements with Robin Cox.
21. Need to keep irrigation records and PAN by pulls rather than by field.
21. 2004 soil test results ok. Don't forget to obtain 2005 results.
22. Could not locate rain change. Must install one on site.
Page: 1

40
Permit: AWS790003 Owner -Facility: Jerry Apple
Inspection Date: 03/11/2005 Inspection Type: Compliance Inspection
Facility Number: 790003
Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Swine
O Swine - Farrow to Wean 1,140 724
Total Design Capacity: 1,140
TotalSSLW: 493,620
Waste Structures
Type Idenllfler Closed Date Start Date Designed Freeboard Observed Freeboard
Lagoon PRIMARY 18.00
Lagoon SECONDARY 72.00
Page: 2

Permit: AWS790003 Owner -Facility: Jerry Apple Facility Number: 790003
Inspection Date: 03/11/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Dlyarges & Stream Imnaetp
1. Is any discharge observed from any part of the operation?
Vee No NA
❑ ❑
NE
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑ 0 ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWO)
❑ 0 ❑
❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ M ❑
❑
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?
❑ 0 ❑
Vne No NA
❑
NE
Waste rollpntinn_ StoranA & Treatment
4. Is storage capacity less then adequate?
❑ 0 ❑
❑
If yes, Is waste level Into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Ire./ large trees, severe erosion,
0 ❑ ❑
❑
seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a waste management or
❑ 0 ❑
❑
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
❑ 0 ❑
❑
and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑ 0 ❑
❑
Improvement?
Vee No NA
NE
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or Improvement?
❑ 0 ❑
❑
11. Is there evidence of incorrect application?
❑ ❑
❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
0
Is PAN > 10%/10 lbs.?
❑
Total P2O5?
❑
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
Fescue (Hay)
Crop Type 2
Small Grain
(Wheat,
Barley, Oats)
Crop Type 3
Crop Type 4
Crop Type 5
Page: 3

E
Permit: AWS790003 Owner -Facility: Jerry Apple
Inspection Date: 03/11/2005 Inspection Type: Compliance Inspection
Facility Number:
Reason for Visit:
790003
Routine
Waste Application
Crop Type 6
Yes
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 Certified Animal Waste Management Plan(CAWMP)? 00
❑
❑
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?
❑
0
❑
❑
17. Does the facility lack adequate acreage for land application?
❑
0
❑
❑
18, Is there a lack of properly operating waste application equipment?
❑
Yes
0
No
❑
NA
❑
NE
Records and Dncuman}s
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0
❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
0
❑
❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need Improvement?
0
❑
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
Weather code?
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
❑
Inspections after> 1 Inch rainfall & monthly?
0
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?
E
❑
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
❑
IN
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
M
❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
N
❑
❑
26. Did the facility fail to have an actively certified operator In charge?
❑
0
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑
N
❑
Page: 4

Permit: AWS790003
Owner-Faclllty: Jerry Apple
Facility Number: 790003
Inspection Date: 03/11/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
OthOth .r lycrisss Vee No NA N
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 ❑ M ❑ ❑
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 ❑ M ❑ ❑
representative immediately.
31. Did the facility fall to notify regional DWO of emergency situations as required by Permit?
32, Did Reviewer/Inspector fail to discuss revlew/inspeclion with on-slte representative?
33. Does facility require a follow-up visit by same agency?
Page: 5

Type of Visit b6 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: i_''J/ I I i (.L71 Arrival Timne: Departure Time: Countyl Region:
Farm Name: o. Rury✓i Owner Email:y
— _ t
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Phone: 3 it a .1 I a I_ r&r
3 r0 Wn S�Irn>Yul-I-, Nc, a7 a
one No: 2 5915
Phone No:
Onsite Representative: Integrator:
Certified Operator: '�hi �l'T�_mU���s Operator Certification Number: ;2()L2) O�
Back-up Operator: r le -
5-
Title:
P_e"l
Back -up Certification Number:
Location of Farm:
Latitude: = U = , = ,,
Longitude:
= e = , = ..
r-4o E c�so , us
a9 nor+- -ta 13uS Kuy
aR
N . . onto
Irv��rov�� U �A
one, K-Z-Po-h C.PnUrc�
P� i
��. one
Swine
Other
❑ Other.
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Non La et
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?
Design Current
Cattle Capacity Population
EfDairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cow
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)?
Number of Structures: ®l
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
0
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes
ElNA
❑.NE
El/ Yes
❑ NA
❑ NE
12128104 Continued

Facility Number: 1 — • Date of Inspection •
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes I�No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? []Yes 1"( o ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:Pr:i mox4 o
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
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
XYes
[I NA [I NE
8. Do any of the stuctures lack adequate markers as required by the permit?
El Yes
�,❑.,`N�o
LMNo El NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)TTT"/
9. Does any part of the waste management system other than the waste structures require
Yes
L,�pVo [INA [I NE
maintenance or improvement?
/ ,
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�No ❑ NA ❑ NE
maintenance/improvement?
lull[ ``
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 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
Evidencce of Wiinnd Drill ❑ �Atpplicationn Ou�tside ofAP./12. Crop type(s) c6� � t- 1 J PA U Y � QtddLl—�2
❑ Outside/of Acceptable Crop Window P�K
J �_
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
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
aOO µ 561
rrl ej a-i on
1 (I/o41OLt For #7b
i n to n et,J to
-b3
-7 9 a I q,9-ljvq
a/ 16 /os
Reviewer/Inspector Name �; ° ^ ` ��`" ;, "�,, ,.: Phone:
Reviewer/Inspector Signature:
��Date:
�I � p I2118104
'tr1Vfi�� SST-as.5 r�rnrm �Ip-Iz)ee-n
No ❑ NA
❑ NE
No ❑ NA
❑ NE
No ❑ NA
❑ NE
No ❑ NA
❑ NE
No ❑ NA
❑ NE
416
b(o)%
Continued
U PPP-+'t- lot -we

Facility Number: — D*f 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 appropirate box. ❑ WUP ❑ Checklists Design
g ❑Maps ❑Other
21. Doe record keeping need irt}provement'? If yes, chec the appropriate box low. Yes ❑ No ❑ NA ❑ NE
Waste Application NJJWee ly Freeboard���/// Waste Analysis Sod Analysis Waste Transfers
Rainfall Stong Crop Yield pQ 120 Minute Inspections Monthly and I" Rain Inspections Weather Code
/`
22. Did the facility fail to install and maintain a rain gauge?
A Yes
❑ No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
1XNA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
. *o
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
VNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
VNo
❑ NA
❑ NE
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 ❑ No $NA ❑ NE
❑ Yes No
❑ Yes XNN0
El Yes /INN, o
ElYes ((No
❑ Yes �No
❑ Yes t6o
❑ NA ❑ NE
❑ NA ❑ NE
❑NA El NE
❑NA El NE
❑NA El NE
❑ NA
C `
9
12128104
f�vs} ola a�n I.rr�q�;lov� �es:9'� � I�e�p oinstfe

I �r
ethnical Assistance Site Visit
r MKion of Soil and Water Consei
Natural Resources Conservation Service
Soil and Water Conservation District
Other...
Facility Number 79 - Date: /9I04 Time: 9:30 Time On Farm: F 90 WSRO
Farm Name Hill Top Farm County Rockingham Phone: [phone]
Mailing Address 5403 Hwy 150 East Brown Summit NC 27214
Onsite
Representative Robin Cox Integrator N G Purvis Farms, Inc.
Operation Review
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ Operating below th
IN Swine ❑ Poultry ❑ Cattle ❑ Horse
Design Current
Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
N Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
1140
705
Routine
Response to DWQ/DENR referral
Response to DSWC/SWCD referral
Response to complaint/local referral
Requested by producer/integrator
Follow-up
Emergency
Other...
Design Current
Capacity Population
❑ Layer
❑ Non -Layer
❑ Dairy
❑ Non -Dairy
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes N no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached ❑ yes N no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees, ❑ yes N no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes N no
requiring DWQ notification?
5. Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes N no
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes N no
Structurel Structure 2 Structure 3 Structure 4 Structure 5
Identifier Primary Secondary
Level (inches) 20 30
CROP TYPES Wheat j lFescue-hay
SPRAYFIELD
SOIL TYPES Cw
HeB
SeB
VaB
ffilij
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03
❑ Dairy
❑ Non -Dairy
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes N no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached ❑ yes N no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees, ❑ yes N no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes N no
requiring DWQ notification?
5. Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes N no
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes N no
Structurel Structure 2 Structure 3 Structure 4 Structure 5
Identifier Primary Secondary
Level (inches) 20 30
CROP TYPES Wheat j lFescue-hay
SPRAYFIELD
SOIL TYPES Cw
HeB
SeB
VaB
ffilij
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes N no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached ❑ yes N no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees, ❑ yes N no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes N no
requiring DWQ notification?
5. Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes N no
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes N no
Structurel Structure 2 Structure 3 Structure 4 Structure 5
Identifier Primary Secondary
Level (inches) 20 30
CROP TYPES Wheat j lFescue-hay
SPRAYFIELD
SOIL TYPES Cw
HeB
SeB
VaB
ffilij
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

0
C]
Facility Number 79 3 Date:
6/9/04
PARAMETER
Q 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 w/producer
❑
❑
❑ 12.
Waste structure integrity compromised
28. Forms Need (list in comment section)
❑
❑
0913.
Waste :structure needs maintenance
29. Missing Components (list in comments)
❑
❑
[314.
Over application >= 10% & 10 lbs.
❑
❑
[115.
Over application < 10% or < 10 lbs.
30. 21-1.0200 re -certification
[116.
Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
❑ 17.
Deficient irrigation records
32. Irrigation record keeping assistance
❑
❑
❑ 18.
Late/missing waste analysis
33. Organize/computerization of records
❑
❑
❑ 19.
Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
❑ 20. Late/missing soils analysis
[121.
Crop needs improvement
35. Sludge or Closure Plan
❑
❑
❑ 22.
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:
design/installation
❑
❑
❑ Other...
43. Irrigation 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 certification/rechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
2,
49. Drainage worklevaluation
❑
❑
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
❑
❑
55. Waste operator education (NPDES)
El
❑
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

Facility Number 79 Date: F 6/9/04
COMMENTS:
Waste analysis: 1-21-04 ALS 0.89 Ibs.N/1000 gals. I, 6-02-04 ALS 1.6 Ibs.N/1000 gals. I
# 13. Continue efforts to control vegetation on the Primary lagoon embankment.
* Remember to get your 2004 soil samples in.
The irrigation system appears to be about complete and the technical specialist will be able to update
he waste plan to reflect the new system and wetted acres.
TECHNICAL SPECIALIST Rocky Durham
SIGNATURE
Date Entered: 6/10/04 Entered By: lRocky Durham
3 1 03/10/03

Type of Visit 0 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 79 Date ol'visil: 1/22/2004 Time: 0900
10 Not Operational O Below Threshold
Permitted N Certified ❑ Conditionally Certified 0 Registered Date Last Operated or Above Threshold : ....... ......
Farm Name: H1tl.Tnp.Farm....................................................................... County: it.OSkingham ........................... 1. S&O......
Owner Name: de[rY-_•-•---•-•-•---•--- ADALe--------------.-.-.-.-.---•-. Phone No: 33fi 141.112411arotL 335,392 d415 fcelU--
MailingAddress: S.4.9.1 .»'y..M.East............................................................................. Rxo.wx.$.w alit.N.C............................................. 17214 ..............
Facility Contact:)'bliliR.M.uUis.nr.linbin_Cnx............... Pitle:............................................... Phone No: 33b,451.43.1.7..................
Onsite Representative: Integrator:1y
Certified Operator: Phittp..7:................................. MixItis................................................ Operator Certification Number: ZQ.3#7 ............................
Location of Farm:
1-40 east to GSO. Hwy 29 north to Bus. Hwy 29 north. Right onto. Elm Grove Church Road. Right onto Mizpah Church Rd.
Right onto Cotten Rd. Farm is at the end of the road. Farm address is 225 Cotton Rd. �
® Swine [3 Poultry [3 Cattle [3 Horse Latitude 36 • 16 32 Longitude 79 • 37 02
Swine
Design
Ca aci
Curet" of
P,o ulation
Design Current Design Gurren`t
Poultry Ca tact P,o ulation Cattle Ca acit P,o ulati°on
❑ Wean to Feeder
❑ Layer
❑Dairya
❑ Feeder to Finish
❑ Non -Layer
❑Non -Dairy
® Farrow to Wean
1140
690
❑Other .
Total Design Capacity 1,140
Tiotal SSLW 493,620
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons
HO 0
Discharees & 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 OR No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......Ptimat:y........ ...... Secondary ..... .......................... -----------------------...----------------------...........................
Freeboard (inches): 8 24
12112103 # q /�!/ / Continued

I -.
Facility Number: 997 Date of Inspection 1/22/2004
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
M 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
M No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
M No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
M No
elevation markings?
Waste Anolication
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
M No
11.
Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
M No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12.
Crop type Fescue (Hay) Small Grain (Wheat, Barley,
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
M No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
M No
b) Does the facility need a wettable acre determination?
M Yes
❑ No
c) This facility is pended for a wettable acre determination?
M Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
M No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
M 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 M No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes M No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes M 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 M No
Air Quality representative immediately.
ents refer to o # : Explain any YE an a and/or any commendations or an, of er omme ts.
awings o fa to etter a plain situations. u dd'tio al pa a as nece ary : ❑Field Copy M Final Notes
17.Continue efforts to control groundhogs on the lower stage lagoon. The overflow pipe in the upper stage lagoon appears to be clogged.
o clean this pipe out as soon as possible to overt a possible overflow.
and c. Owner has not completed a wettable acre determination for the current CAWMP.
ew dead hole is >300 feet from flowing waters.
21. Most recent permit dated May I, 2003 was not with records. Need to keep this onsite. The Certificate of Coverage (COC) was not
onsite either. DWQ to fax copy of COC to Ms. Cox at 336.824.8851.
22. Need to obtain the most recent version of the CAWMP (1999) and keep with records at the farm. Contact Rockingham Co.
SWCD/NRCS for assistance.
3. Facility did not obtain soil test results for 2002 or 2003. Per Ms. Cox, 2004 samples have already been sent and they are awaiting
those results. Notice of Violation/Notice of Intent to Enforce to be sent to owner.
3. Suggest making note of transfers from upper to lower stage lagoons on the freeboard form. This would help explain the
discrepancies between the freeboard form and application records.
9. Facility has not finished laying pipe for new solid set irrigation system. Will need a revised waste plan based on effective acres prior
o using new irrigation system. Owner has still not completed wettable acres for current CAWMP.
Reviewer/Inspector Name ;Melissa Rosebrock
Reviewer/Inspector Signature: Date:
12112103 ` 1 Continued

IFacility Number: 79_3 �te of Inspection 1/22/2004
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ 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?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 3I-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Stocking Form ❑ Crop Yield Form []Rainfall ❑ Inspection After I" Rain
® 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
❑ Yes ❑ No
❑ 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.
ME[ r onaIRomments and%oi7Drawines:
WQ to send Mr. Mullis and Ms. Cox a list of currently available operator renewal courses.
12112103

M •
Type of Visit P �Compliance Inspection 0 Operation Review 0 Lagoon Evaluation I
Reason for Visit (dt Routine O Complaint Q Follow up 0 Emergency Notification 0 Other ❑ Denied Access
!! �� Date of Visit: Time:
Facility Number
10 Not Operational 0 Below Threshold
Permitted 1( Certified 0 Conditionally Certified Q Registered Date Last Operated or Agove Threshold:
fQ
Farm Name: 11I Ton rarm County:
Owner Name: ;]P,Cr4 Tn� Phone No: + 1 Z .
Mailing Address: 540 3 H luu ISO ea5�- .Rrowr) S U ra IM I j f ' % C' a7,, I -U 136 •38Z J*j
Facility Contact: r 1l i 11
Onsite Representative: P)
Certified Operator:
Location of Farm:
Z- 40 E7aS4- to
Title:
a9 No r`f G) -}m
Phone No: ,53L4s1. � -3 [ 7
Integrator: Grp PUry IS Fa tr22mp� fTnea
Operator Certification Number: O? W U-7
a9 nor%?
MIM
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �-L_L.f✓_, ��� Longitude , �oo �° ®«t
Swine
IDU Farrow to Wean I 1 14l I 1 0410 1.
Boars
Design Current Design Current
Poultry Capacity Po mlation Cattle Ca aci Po mlation
❑ Layer I I JE3 Dairy
❑ Non -Layer I I ILJ Non -Dairy
❑ Other
Total Design Capacity I
Total SSLW -A /_ 7 71
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 Slate? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated now in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
y Field Area
❑ Yes -11�o
❑ Yes ❑ No
❑ Yes ❑ No
❑ 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 l'o
Waste Collection & Treatment �,,/
4. Is storage capacity (freeboard plus storm storage) less than adequate? IJg Spillway ❑ Yes �lo
Structure 1 Structure Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
5
Freeboard (inches):
05103101 Continued

Facility Number: Date of InspectionO�L
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes IXI 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 ,,M�N�oo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? El Yes �.No
9. Do anv stuctures lack adequate, gauged markers with required maximum and minimum liquid level //` �'�
elevation markings? ❑ Yes No
Waste .Aonlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes Y No
. 11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes �<o
12. Crop type (:U r2wo 11 1 rQ n
13. Do the receiving crops differ with hose signated in the CertiKJ Animal Waste Management Plan (CAWMP)? ❑ Yes Xl<
14. a) Does the facility lack adequate acreage for land application? ❑ Yes WNo
b) Does the facility need a wettable acre determination? OYes ❑ No
c) This facility is pended for a wettable acre determination? XYes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ;
WNo
16. Is there a lack of adequate waste application equipment? ❑ Yes �t No
Required Records S Documents / `
17. Fail to have Certificate of Coverage A 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? ,,TTTT.T,('"'
(ie/ WUP, checklists, desien. maps, etc.) �� DSI Yes ❑ No
tioeeboa
19. Does record keeping need improvement? (ie/ irri) n, , waste analysis &S
sample reports) ,'Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes gNo
21. Did the facility fail to have a actively certified operator in charge? El Yes o
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie' discharge, freeboard problems, over application) ElYes No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes t%No
24. Does facility require a follow-up visit by same agency? ❑ Yes'o
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes XNo
10 No violations or deficiencies were noted during'this visit. You will receive no further correspondence about this visit.
Field Copv ❑ Final Notes
Reviewer/InspectorName =l
Reviewer/Inspector Signature: k /UfAn F1 a4 A A I /Rdj / A, Ab Lb Date:
05103,101 1 V� Continued
��,, 6o� IC�D�X�tc� 336 . ga y. 8�S/a

0
Facility Number: —
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?
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
El Yes 12GNo
❑ Yes WNo
❑ Yes ,b(No
❑ Yes .4No
❑ Yes J�(No
l„ W it �� �� %�%/ / tl l it
7-7
I or
�/
.�
/ • / ifs ti'l/ tl%
t
M
/-
Oy
0510310I a a3 UJ t! "' l l •
/'�' �e►�dsvi Ile/N �
a 73c;-)0

Technical Assistance Site Visit
Ion of Soil and Water Conservati(W
Ural Resources Conservation Service
Soil and Water Conservation District
Other...
Facility Number
79 -
Date: 10/9/03
Time: 9:15 Time On Farm: 90 WSRO
Farm Name
Hill Top Farm
County Rockingham Phone: [phone]
Mailing Address 5403 Hwy 150 East Brown Summit NC
Onsite
Representative Jerry Apple, Robin Cox Integrator IN G Purvis Farms, Inc.
Type Of Visit Purpose Of Visit
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ 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
1140
aso
Response to DWQ/DENR referral
Response to DSWC/SWCD referral
Response to complaint/local referral
Requested by producer/integrator
Follow-up
Emergency
Other...
Design Current
Caoacity Pooulation
❑ Layer
❑ Non -Layer
❑ Dairy
❑ Non -Dairy
❑ Other
27214
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
❑ Dairy
❑ Non -Dairy
❑ Other
27214
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
❑ Other
27214
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
OR 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?
6. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes ® no
Structure1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier Primary Secondary—�
Level (Inches) 13 48
CROP TYPES heat Fescue -ha
SPRAYFIELD
SOILTYPES HeB SeB VaB Cw
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

r
Facility Number 79 - 3 Date:
10/9/03
PARAMETER
p No assistance provided/requested
❑ 8.
Waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9.
Waste spill contained on site
25. Waste Plan Revision or Amendment
❑
❑
❑ 10.
Level in structural freeboard
❑
❑
❑ 11.
Level in storm storage
26. Waste Plan Conditional Amendment
27. Review or Evaluate Waste Plan w/producer
❑
❑
❑ 12.
Waste structure integrity compromised
28. Forms Need (list in comment section)
El
❑
® 13.
Waste structure needs maintenance
❑
❑
29. Missing Components (list in comments)
❑ 14.
Over application >= 10% & 10 lbs.
❑
❑
❑ 15.
Over application < 10% or < 10 lbs.
30.2H.0200 re -certification
❑ 16.
Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
❑ 17.
Deficient irrigation records
32. Irrigation record keeping assistance
❑
❑
❑ 18.
Late/missing waste analysis
33. Organize/computerization of records
❑
❑
® 19.
Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
® 20. Late/missing soils analysis
❑ 21.
Crop needs improvement
35. Sludge or Closure Plan
❑
❑
❑ 22.
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
❑
❑
Reaulatory Referrals
41. Site evaluation
❑
❑ '
❑ Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
El Other...
43. Irrigation system design/installation
❑
❑
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 certification/rechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
2
49. Drainage worklevaluation
❑
❑
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
❑
❑
55. Waste operator education (NPDES)
❑
❑
5.
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6
58. Cropiforage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

Facility Number 79 0 Date: 1019/03
COMMENTS:
,,a`steranaly"s'is�'2":lW-03+ALS�3:3slbs.N/1000.gals41=5ALS.3;34lbdtN/1000'gals=lL.J
fE9=1'1= 30 ALS_1
# 20. Mrs. Cox could not locate a copy of the 2002 soil analysis.
# 19. The freeboard records need to be updated to the current date. ' The lagoon freeboard records do not coincide with
he pumping events.
Mr. Apple is in the process of having a new irrigation mainline and hydrants added to the irrigation system and a new waste
plan will be done. The new fields need to be calculated on effective acres.
Continue efforts to get rid of groundhogs and establish grass on the primary lagoon embankment. Looks better this year
hough.
Suggest having more grass added to the new waste plan for more application options during the year.
TECHNICAL SPECIALIST IRocky Durham
SIGNATURE
Date Entered: 10/10/03
Entered By: [Rocky Durham
03/10/03

I Facility Number 79 3 Date of Visit: 5/20/2002 Time: 0930
O Not Operational O Below Threshold
M Permitted M Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .. ... ..... . ..........
Farnt Name: klillI.Q.p..Faxm............................................................................................... County: RQ.i;kjKjghAw ................................... !Y.S.RQ........
Owner Name: d¢.r.ry........................................ Apple ........................................................... Phone No: dJ.6-3.42.:1.12.4...C'.¢.II..�d.G,�13.2,89.1.5...................
Mailing Address: S.4.Q1llwn-15.0.1.aSt............................................................................ BXUSVU.$.unnmlt.P C............................................. 2.7.21.4 ..............
FacilityContact: PURP..lY.1UM5................................................... . I'itle: ................................................................ Phone No:...................................................
Onsite Representative: l3UltLU..9X.824,2SB.1.2132..F1)YX22.111UA5.¢.UX,.2.7.a.14. Integrator: ......................................................................................
Certified Operator: pltilip..1.................................. Mullis ................................................ Operator Certification Number:2.Q3.8.7 .............................
Location of Farm:
Mizpal Church Rd. off of 87 to Cotten Rd. farm is at the end of the road. Farm address is 225 Cotton Rd. +
M Swine []Poultry []Cattle []Horse Latitude 36 • 16 ° 32 {{ Longitude 79 • 37 02
Design Current
Swine Canacitv Ponulation
❑
Wean to Feeder
❑
Feeder to Finish
M
Farrow to Wean
1140
708
❑
Fan ow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Number of Lagoons
Holding Ponds / Solid Traps
Design Current Design Current
Poultry Capacity Population, Cattle Capacity Population
❑ Layer I I airy
❑ Non -Layer I I " ❑ Non -Dairy
❑ Other
Total Design Capacity 1,140
Total SSLW 493,620
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes M 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 M No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes M No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? M Spillway ❑ Yes M No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:.........Primary.................Se caidary.....................................................................................................................................................
Freeboard (inches): 18 60
05103101 G �d r 'ham 0,ttinuea

Facility Number: 79� Date of Inspection 5/20/2002
5. Are there any immediate threats to the int my 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 Agnlication
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, 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?
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 flail 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 ® No
■ A4 X,
F�
❑ 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 question #)n Explain!'any,YES answers and/or any recommendations or any other comments
Use drawings of facility to better explainsituations. (use additional pages as necessary) �® Field Copy ❑ Final Notes
7. Upper lagoon has burrow holes (approx. 6-8" diam.) on east and west sides. West side of upper lagoon has some woody vegetation
that needs to be cut. Need to establish permanent vegetation on dam between upper/lower lagoon. Getting burrow holes in this wall.
14. Irrigation design has been completed for new system which has NOT been installed yet. Map of irrigation layout was not included in
paperwork... need to obtain this. Need to also specify wettable acreages in design.
19. Need to specify field number in IRR-2 forms. Need to change wheat PAN on IRR-2 from 151.54 to 130 per 1999 CAWMP. No
over -application has cccured, however. The CAWMP listsTract 4615 as 40.2 acres while IRR-2 form had 27 acres. Should describe
why the acreages were different.
Lower Lagoon waste analysis: 2/l/02 = 1.9 lbs. N/1000 gal. #W05385
_.... _
Reviewer/Inspector Name Mel' sa Rosebrock
Reviewer/Inspector Signature r Date: a�
05103101 Continued

Facility Number: 79_3 If of Inspection 5/20/2002 •
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
19. 9/14/01 Soil analysis (sample #2) showed an increase in P, Cu, Zn from the previous analysis. Check 2002 soil analysis to
compare. Per Ms. Cox, soil samples have been sent already but results were not back, yet.
25. CAWMP that Ms. Cox was using (1997?) is not the same one that was sent in with D WQ permit application (1999). Owner
to furnish record keeper with updated CAWMP and irrigation design.
Tony Esteridge is picking -up mortality now. The CAWMP on site did not have "rendering" as a diposal option, however, the
WMP sent in with DWQ permit application did have this checked. Made copy of this page to leave with Ms. Cox.
copy of this fonn to: Robin Cox - 336.824.2581, 2132 Hwy 22, Ramseur, NC, 27316
05103101

Type of Visit A Compliance Inspection Q Operation Review O Lagoon Evaluation
IReason for Visit x1 Routine 0 Complaint 0 Follow up 0 Emergency Notification
Q Other ❑ Denied Access
I
Date of Visit: AjQ OZ
Time:
Facility Number
Not Operational Below Threshold
�(
Permitted d Certified
13Conditionally Certified O Registered Date Last Operated or Above Threshold:
Farm Name: ICI Too
Owner Name: �T�—r�
I County:
Phone No:
d38�. 89/S
2�
,J.3�o —3 a . i"ia
jW(.
Mailing Address: "t 7t/�
G� f
l� �S� Ca54-y f0111)n SI IAl14
t Qc� 22 '2
Facility Contact: I /11 Title: Phone No:
e �t33(0 Sa' a6va 13140
Onsite Representative: i�0►/1 tok ;1132 -14012Tje4g4Sa, %r Integrator: puy-fi l.5
Certified Operator: L) 111 5 Operator Certification Number: Q Q 3 $ —7
Location of Farm:
swine []Poultry [:]Cattle ❑ Horse Latitude ®e =' ®.. Longitude EMo =, E0­20..
Design
Current
- Design Current Design
Current
Swine
Capacity
Population
Poultr . Ca aci Population .Cattle Capacity
❑ La er ❑ Dai
❑ Non -Layer ❑Non-Dai
❑ Other
Population-
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
Q
Farrow to Feeder
Total Design Capacity Q
Total SSLW I '43
❑ Farrow to Finish
❑ Gilts
❑ Boars
=Number of Lagoons ID Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
,Holding Ponds 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 L No
Waste Collection B& Treatment �I�yyyyy
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway
//
❑ Yes KNo
/ y
(� Structure 1 Structure 2 Structure 3 ' ` Structure 4 Structure 5
Structure 6 TTTT��I
Identifier: Tf dox
�
Freeboard (inches):
05103101
Continued

Faci ity Number: —_3 Date of Inspection r /
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
W No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
�,./
closure plan?
(It 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
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
trNo
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑
)jrNo
elevation markings?
Yes
Waste Aoolication
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
, Vo
11.
Is there evidence of over application? ❑ Excessive Pending ❑ PAN ❑ Hydraulic Overload
❑ Yes
Atl�o
12. Crop type 5 MQ I 1 dr
13.
Do the receiving crops differ with those designated in the Certified Animal {haste Management Plan (CAWMP)?
❑ Yes
5kNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
XNo
b) Does the facility need a wettable acre determination?
IRYes
V Not` , —
c) This facility is pended for a wettable acre determination?
0 Yes
1*No�'
15.
Does the receiving crop need improvement?
❑ Yes
No
16.
Is there a lack of adequate waste application equipment?
❑ Yesk
o
Regpired
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?
WUP, design,
ElYes
1e�
No
(ie/ checklists, maps, etc.) / J ✓
.ty
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste & soil sample reports)
VYes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
t,tYNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
('0`C�I No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
—
❑ Yes
,r�,,�
IA No
(ie/ discharge, freeboard problems, over application)
T�'(No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
24.
Does facility require a follow-up visit by same agency?
❑ Yes
o
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
b Yes
rNo
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refergto queshon #) Explain any YES answers.end/or any,r"eeommendetions or,annyy other comment
c :,u :.�7.'a„ z zae :a
U`sedrawings?hf facility'fo' betterexplain situations (useiiddtionel pages as necessary) Field Copy ❑ Final Notes
h, e, , s ,� �,-,,,M
1. U�po r 1 0M bu r OLO holes on a Qs+ wes l S I e-5. WeS+ Side-
P
has ve a�os7 �FPna-� needy S -it 6e C.u-i .
14. �rri3a4loil dFsl�n+o s�tFoy I�ebiC"dmre,5in des n 6i 0►1 S1f
^
49.
egPu�F lus. -
C cJ
3 .��,. • - I
Reviewer/Inspector Name -. Q.: , Q' . . OC s_.s•�.� 7
Reviewer/Inspector Signature Date:
05103101 Continued
r:F

Facility Number: '19 — 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?
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 fans) 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 permanenUtemporary cover?
r
❑ Yes [ <No
❑ Yes XNo
❑ Yes )�No
❑ Yes X No
Cl Yes XNo
8 No
1 �J� k4
Cozue�� *� 1,9 l �s. i`l�jooa gyp. a/i /oa os 3 ss
0-
pak74 /Mzt�
11�lw
AJ
i .� i
2�t
'' � Try -a •
PO I' �
a
1 �° •
OAR" r l
O5103101

1
{pen,1{ 41111:1i iil IIIt. fl.nliL
Type of Visit O Compliance Inspection 0. Operation Review O Lagoon Evaluation
Reason for Visit 0• Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 79 3 Date of Visit: 3/12/2002 'rime: 14:30
0 Not Operational 0 Below Threshold
® Permitted 0 Certified 0 Conditionally Certified 13 Registered Date Last Operated or -Above Threshold: .........................
Farm Name: lllllXQp.X7A M............................................................................................... County: RQ.rkjjjghAW ................................... WS.RQ........
OwnerName: dRX.r.y........................................ Apple ........................................................... Phone No: 342-112.4....................................................................
Mailing Address: 54Q3.Hxyy.15.Q.E.a51 ............................................................................ bxalyn.Summit.11lG............................................. ZU14 ..............
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
OnsiteRepresentative: Robin..Gox.................................................................................... Integrator:......................................................................................
Certified Operator: Philip.T.................................. M.ullis................................................ Operator Certification Number:ZQ3.8.7 .............................
Location of Farm:
Uizpal Church Rd. off of 87 to Cotten Rd. farm is at the end of the road. Farm address is 225 Cotton Rd.
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude F 36 • F 16 ° F7T271, Longitude 79 • F 37 02 1.
Design Current
Swine Cnnneity Pnnulation
❑
Wean to Feeder
❑
Feeder to Finish
0
Farrow to Wean
1140
652
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Number of Lagoons. ; L 2
Holding Ponds / Solid Traps
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I Dairy
❑ Non -Layer I I JE1 Non -Dairy
❑ Other
Total Design Capacity 1,140
Total SSLW 493,620
�, . ,,; ❑ Subsurface Drains Present ❑ Lagoon Area [[]Spray Field Area
❑ No Liquid Waste Management System
Disebarees & 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 0 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:..........Primary.................Secandary................................................................................................................. ...................................
Freeboard (inches):. 24 60
05103101 Continued

Facility Number: 79-3 1 Date of Inspection 1 3/12/2002
5. Are there any immediate threats to the innoty of any of the structures observed? (ie/ tre*vere erosion, ❑ Yes N 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 N 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 N No
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 ❑ Hydraulic Overload
12. Crop type Fescue (Hay) Wheat
❑ Yes
❑ Yes
❑ Yes
❑ Yes
N No
N No
N No
N No
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
N No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
N 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
N No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
N No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
N 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
N No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
N No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
N No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
N No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
N No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
N No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
N No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
N No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #): Explain any ,YES answers and/or any recommendations, or any,other comments n I, I,` .
Use drawing's of facility to better explain situations. (use add�tional'pages as necessary): ❑Field Copy N Final Notes .I
The facility is in the process of having a new, underground main, irrigation system installed ( contracted by Mid -Atlantic irrigation).
Construction has not begun to date however. The waste utilization plan will be revised based on effective acres and will also include
tobacco with the fescue and wheat rotation. The waste utilization plan is proposed to be done by Larry Graham.
Need to check for waste analysis for the Feb/March applications.
Reviewer/Inspector Name RockylDurham,,
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Numb
D*f Inspection
3/12/2002
.
Odor ]slues
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 pemranendtemporary cover? ❑ Yes ❑ No
analysis: 9-10-01 ALS 0.84 lbs.N/1000 gals. I, ALS 0.99 Ibs.N/1000 gals. I
05103101

(Type of Visit O• Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 79 3 Dale of Weil: 227/2001 Time: 0910
0 Not Operational 0 Below Thresl
■ Permitted ■ Certified 13 Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: 1101.1opY,acrn................................................................................................ County: Rocking►tam.................................... .W.S1i.Q........
OwnerName: dert'y........................................ APPIg .......................................................... Phone No: 3.3.673.42.112.4 ..........................................................
MailingAddress: 5.4.0.3.Rw.y..A,SA.Xast............................................................................. Hrow.tt.$.umnrit.N.C............................................. Z721.4 ..............
FacilityContact: P11i11tt.1,!'filift...................................................Title:............................................................... Phone No:....................................................
Onsite Representative: 1'Itilip..lkluAlS..alAd.fiOkirl.GOr............................................. Integrator:.......................................................................................
Certified Operator: P.Iti111t..................................... MWU5 ................................................ Operator Certification Number: 2.0.3#7..............................
Location of Farm:
dizpal Church Rd. off of 87 to Cotten Rd. farm is at the end of the road. Farm address is 225 Cotton Rd.
® Swine []Poultry [I Cattle [I Horse Latitude F 36 • 16 32 Longitude 79 • 37 02
°i:
' • r.
Swine
esi
Design
Ca iacit
WYM:' '.p �. - - si 'YII!,li:AV
Current Design Current
Pop nation Poultry Ca acit P,o ulatI n,
j ]y 1" AA "d\t l'r' Fa`3F ryp t i'.
+ Design„ Current * .,
Cattle -------
Wean to Feeder
❑Layer
❑Dairy
❑ Feeder to Finish
❑Non -Layer ❑Non -Dairy
❑Other'
Total Design Capa-eity 1,140
Total SSLW 493,620
® Farrow to Wean
❑ Farrow to Feeder
1 140
852+
❑ Farrow to Finish
0 Gilts
❑ Boars
Discharges &c Stream Itnuacts
I. 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 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
01/01AII ly-1 7 Continued

Facility Number: 79-3 • Date of Inspection 2/27/2001
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3
Identifier: .........ftia0my.................5&GA.ndafy.....................................
Freeboard (inches): ................ L4................ ............... ,.6................
® Spillway
Structure 4 Structure 5
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
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
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 ❑ Hydraulic Overload
12. Crop type Small Grain (Wheat, Barley, Fescue (Hay)
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?
17. Are rock outcrops present?
❑ Yes ® No
Structure 6
❑ 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
18. Is there a water supply well within 250 feet of the sprayfield boundary? ❑ Unknown ❑ Yes ❑ No
❑ On -site ❑ Off -site
Required Records & Documents
19. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ® No
20. 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
21. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
22. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
23. Did the facility fail to have a actively certified operator in charge?
24. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
25. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
26. Does facility require a follow-up visit by same agency?
27. Were any additional problems noted which cause noncompliance of the Certified AWMP?
Odor Issues
tes
28. 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?
29. Are there any dead animals not disposed of properly within 24 hours?
01/01/01
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ®No
❑ Yes ®No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
Continued

Facility Number: 79-3 D• a of Inspection 2/27/2001 •
30. Is there any evidence of wind drift du land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
32. 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.) .
33. Do the animals feed storage bins fail to have appropriate cover?
34. Do the Flush tanks lack a submerged fill pipe or a permanent/temporary cover?
printed on: 2/27/20011
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Gammen efer to uestlo # : Explain ony Sans er and/or any recommendations or an go en1conanents.
hls d awin of acilit to ette ex lain situation . vs additional pag as nece ary : ❑ Field Copy ® Final Notes
14. Mid -Atlantic Irrigation is to complete WA. See letter from Robin Cox to Sonya Avant (1/31/01).
26. Discharge pipe is about 3 feet above liquid level. Is not a concern or problem on this farm.
27. Dead hole is greater than 300 feet to creek.
T-4615 F-1 needs to be listed as "tobacco" in WUP if that crop is to receive waste this year.
Reviewer/Inspector Name Melissa Rosebrock
Reviewer/inspector Signature: Date:
01/01/01

q
0 Other Agency
p "y
f�
Type of Visit P Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit ()(Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit:
® Permitted Ed Certified C] Conditionally Certified E3 Registered
(Farm Name: %...A1.l........ Lp....... F..a;►m.........................................................
Owner Name:
Facility Contact: . x
Mailing Address: ..s..i..
Onsite Representative::
Certified Operator:,,,,.
Location of Farm:
o 1O
onal O Below
Date Last Operated or Above Threshold: .........................
County: .... .A�..oc--&—' j���.,./p].h.am ...............'.`.�...........
Phone No:.�✓.i.t...`�.J..d...... Zia ....�1..
...............................der hol 33 6. 5�
.
...,.../.u(�t>�..1 f....�e. �Z 7�1
Integrator:.._!„" l'J t" u r iz
Operator Certification Number: ........ CZ93,,a..] ...
_h! rM'is a
Swine []Poultry ❑ Cattle
[]Horse Latitude
Longitude ®•
Design
Current Design
Current
Design Current'
Swine
aacoa,;s,
: on°
❑ Wean to Feeder
❑ Layer
❑ Dairy
❑ Feeder to Finish
❑ Non -Layer Non -La y
❑Non -Dairy
as
arrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
❑ Boars
Total SSLW
;.
Number.of Lagoons Z
Holding Ponds / Solid Traps
I❑ Subsurface Drains Present
❑ Lagoon Area
❑ Spray Field Area :.
❑ No Liquid Waste Management System
Discharges & Stream Im acts
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. II' 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 -jP`&o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? []Yes S3*90
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway
❑ Yes A No
Structure I Structure j Structure 3 Structure 4 Structure 5
Trlh!io See on
Structure 6
Identifier:
Freeboard (inches): 1-
5/00
Continued on back

Ficility Number: — 1W Date of Inspection 6[/d7/OJT Printed on: 1/9/2001
5. Are there any immediate threats to ttegrity of any of the structures observed? (ie/ trees, severe erosion, UYes 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 KNo
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes XNo
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes l�l No
Waste Aoulication
�T
10.
Are there any buffers that need maintenance/improvement?
❑ Yes f Rmo
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes 'N-No
12.
Crop type ce6cUe, i
13.
t
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 I'No
16.
Is there a lack of adequate waste application equipment?
❑ Yes , "o
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes XNo
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 XNo
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?
❑ YesJV0
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes 'CX 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 ,NNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes '�Mo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes No
iQ•Yipla{iprjs;oi ftrjcpenr`1es •wire A9te$. O(Wj#g tjlis:visjt; • You w111•1•ec$iye 06 futth : • . •
etiries' o deitce:abotitthis:visit:.::::::::::::::•:•:•:•:•::•:•:•:•:
. Con+; vlve e ��0�+5 �o CoV� �ro� �purrocJ �'lo�eS — Jvsf one
�n4 oh 000,
d an 1 s or) rvl 0-CiLer- — +e P <Ler
.,
Reviewer/Inspector Name
Reviewer/Inspector Signatutb 910 14 Ad 6 tkko I b .rr 1'A i Date: Q % ZQ I SM0

Facility Number: — 3 jtate of Inspection b[/•Z 7/p/ I • Printed on: 1/9/2001
Odor Issues 6
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 4No
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 o
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 0No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes O No
Aqdltiorud'- omments an or, ratings:. `'f .� �,::� �I
Ngt5: � SalMpies /ill �6 41,5 weeg- le'VeIs 7 b1:56 ;y ?
•
$orrou� holes ? (,vl�ea% �+ondl41
CDC to/ records ?
14. bx+- iecvhon Form 6orAp)e+ed 2 12e5ponSe+m V(g%1
Ie,+kr Milk- A+IE- s -ks
C o'SMdpn +ram Ll� A. 5 e� l e}�e� �o , vl �0� +c�
j q A Van-+ (13 1 /O 1
300
a(C. Dischot-92 PIPS dischar9� 0,60i 3�c�b0ve.
19 v i d � P�/2.� . ZS � a -I- �c C o � ee.�'✓1 � r' � ('D � � Vv1
Feld 1 bt T— 4(o IS �� d
L)
S/00

COMPLAINT REPORT
Division of Water Quality
WINSTON-SALEM REGIONAL OFFICE
DATE • s I l 0
TIME:
PM
DID CALLER ASK TO REMAIN ANONYMOUS? Yes_ No_/�Jp { S�Q �i ncF
(If yes, skip to�DIRECTIONS,.)Q�
NAME OF CALLER:
ADDRESS: / q
TELEPHONE NUMBER: 3 •�10) 3��• / �aZ
DIRECTIONS: •
SOURCE OF PO LUTION:
COUNTY• .�^���(���L �///� _/ �/
NATURE OF CALL: //1/ J/iIYIX/.Y//YS , / 1_Y /� /Y b /A, et drIJA> v-1 /I d, z/,j
REPORT REFERRED TO:
IMMEDIATE ACTION TAKEN:

� 1 /
40

lWtvision of Water Quality
tvision of Soil and Water Conservation
Q Other Agency
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
Dade of Visit: 8/22/2000 Time: 9:20 Pruned on: 2/15/2001
79 3
O Not Operational O 1lelow Threshold
S Permitted ■ Certified 0 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: .........................
Farm Name: kIiI1. CaP..Faeml............................................................................................... county: :oclxifagltmnx...................................
..,SRO ........
OwnerName: Jgr.rya....................................... ApPIC ........................................................... Phone No: 34;..JL1.2Z4.... �0,fv.n............................................
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
Mailing Address: SkQ3.kl�tx..1S0.E.ask............................................................................ Brown Summit.N.C............................................ Z7214 .............
Onsite Representative: Phillip..M.mUis.............................................................................. Integrator: ri....Pua:Y.iS..)!.itA7ItL5.,.lft1:......................................
Certified Operator:Philip.L................................ lYa.0i11S................................................ Operator Certification Number: ZQ}8.7..............................
Location of Farm:
off of 87 to Cotten Rd. farm is at the end of the road. Farm address is 225 Cotton Rd.
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 36 • 16 32 " Longitude 79 • 37 02 1'
Design Current
Swine Canneitv Pnnulatinn
❑ Wean to Feeder
❑ Feeder to Finish
® Farrow to Wean
1 140
750
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I ❑ Dairy
❑ Non Layer I 1 1[] Non -Dairy
❑ Other
Total Design Capacity 1,140
Total SSLW
Number of Lagoons I 2 I Iu Subsurface Drains Present IIU Lagoon Area
IU spray tield Area I
Holding Ponds / Solid Traps
❑ No Liquid Waste Management System
Discharges _& Stryarn 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. Dues discharge bypass a lagoon system? (1f 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 I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: .......... Primary .......... ....... Secoadary........ ................................... .................................... ....................................
....................................
Freeboard (inches): 20 18
5/00
Continued on back

(Facility Number: 79-3 I Date of Inspection 8/22/2000 Printed on: 2/15/2001 t
5.
Are there any immediate threats to the integrit. y of any of the structures observed? (ie/ trees ere 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 Wheat Fescue (Hay)
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 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)
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?
13' No vtotatigtis;oir :deficiencies were;noted ;during this; visit::Ytiu;wil.l rt ce ve nti ftirth;er ;
corresaonden& about this visit. .
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
ti
19. Waste analysis needs to be within 60 days of application. Missing analysis between 4/7/99 and 7/15/00 for applications 9/99-4/00.
Need to start keeping weekly lagoon levels per the General Permit requirements.
2. There was a small amount of past discharge from the lower (flushed) house that did not reach the waters of the state. The operator
will try to repair the leak area and contain spilled waste.
7. Continue efforts to get rid of ground hogs.
15. Fescue needs weed control and needs to be removed after cutting.
The secondary lagoon was at the pump out marker and Mr. Mullis said they would be pumping as soon as possible.
17. Informed Mr. Mullis he needed to keep a copy of the Certificate of coverage with the application records.
Reviewer/Inspector Name Rocky Durham I
Reviewer/Inspector Signature: Date: 5/00

Facility Number: 79-3 of Inspection 8/22/2000 • Printed on; 2/15/2001
( dor Issueg
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 till pipe or a permanent/temporary cover? ❑ Yes ❑ No
5100

I* Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other l
Facility Number 79 03 Date of Inspection 3/8/2000
Time of Inspection 0900 24 hr. (hh:mm)
® Permitted § Certified 0 Conditionally Certified 13 Registered Not O erational Date Last Operated: ..........................
FarmName: flitI.T.apYasnu............................................................................................... County: liacltitlg am................................... WSRQ ........
OwnerName: lgr.ry ........................................ Apple ........................................................... Phone No: 33.W.42.:1124... V ......................................
Facility Contact: Phillip.11 Wlis................................................. Title: Qper,%LQK ........................................... Phone No: JbrbSb.:QB#b....Jx/..:.I....1..
Mailing Address: 5403.2w. x..191jasl............................................................................ Bromt.Summit.lHG............................................. 2.7214 .............
Onsite Representative: Phillip..Nlrlllls.............................................................................. Integrator:
Certified Operator:PhRiP................................ Muni$ ............................................... Operator Certification Number: 203.8..7.............................
Location of Farm:
Latitude 36 • 16 32 .. Longitude 79 • =1 O2 {'
Disi n
e Ca raeit +
Cunrent ' poultr. Design Current '
P,o ulation Y Ca Tacit P,o ulation Cattle
Design Current
Ca acit P,o ulation
ean to Feeder
❑Layer
❑ Dairyeder
to Finish
❑ Non-Layerrrow
to Wean
r-
1140
750
❑ Otherrow Total Design Capacity
lJ40
rrow to Feeder
to Finish
ilts
ooars
Total SSI W
493,620
Number of Lagoons =
Holding Ponds /Solid Traps F
❑Subsurface Drains Present' ❑ Lagoon Area ❑ Spray Field Area
❑ No Liquid Waste Management System
Discharaes.&C 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. 1f 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?
Waste Collection _ Treatment
4. Is storage capacity (freeboard plus stone storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: Primary Secondary
Freeboard(inches)...............4...............................30.................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99 a q
'lf%l'l
❑ Yes ® No
❑ Yes []No
❑ Yes ❑ No
❑ Yes []No
❑ Yes I& No
❑ Yes ® No
❑ Yes ® No
Structure 6
❑ Yes ® No
Continued on back
Printed on 3/9/2000

- Facility Number: 79-03 1 Date of Inspection
6. Are there structures on -site whichOnot properly addressed and/or managed throuowaste 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 stuct ores 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 Small Grain (Wheat, Barley,
3/8/2000
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
®No .
❑ Yes
I@ No
❑ Yes
® No
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?
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? lie/ 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?
lie/ 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?
? yWa,o;ons:or defciene es ivere:noted:dpthie this: visit::Ytiu:will receive ito further
corresooriden& Aouf this VISIL
17. No permit, owner may have it.
❑ 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
19. Last waste analysis was 4/7/99. Have been applying most every month. No record of the 1999 Soil test results. Robin Cox
;Tarheel Consulting) may have records.
Pipe discharges above liquid level. Does not appear to be a problem. No odor complaints.
Reviewer/Inspector Name IMelissa Rosebrock David Russell
Reviewer/Inspector Signature: Date:
u
on 3/9/2000

Facility Number: 79-03 )ate of Inspection 3/8/2000 .
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
Printed on 3/9/2000

Facility Number 79 03 Date of Inspection 3/8/2000
Time of Inspection 0900 24 hr. (hh:mm)
® Permitted ® Certified [3 Conditionally Certified 0 Registered Not O erational Date Last Operated: ..........................
FarmName: WO.TaaYarm............................................................................................... County: KQ.CkixtgbAM ................................... WSRO ........
OwnerName:Jgr.ry........................................ Apple ........................................................... Phone No: ]3b..3.4Z IZ4...........................................................
Facility Contact: PitilliP.J.I' W115................................................. Title: Ditcratur ........................................... Phone No: 3brbS.b.:A.&$b.......................
Mailing Address: 5AQ3..H.wy..15Q.E.ast............................................................................ Hr9.wxt.Sixmmit.NC ............................................ 27214 .............
OnsiteRepresentative: Phillip.2l x1W5............................................................................. Integrator:......................................................................................
Certified Operator: Pllllip.'1�.................................. lY. unis................................................ Operator Certification Number: Z03.8.7..............................
Location of Farm:
Latitude 36 • 16 1 32 {f Longitude 79 • 37 02 11
Dest n Currents Desi Current �
/" Die ign� �Cu�rrent.,, r;a q.a g d yr rN Design r sfl�>s• '
x Swine ., q y Ca iamt�Po wlation P�oultrY ' dl Ca acit ,Po ulatton �� Cattle,;x Ca tactf =,mPo wlationr..
❑ Wean to Feeder ❑Layer ❑ Dairy r«
❑ Feeder to Finish ❑Non -Layer ❑ Non -Dairy [,
®Farrow to Wean 1140 750
i ❑ Farrow to Feeder ❑ Other �
I ❑Farrow to Finish }; i; TDesign Capacity 1,140
f� ❑ Gilts
aV i y t.P
Boars ,;. N � Total SSL�W " 493 620 r,
r
;Number❑Subsurface Drains Present 110 Lagoon Area IoSpray Fidd Area
Hot ingwP�onds /Solid Traps ❑ No Liquid Waste Management System
Discharges &� am 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: Primary Secondary
Freeboard(inches).................Q................................4...............................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? fie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
3/23/99 Continued on back
Printed on 3/9/2000

Facilit Number: 79-03 Date of Inspection
6. Are there structures on -site which0not properly addressed and/or managed thro* waste 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 Small Grain (Wheat, Barley,
3/8/2000
❑ 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? (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?
�' No ,viol a'tiotis;or ;deficiencies were:note'd ;during this: Visit. Nou;wilI r&dvv naftirtlie � : :
cori esuotidence about this NISI :: .
7. No permit, owner may have it.
❑ 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
❑ Yes ® No
Last waste analysis was 4/7/99. Have been applying most every month. No record of the 1999 Soil test results. Robin Cox
heel Consulting) may have records.
Pipe discharges above liquid level. Does not appear to be a problem. No odor complaints.
Reviewer/Inspector Name jMelissa Rosebrock David Russell
Reviewer/Inspector Signature: Date:
on

Facility Number: 79-03 4P)ate of Inspection 3/8/2000 •
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
IN 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
Printed on 3/9/2000

s Divi f Soit,arid Water,Covation Operati PeWfr , k r' Nv
"x Qe ,+ 1�
°G . ll i ' :�`17 Divpsp of Soil and Water Conservation Complia nspectiony frrt�i�r t 4l
DrvLsionofWater.Qualpty 'Co mphancelnapection t , t 1r't:
OthenAgency = 0perahon Renew r,, {+ , , . ` �;a, ' � ..�' e' K
Routine aCom laint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number Date of Inspection O O$ O
Time of Inspection 24 hr. (hh:mm)
Permitted 13 Certified [3 Conditionally Certified [3 Registered Not O erational Date Last Operated:
Farm Name: N'I�I.T4� Fa✓.i,td............................................................... County: .... �:�-.�.�.n�..h.am.......... ......................
..........................................
OwnerName:......T+?.�c.r. ..........le............................................................. Phone No:.33W.:.._�ry.X.°.._.....���/.a. / ...........................
-el
FacilityContact: ... :.......................................................................... Title: .................... .................
........................... Ph nne N
Mailing Address: 57..11..�...... K!egy.._150..E2.4 .... t..... f .rOw.r1.. ..u.mrni.l i ., _..N..... ....... a.. ..a ........................
OnsiteRepresentative: Ph.A.1.Lp M.............................................. Integrator:......................................................................................
Certified Operator:••,•• rhi..I.1..1.p.... fY. 1 L L,;5...................... ........... Operator Certification Number: ... ..`3 U
.......................
Location of Farm:
Latitude =•=' =•' Longitude =• =1 =11
Design,•',Current'
Design '-Current
Desi Current
Swpne 'Ca racit Po ulation
Poultry
,: t?
Capacity' . Po +ulation ;Cattle , , Ca taci ` Population
❑ Wean to Feeder
Feeder to Finish
�r
q,o Farrow to Wean
,;,� , ���q� �� •.,r j
, ,�„ ���.; , �,
Farrow to Feeder,
❑ Other
.�a
[]Farrow to Finish
Total Design;Ca06i
❑ Gilts
❑ soars
Total SSLW ;
Number of Lagoons .,f ®
❑Subsurface Drains Present ❑Lagoon Area
❑Spray Field Area Vi
Holding Porids / Solid Traps '.
❑ No Liquid Waste Management System
1J
❑ Layer
❑Dairy
❑ Non -Layer
�•'
10Non-Dairy
utscnarees & mream impacts yyy ���
1. Is any discharge observed from any part of the operation? ❑ Yes pp 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 ycs, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (II yes, notify DWQ) ❑ Yes []No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes XNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes XNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway [:]Yes �No
Structure I Structure ? Structure 3 Structure 4 Structure 5 Structure 6
Identifier: Pftftlau seconain
' Lgll
Freeboard(inches): ....... ...................�.............. �....1..0...,.........................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? fie/ trees, severe erosion, ❑ Yes] No
seepage, etc.)
3/23/99 Continued on back

-' FaeilityNumber: — Date of Inspection I K J/piJ/aQ
6. Are there structures on -site which a not properly addressed and/or managed thro0a waste management or
closure plan? ❑Yes X.1 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 o
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 ❑ Yes No
12. Crop type t,,3 h P &,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes o
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
Reouired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? XYes ❑ 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 KNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) )4 Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 9No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes 14No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) []Yes VNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes gNo
24. Does facility require a follow-up visit by same agency? ❑ Yes �XNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ElYes pp No
-yiQla(iOos ot- 00flejeAtib •�vgrb 00tgo.00-- irig this;vpsit' • Yoit ivili•�•ebgiye t)o; fuf fir; -; ;
comes otidence: abotif this :visit:
Comments (refer to,question'#) Explain anyYESlanswers and/orany recommendattons,orny`otler comments t,) p, ti+'"+
Use,drawG' of factLty.,to'better explain situations; (useadditional� pages as
/ h�f - ift
No Pet-H)'A owner r) o-y have. {�
Iq. l ail LOas+e anojl s1s as y/�9 I VY u a Pplt�`�1��
MO5+ 2V IYlon`�10 o re,eon o 44'1e. Iq 90 II 4-e5+
reSul+S. l�bin OX5v Ma, have reco S
a (J, P'► Pe iselho ryes above
cab No 6Aor Cb ` ,) n +_
Reviewer/Inspector Name (' ' - 5,7c. �' `; J' i'"'0 •''�
w .
Reviewer/Inspector Signature: Date: tvUM

.,,FaciJityNumber: '"1 Date ofluspection OQ •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge allor below Yes ❑ No
liquid level of lagoon or storage pond with no agitation? 14
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 bells, 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 till pipe or a permanent/temporary cover?
❑ Yes No
❑ Yes No
❑ Yes VNo
❑ Yes `1J No
❑ Yes $] No
❑ Yes /K` No

Facility Number 79 3 Date of Inspection 6/29/99
Time of Inspection 10a0 24 hr. (hh:mm)
0 Permitted ® Certified 0 Conditionally Certified 0 Registered Not O erational Date Last Operated: ..........................
Farm Name: (iitl.T.QwF etu............................................................................................... County: KQ.ckixtgham................................... lISItQ........
Owner Name: Jet:ry........................................
Phone No:
Facility Contact:11exry.AFRkC .....................................................Title: QW..1ler................................................. Phone No: 33A,342.112.4 .......................
MailingAddress: SAQJ.11wx..1Sll.ast............................................................................ I)rolxn.Suamulit.l`IG............................................. 2.7214 ..............
Onsite Representative: Fit11ip.Mtkilis............................................................................... Integrator:
Certified Operator:PbRiP.L................................
Location of Farm:
Latitude 36 • 16 32 1.
Operator Certification Number:203.$.7.............................
Longitude 79 • =1 =11
lei v
'Swine 3^ �p"1"..Ca
,. ❑ Wean to Feeder
Design
Ca tacit
Current
P,o ulation
"' Design ' Currents t ri Desi n Current i
Poultry Ca tacit P,oiu anon Cattle �4: x°s •'
tacit , rP,o mlation,
"�'' ❑Layer ❑Dairy �'.,
t!.
`
❑ Feeder to Finish
❑Non -Layer
`,
❑Non Dairy
pt.?
® Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
1140
750 Sows
❑Other j'' w tr ,I
T40 Design @apac1ty 1,140
Total SSLW 493,620
❑ Gilts
❑ Boars
Number of Lagoons 2 ❑Subsurface Drains Present ❑ lagoon Area 10 Spray Field Area
Holding Ponds /Solid Traps ❑ No Liyuid Waste Management System
Discharges & 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 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 I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): .............. 2.4................. .............. 54................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
3/23/99 Continued on back

Facility Npmber: 79-3 D of Inspection 6/29/99
6.'Are there structures on -site which are n000perly addressed and/or managed through a womanagement 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
❑ Yes
❑ No
12.
Crop type Wheat
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 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
iVo viol'atiotis;op;deficienc es•were:noted:duiing this: vis.i,L You:will recewe-no furtheie
corres oridence. abod this vtsd. ,
Comments refer to uestion xpini any 5 answers and/or any recommendations or any other comments.
Use drawings o acilit to better explain ituation ..use additional pa es necessary
•
Reviewer/Inspector Name �Davt Russell
Reviewer/Inspector Signature: Date:
3/23/99

a i Division of
llp�'k1. Division of
Other Aeet
112 Routine O Complaint O Follow-up of DWQ inspection O Follow -tip of DSWC review Q Other
Facility Number Date of inspection
Time of Inspection 24 hr. (hh:mm)
[3 Permitted XCertified 1_-] Conditionally Certified 0 Registered Not O erational Date Last Operated:
Farm Name: ..../7........ .............lTt County:.../C.oG�Ci..... ..... ..................
����...................................................................
OwnerN:ame:..SJ.e(gv........... ....................................................................... Phone No:(�-�7. .L..Z.. �l�-r...A?o_.:....y[LV.../C�
Facility Contact: •?1�/.... /..............................Title:....._OC%Q_2.........:...................... PhoneNoCJ.3.•7L/..rl....
/ C/
Mailing Address: ................ • T
�S`o w.........�...........�/e s........................................ B�.o�t��... Su.�,., �..c-.... �.- � i
...........
Onsite Representative:.....
/.tl.../.tom%......../•„.11iS......................................... Integrator: .....:.................................
Certified Operator:
Location of Farm:
n
Qperator C
4—Aj t, S 7
Latitude Longitude U�fl' ELI,
Design
Current' '
Design Current ,
Swane • i,
Population
Polt Cattle
I„
�,�aCapacity Population
---_.
' ❑Layer ❑ Dairy
:❑ Non -Layer if„ ❑ Non -Dairy
❑ Other
Total Design!Ca,i ity j
2 c
Total SSLW °'
•:; I ber Lagoons, s - „"; ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area {
Holden , u Ponds /Solid Traps ,' ❑ No Liquid Waste Management System
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
17�Q
❑ Farrow to Feeder
[]Farrow [o Finish
❑Gilts
❑ Boars
Discharges a& Stream Impacts �/
1. Is any discharge observed from any part of the operation? ❑ Yes 129 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other L "
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? ❑ YesrNo
o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
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: 1..� 11 e 11
Freeboard (inches):..........!.........................J....................................... :............. ................................... ..
.........................
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 �nback

Facility Number: — • 1 of Inspection
6. Are.thire structures on -site which are not properly addressed and/or managed through a Ve 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 Fo
Waste Application LLLGGL ������''"'
10. Are there any buffers that need maintenance/improvement? ❑ Yes YN/ o
11. Is there evidence IIof over application? ❑ Excessive Pending ❑ PAN ❑ Yes IJQNo
12. Crop type L)Alr'i--
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes �3 No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
ANo
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
❑ 0
GTTTT
Required Records & Documents,
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
wo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ W UP, checklists, design, maps, etc.)
❑ Yes
�o
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
AYes
[:] No
20.
is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
o
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
PNO
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
ElYesjNo
o
24.
Does facility require a follow-up visit by same agency?
❑ Yeso
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
3/23199

Facility Number: D.f luspection F-trIFETU11.
Odor Issues
26.1 Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge actor below xYes ❑ 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 IRNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes �3I0
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 V0
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or A
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes o
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes Wo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Yes ❑ No
I�r G �{' IIR.( W/✓St t / 'N
/�i�C7i N CO x1
G.14_ ^ u I
c/1 nn
S
0 �
� At" 5 G� "lru- 10 r 95/ 0 Jd-
C�toA. o. is Jer
1
Aa2. �eLOJS
1�
Wece
04A
3v. �eavO� e.S'
3/23/99

Division of SoWd Water Conservation ❑ Other
Division of Water Quality
IIJR Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Date of Inspection /S
Facility Number Time of Inspection 0 0 0 24 hr. (hh:mm)
Registered A Certified 0 Applied for Permit 0 Permitted 113 Not Operational Date Last Operated: ..........................
lD O /—�Jlty.
Farm Name:.......f .11.l �.........Q...�..... I County: ySN!.f.�f.'.............................�.�........
Owner Name: ryI�...................................................................... Phone No�..3.... .... �iZY.V1+* �'ce)
Facility Contact:
Mailing Address:. Sy0
Certified Operator ......... i
Location of Farm: f"
........................... I.................. Phone No:...................................................
�.�.......� .............
........ Integrator: ......................................................................................
....... Operator Certification Number.2=03.2..?..............
Latitude 3�• ID, 0°° Longitude Ef�• ©' 07L ,
General
I. Are there any buffers that need maintenance/improvement? ❑ Yes ANo
2. Is any discharge observed from any part of the operation? ❑ Yes 0(,iVo
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 o
3. Is there evidence of past discharge from any pan of the operation? El Yes No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes 'ONO
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes No
maintenance/improvement? TTT���
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes �19 No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes kNo
5/97

Fa,ilityNumber: 7el— 3
81.1
Are there lagoons or storage ponds on which need to be properly closed?
❑ Yes
ry o
Structures (Layoons.11oldini! Ponds. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
�o
. Structure l 9 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:.t»A%...L............IL:A5'tub!�Z
Structure 6
.................. ...................................................................................................................................
Freeboard(ft):�V P..LJ.�....�M.(........................ .........................................................................................................................................
10.
Is seepage observed from any of the structures?
❑ Yes
0No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
6No
12.
Do any of the structures need maintenance/improvement?
❑ Yes
(If any of questions 9-12 was answered yes, and the situation poses
i4No
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
VNo
Waste Application -
14. Is there physical evidence of over application? J6,0 �19' Flt r^J t^S�
❑ Yes
No
(If in excess of MP, orrun off entering waters of the State, notify DWQ)
15.
Crop type(............l..l....+..^./...+..........................................................................................................................................................................
I............
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
O No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
KNo
18.
Does the receiving crop need improvement?
❑ Yes
4 No
19.
Is there a lack of available waste application equipment?
❑ Yes
KNo
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
No
22.
Does record keeping need improvement?
) §Yes
❑ No
For Certified or Permitted Facilities Only
$No
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
IgNo
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
PrNo
[3-No.vitiltitionsordeficiencies:werenotedduringthis'visit.
You:willreceive•iltiftirther
ctirresppndeitce 6 oiit this'visit. ; ::::::: • • ; :::.: • :::
Z2 et
"t
K(«oti�IS
COX
Le,Jlt q� V� fivj�o .a&wndS of7
�,afi A d� sr��, ���zOs N•�a.Q ?� �
7/25/97

Facility Number Date of Inspection
3 J
Time of Inspection 24 hr. (hh.mm)
Total Time (in fraction of hours
Farm Status: ❑ Registered ❑ Applied for Permit (ex:1.25 for 1 hr 15 min)) Spent on Review
K'Certirted ❑ Permitted I or Inspection (includes travel and nrocessin,
❑�N�ot Operational Date Last Operated: .................................
Farm Name: .._s-! .. &.... .......... 5 _.................
............./.Q........ _ 2
Land Owner Name:....... .__.... .. �/LR�]..! f �t..........._......._....__...............
11 �2 ...
Facility Conctact:.5:19.4. 99Y....._..1.*el .................y...... Title:...................
Mailing Address:nae3 /Z�V F Sy /S
Onsite Representative:
Certified Operator:
Location of Farm:
Latitude a a * © _33171 «
County:..kCQ�Ke..Al..9.,trI�....... ,...
t� q�
Phone No:(
PhoneNo: .... _...... _............................................
UAVV:?.�✓:�....................... �-�=.....
.Ll.1..r.�.i....................................... Integrator:..............................................................................
... . .............................. Operator Certification Number:,;c631_ ...............
Longitude F-77-7• [� py <.
1. Are there any buffers that need maintenance/improvement?
2. 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 Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gaVmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/97 maintenance/improvement?
❑ Yes ko
❑ Yes *0
❑ Yes 4No
❑ Yes ONo
❑ Yes ONo
❑ Yes �*o
❑ Yes �No
❑ Yes ANo
Continued on back

Facility Number:........... ..
6.
7
I�Iacility not in compliance with any able setback criteria a in effect at the time of n.
❑ Yes
FNo
7.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
PfNo
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
93 o
Structures
9.
(Lagoons and/or Holding Ponds)
Is storage capacity (freeboard storm storage) less than adequate? 2-
❑
plus 5 p
Yes
to
Freeboard (ft): Strtjture 1 Styture 2 Structure 3 Structure 4 Structure 5
Structure 6
'ti a_1
............................ ............................ ............................ ............................ ............................
............................
10.
Is seepage observed from any of the structures?
❑ Yes
KNo
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
r�o
12.
Do any of the structures need maintenance/improvement?
❑ Yes
ONo
(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 ade to mini um or maximum liquid level markers?
i1'1A�< h2v e_r. IS i!✓ ce// A+IN. M/-'/to�'Lr�-
/R
❑ Yes
❑ No
...- Y.-
Waste Application W, ) I L.— lP c. e,Q U7PI u //d 5 0wo Ac 0' -+
p
14.
Is there physical evidence of over application? /
El Yes
�o
(If in excess of� ,WMP, or runoff entering waters of the State, notify DWQ)
P type k�f� �4Ffl./.....P.f ��
15. Cro e..................................................................
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 4� 2� o
18.
Does the receiving crop need improvement?
❑ Yes
%(�o
19.
Is there a lack of available waste application equipment?
❑ Yes
20.
Does facility require a follow-up visit by same agency?
❑ Yeso
tNo
21.
For
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
Certified Facilities Only
❑ Yeso
22.
Doe�tthe facil itysfail to ave a opy ofthhe Aa imal Waste e Maga�emcenvt Plan readily available?
❑ Yes
❑ No
23.
Were any ¢dditional problems noted wiliA cause noncommpliaence of the Certified AW
❑ Yes
�No
24.
!MP?
Does record keeping need improvement? n%D t 1p S U 4 FLe ce u1_/`1 /)�D / ie
❑Yes
[INo
Ctimments,(referto question #) Explain any YES'answers and/or any, recommendations or an' othef &rnments
/�/�tom//�•..:A_�..,. 0OV/EU,.O: N k✓A K
W %ll be r`Nsf/8%�•Q QAv /�oo,.t it �u �e.Q. 2N� �g�oaN ,'r Alfi
Of ,04
r
Reviewer/Inspector Name rlw%'t e _»�;? { L .. ° ..i' : , ;. M t m'i
c
Reviewer/InspectorSignature: C- Date: 99%O^///
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97