850009_INSPECTIONS_20171231

Date_of Visit: WMMArrival Time: Departure.Time: � County: j6g Region: V1 5
Farm Name: Shot e hl LI Farm Owner Email:
Owner Name: ftQ-Y tL s� r, r e. Phone: 5"I I — % 1 $9
Mailing Address: a �j3I I ROSP a705
Physical Address:
"
Facility Contact: 0.4rK— 5hprt0_ Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:(,U 1 LIng—35,LLI
Integrator:--�
Certification Number:
Certification Number:
Latitude: 3(0 ° $ / oZs tt Longitude: �0 a
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4
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)?
❑ Yes PQ No ❑ NA ❑ NE
❑ Yes ❑ No � NA ❑ NE
Yes �I No , ,�/NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ///�,YYY/�❑ Yes ❑ No I�7 NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ❑ No NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 21412015 Continued

Facility Number: - • Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier: N1,3 0 "POY-X.I—
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2
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
WNo
❑ NA
❑ NE
waste management or closure plan?
!!f!!f```"`'''"'
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
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
[V No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
FW No
❑ 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 Drill ❑ 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
t,<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
❑ Yes
❑ No
17�I NA
❑ NE
acres determination?
7�
17. Does the facility lack adequate acreage for land application? ❑ Yes yXNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes D(I No ❑ NA ❑ NE
Required Records & Documents ./' t� ttt/����,,,���
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? `�G,; kqE; 1 Yes o ❑ 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 0 No ❑ NA ❑ NE
❑ aste Application 50ee kly Freeboard ❑ Waste Analysis ❑ Soil Analysis n "�:�.�ns4ers ❑ Weather Code
❑ ainfall ❑Sto-1,;ng ❑ Crop Yield ❑ Monthly and I" Rainfall In �. r
22. Did the facility fail to install and maintain a rain gauge? gSfl es No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [—]No NA ❑ NE
Page 2 of 3 21412015 Continued

[Facility Number: 7 !j - © 4 1 Date of Inspection: �(
24. Did the facility fail to calibrate waste application equipment as required by the permit? es IXI No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [:] No WA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ® Yes ❑ No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Dij"No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 'A 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
KNo
❑ 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
M 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
WNo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
0No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
r
4b'No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
� No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. '
Use drawings of facility to better explain situations'(use additional pages as necessary).
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al. So1l eSf5 a Cue i r� �ot1 Cot�Le- tee fie' ? NO
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Reviewer/Inspector Nami
Reviewer/1 nspector-S ignt
Page 3 of 3
qLL- CRa�s. G�IEl2o
Phone: 2-7,{%_ ti9�
,pate:, //I �1
21412015

Type of Visit: Acompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: �Wfioutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1=`� Arrival Time: Departure Time:® County: �f�Z
Farm Name: S f� w& 6 L I Fax-M Owner Email:
Owner Name: (• 6xy- S ho r-0,
Mailing Address: a 3 3 1 Po $e-6 A )�_1d • 1
Region:
Phone: fl - S 91- 718 q
1P11
i 9 %0SoZ
Physical Address: 4
Facility Contact: puf 5 Or {� Title: Phone: 0, q6 —
Onsite Representative: Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Certification Number:
Certification Number:
Latitude: 36 ° 19,1 Longitude: 166 i1 /
I wy `d N,
f3rooK eov�
L IrJa $
P-d, /
/�osebu
Swine
Wean to Finish
FI
Design Current
Capacity Pop.
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dai Cow
Wean to Feeder
Non -Layer
I IDai
Calf
Feeder to Finish
Dai Heifer
Farrow to can
Farrow to Feeder
Farrow to Finish
I)t, + Pto' 'r.
La ers
Design
Ca act +
Current
P,o P.
D Cow
Non-Dai
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turke Poults
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
[ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes f;� No ❑ NA ❑ NE
❑ Yes oNo ❑ NA ❑ NE
Page I of 3 21412014 Continued

Facili Number: C
jDate of Inspection: '
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier. WOV 5
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �G
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.) ,y..�
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes I x I No ❑ NA ❑ NE
waste management or closure plan? �C
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 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 �,Ao ❑ 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? ''����77"````
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):
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 ,❑,.5 NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No 17t1 NA ❑ NE
acres determination? T`
17. Does the facility lack adequate acreage for land application? ❑ Yes No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? Yes 777❑] No ❑ NA ❑ NE
Required Records & Documents T'
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. L)�es record keeping need improvement? ❑ Yes NdNo N�" ❑ NE
Waste Applic lion Weekly Freeboard Waste Analysis oil Analysis Efer5 eather Code
F2Rainfall �Slocking Crop Yield �0 Minute Inspections Monthly and V Rainfall Inspections nQviecge v�;�
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [-]No [�(NA ❑ NE
Page 2 of 3 21412014 Continued

Facilit Number: - • jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 No �❑ /NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No A ❑ 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 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes qNo ❑ 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?
❑ Yes [(No
❑ Yes t�No
❑ Yes �(No
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)
3 L Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
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 o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑Yes No ❑ NA ❑ NE
Comments (refer to question•#): Explain anyYES answers`pand/„or anylladditional{recommendations'or any other comments ;A;,
♦,ddi ,rayt
Use drawings of facility3o better explain situations (dse additiooal.pagesse, as,necessary).
{ barn moWW-A 7 62015) Lp J- A
Spi l l wa� raised ? �oZAi S� Iv o e- l`e e,c�t,, ���s2 cue Q` �0A
156 a ujo 5 to 5 P re_ia ? N of `tm
a 51urr Cali broi_A�orn Jue aolb , 5oliddoovtfle- feJ apt's?
Q2016a
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Reviewer/InspectorName--1,1lQ�yr�� Phone: ,�fL�L�
Reviewer/Inspector Signature: tub tL �(ib rO t Date: 01
Page 3 of 3 21412014

for Visit: tD Routine Q Complaint U Follow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: ZO Arrival Time: Departure Time:®Q County: Region: bj 5p—
Farm Name: Sbbmt')i W F&M Owner Email:I
Owner Name: Wry Shore Phone: lw- 7 / 8 9
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: MAI— Y-e !)AME4 �
Certified Operator:
Back-up Operator:
Location of Farm:
Integrator:
Certification Number: 5
Certification Number:
Latitude: 36 11 a S Longitude: Q 0 `f 6
y ,
., L wa
Swine
Wean [o Finish
Design Current
Capacity Pop.
Wet Poultry
La er
Design
Capacity
Current
Pop.
Cattle
DairyCow
Design Current
CapacitVIE, op
01 S 0
Wean to Feeder
]Non -Layer
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D , P,oultr. r
Layers
Design
Ca Act,
Current
P,o
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turke Poults
Other
01
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
PKrNo
❑ 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 DWR)
❑ 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 DWR)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
KNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
CffNo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 21412014 Continued

Facility Number: Date of Inspection:
dO
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
P5No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
(� Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: W s P
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
gNo
❑ 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
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
�o
❑ 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
C.X Vo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[yNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
gNo
❑ 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): C�U'VN
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
XNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ZNo
❑ 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
WNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
10
�i
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[N*No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
XNo
❑ NA
❑ NE
the appropriate box. Co P 4 7
❑WUP ❑Checklists ❑Design ❑Maps ❑ Lease Agreements ❑Other:
21. oes record keeping need i provement? 19 q �I he-etpl9 - Pi Yes [:]No A ❑ NE
aste Applicptioneekly Freeboa ❑Waste Analysis 6�7Soil Analysis s We
Code
Rainfall MStocking Crop Yield 120 Minute Inspections ,®'Monthly and 1" Rainfall Inspections giuiigefiurveY-
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ,WNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No NA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: • I Date of Inspection: s
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
KNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
❑ No NA ❑ NE
the appropriate boxes) 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
No ❑ NA ❑ NE
0
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
,
IV1 No ❑ NA ❑ NE
T'
Other lssues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
XNo ❑ 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
C�R-'1slo ❑ 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
[yNo ❑ 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
JX'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
!!!"- / o ❑ NA ❑ NE
Comments (refer to question #):Explain any YEN answers and/or any additional recommendations or any otheA comments.
Usg*?Mwings of facility to better explain situations (use additional pages as necessary). An" . .
R ao(q Cali braAon 664le,fe.d ? d'"k%(4
?o E ►�v-Aowt 1'—kRAq+ ? JA257 ►kou) bria-rs 4- SPraj
7. SPlb�wa.-� r0.ise-C� ? �,oV1+o�.��-%P_ChSPP�ial15i' O�ra�o`r�in�'o
D
3(31/15 = S.
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 77 6
Date: , z0 s
21412014

(Type of Visit: &Corrlpliance Inspection U Operation Review U Structure Evaluation Q Technical Assistance I
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergencv O Other O Denied Access
Date of Visit: IZ Iy Arrival Time: ' Departure Time: County: STvKG'S
Farm Name: Svtt7vtlt;11 FLtArm Owner Email:
Owner Name: MgnPk -s2 n kyey, n Phone:
Mailing Address: 33 I 1'�'1e-L,j W 4I1'.'J4 l.//��aJv--
Physical Address:
Facility Contact:
IMowV �36vt,
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title: oW Ne-&
Latitude:
Integrator:
Region: 6151Z0
Phone Cy")laci - 352y
J
Certification Number:
Certification Number:
Longitude:
Design Current
Design Current
Design Current
Swine Capacity Pop.
Wet Poultry Capacity Pop.
attle Capacity Pop.
Wean to Finish
I ILayer 1
Dairy Cow 2
Wean to Feeder
]Non -Layer
Dai Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
Design Current
D Cow
Farrow to Feeder
Dt. P,oultr.+ Ca acit P,o ,
Non-Dai
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
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)?
[:]Yes E�No ❑ NA ❑ NE
❑ Yes ❑ No NA ❑ NE
❑ Yes [—]No NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes �❑ o NA ❑ NE
❑
2. Is there evidence of a past discharge from any part of the operation? YesYNo
o 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?
Page I of 3 21412014 Continued

Facili Number: jDate of Inspection: 2
y
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
dNA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: ljf
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): '� L
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
0No
❑ 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
E�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
ENo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ff No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
EZNo
❑ 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 ❑jj Application Outside of Approved Area
12. Crop Type(s) com `3,
,�
ceyt., a lvi ?%.I
13. Soil Type(s): N e
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
YINo
❑ A
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
VA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[(No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
dNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[V/No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check 19Yes ❑ No ❑ NA ❑ NE
the appropriate x.
appropriate
❑Checklists ❑Design Maps 2(LeaseA reements ❑Other:
sr,re� ArQJup
21. Does record keeping need improvement? If yes, check the appropriate box below. ) ❑ Yes o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
© Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Inspections
[DNA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes dNo ❑ NA ❑ NE
Pagel of 21412011 Continued

IFacility Number: S5 - bCl I New
Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:)Yes [2fNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes EyNo ❑ 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 to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
EdNo
❑ NA
❑ NE
❑ Yes
❑ No
gNA
❑ NE
❑ Yes
E3"No
❑ NA
❑ NE
❑ Yes E�No ❑ NA ❑ NE
❑ Yes E�No ❑ NA ❑ NE
❑ Yes
E�No
❑ NA
❑ NE
[—]Yes
[]No
❑ NA
❑ NE
❑ Yes
E , 0
❑ NA
❑ NE
[]Yes
�V1J No
❑ NA
❑ NE
(Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. " I
Use drawings of facility to better explain situations (use additional pages as necessary).
21 - Cora y;tlJ? 10 �fa Si��St r(iJIS!'—'iw�C�
Slvrrt d c 20111 . V
3L - til&Ire v, cofN? a►C -who , Icon.�,,L r}/i>u— v[b�a�� N 7J 1 VPOA-r.� WVP) i3e.,;ws � oAI ;1c t, ba-FW�^� PY 4ril� WT � GSSV+tf�C� 7`jtc
.I o coJ
IN&j " n-,,,, �L J —SIC I �JSlvr.� I
Nvn�t �,,r.— Celt-cil rt>..! -�'� attest fic�dS � - rzF �� s C4vSslk]
{-eWAy, Fa,�, %w, ot� $ dam. ,11 •-7 °s �
til k&j I/dal �jv
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 33(a 14T ( • SZ 00$
Date: 9J
2/4/2011

for Visit: X Routine
Referral
Evaluation
Other 0 Denied Access
Date of Visit: t t/p/ iJ Arrival Time:® Departure Time: County: 516 V �5 Region:
Farm Name: S�1hYP.h t I Var VYj Owner Email:
Owner Name: /h��ore— 1 Phone: W S'q j - i / $q
Mailing Address: 'L3 3 1 ICDSe,�u a ". f W o l n u+- Cove I tN C. 2-l b 5;L
Physical Address:
t?
Facility Contact: NV )A- I(-S 410 r e. Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
-K- — -tu-I - o s L -f
Phone:* 14 S4 I - `/4IV
Integrator:
Certification Number: 14
Certification Number:
Latitude: NO Is a S Longitude: $ D l j 4 (o
wI 8 N.
BrootzCove
. L Wa
s tl
, e-u
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
La er
Design
Capacity
Current
Pop.
Cattle
DairyCow
Design Current
Capacity Pop.
l as -
Wean [o Feeder
Non -La er
DairyCalf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dr, P,oultr.
Layers
Design
C•a racI +
Current
P,o ,
D Cow
Non-Daity
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
I jBeefBroodCow
Other
01 Other
Turkeys
TurkeyPoults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence'of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes gNo ❑ NA ❑ NE
❑ Yes []No
❑ Yes [-]No
❑ Yes ❑ No
❑ Yes No
❑ Yes NI -No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 21412011 Continued

Facili Number: Date of Inspection!
Waste Collection & Treatment mr
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes JVNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: wrjP
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
XNo
❑ 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
XNo
❑ 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
gNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
WNo
❑ 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? WTI
TTTT,"''/
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes lyf 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
f 12. Crop Type(s): 44 � J 1
13.
Soil Type(s):
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�Po
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
VNo
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
XNA
❑ NE
acres determination?
17.
Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
XNo
❑ NA
❑ NE
Required
Records & Documents
19.
Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
X�1;o
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
&No
❑ NA
❑ NE
the appropriate box.
❑ WUP El Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
YRaa
es record keeping need i rovement? If eZtpprvpriate b ❑ Yes *No ❑ NA ❑ NE
�rWe Freeboard Waste Analysis Soil Analysis rt" t� saga ❑WeatherCode
nfall Sto�c(kin ❑Crop Yield [� 120 Minute Inspections Monthly and V Rainfall Inspections [ *Ml1! �SM*@y-
22. Did the facilityy tail install and maintain a rain gauge? ❑ Yes 0�`No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No %NA ❑ NE
Page 2 of 3 21412011 Continued

Facill Number: Date of inspection:
Q
24. Did the facility fail to calibrate waste ap . Lion 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
X NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge
levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
06 No
❑ 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
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes i 7p No ❑ NA ❑ NE
I] Yes XNo ❑ NA ❑ NE
❑ Yes IXI No
❑ Yes !!% No
Yes ❑ No
❑ Yes W No
❑ Yes [A No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional -recommendations . or any othercomments: q', C
Use Itawings of facility to better explain situations (use additional pages as necessary). ;3iEF,
. Solid Spreader ciali bra}ed i n a2013 ? tr,�.2.A-. U-C aOIS,
a 1 • aC` 11,E-1- OO-u ao 13 soi l +,es+ ? 2013 CtrU1 � ml
eS6�4 " eM,,p ap/ 3. T414t a61
3(P 3 F- 3 I>ed Lj� vlt_. l�� ` UP
tA
2013 e&tAk_,� LrJtd ✓ Q) -* &4 olc U' �C I
5/V 4/an13 aq N�/vao Ls.) ss-b . L! 6 n)
Reviewer/Inspector Name:
Reviewer/Inspector Signature
Page 3 of 3
Phone: 'I % 1— 2 $ /
Date: 40a o 3
214011

_A013-
Reason for Visit: A Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access n
Date of Visit: jArrivalTime:, '%(7 Departure Time: County: sl_Region:00
Farm Name: djn() P.�1� Far UN
ICI Owner Name: al r,r y_' �W r-4
Mailing Address: a: j 3 j
Physical Address:
Facility Contact:
�— Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Owner Email:
Phone: J- q l — l 1 O /
C
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
I INon-Layer
IDai
Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dr. P,oultr.
Layers
signiLgurrent
Ca aci
P,o
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turkey 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 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 �No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes XNo
❑ Yes O"No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 21412011 Continued

Facili Number: V - oln • jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? .❑ Yes 1j No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes O No WA ❑ 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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
to
any r r n answers anator any
i
,It ;�
� • 1
< 9M
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes No ❑ NA ❑ NE
❑ Yes9 No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes No IXI NA ❑ NE
Yes A) o ❑ NA ❑ NE
❑ Yes 1 No ❑ NA ❑ NE
❑ Yes I }�No ❑ NA ❑ NE
❑ Yes 7-o ❑ NA ❑ NE
❑ Yes9�zo ❑ NA ❑ NE
ons or any other comments.
Phone: —
Date: d �---
2/4/2011

Facili Number: • Date of inspection: l
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑CCCCCC No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):i'
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ONo ❑ 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 NNo ❑ 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 environments threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes DjNo ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) f
9. Does any part of the waste management system other than the waste structures require ❑ Yes I y�NO ❑ NA ❑ NE
maintenance or improvement? �D\1
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 Flo ❑ 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? ❑ Yes eNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑Yes CSK ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes IkNo ❑ NA ❑ NE
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.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
21. yJoes record keeping nee t€y a ehg
L�,/W plicati Weekly Freeboard Waste Analysis
Rainfal Locking Crop Yield 120 Minute Inspections I
22. td 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 AIo ❑ NA ❑ NE
❑ Yes RNo ❑ NA ❑ NE
❑ Yes yr/No ❑ NA ❑ NE
❑ Yes I XT No ❑ NA ❑ NE
❑Other:
es ❑ No Nth ❑ NE
ansfets Bather Code
rfallInspections EJ-Sf e-Srtry
Yes �K No
❑ Yes [:]No
❑ NA ❑ NE
fNA ❑ NE
21412011 Continued

Type of Visit: (& Compliance Inspection V Operation Review O Structure Evaluation Q Technical Assistance I
Reason for Visit:/' t6 Routine Q Complaint 0 Follow-up 0 Referral 0 Emereencv 0 Other 0 Denied Access
Date of Visit: I / I of y / I I Arrival Time: Departure Time: County: S'6 4e-S Region:
o
Farm Name: "S'hb -to, h I I' FQ cm Owner Email:
Owner Name: mar- L- 1- / Phone: nW 59 1— 7g 19
Mailing Address: oC 3 3 1 ��2��jUGC 2� VV 6L 1 V) U t 1..0 eel, NL .2 70S 2—
Physical Address:
Facility Contact: M 4 ar u— S f IO f e Title:
Onsite Representative: ytY' Ot-rIL_
Certified Operator:
Back-up Operator:
Location of Farm:
`ro'f --I
Phone:
Integrator:
Certification Number:
</ Certification Number: 1 / /
Latitude:_ 3 U 16 ;kCLongitude: �d `t 40
N e 8r0C>V_C6\f,._ vi 0.tts 2d. Onto RASebu
Swine
Wean to Finish
Design Current
Capacity Pop.
Design Current
Wet Poultry Capacity Pop.
I ILayer I
Design Current
Cattle Capacity Pop.
Wean to Feeder
I jNon-Layer IDai
Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
Dr, P.oultr, r Ca aci P,o ,
D Cow
Non-Dai
I Beef Stocker
Gilts
Non -La ersI
jBeef Feeder
BoarsI
I
I
jBeefBroodCow
Other
OtherI
I
Turke s
Turke Poults
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 9No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 14 No
❑ Yes I X No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Pagel of 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 1 Structure 2 Structure 3
Identifier: \kwS - PO n
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): y
❑ 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.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes 5�No ❑ NA ❑ NE
❑ Yes Cj&'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? KYes D No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes I XI 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 C�No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0No ❑ 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, etc.)
❑ PAN ❑ PAN > l0% 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 box.
❑ Yes XNo
❑ Yes XNo
❑ Yes ❑ No
❑ NA
❑ NE
❑ NA
❑ NE
1 ,NA
❑ NE
❑ Yes t No ❑ NA ❑ NE
[:]Yes WNo ❑ NA ❑ NE
❑ Yes C!(No ❑ NA ❑ NE
❑ Yes 'D�No ❑ NA ❑ NE
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other.
21. oes record keeping need i provement? ftrepttiate- [:]Yes No ❑ NA ❑ NE
Waste Applic lion [Weekly Freeboard Waste Analysis E
l Analysis [3Vtretc�i�easftS [Feather Code
dRainfall �tocking [V�Crop Yield ❑ 120 Minute Inspections y and 1" Rainfall Inspections �ey-
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 19NA ❑ NE
Page 2 of 3 21412011 Continued

Facilitv Number: - n Date of Insoectian:
24. Did the facility fail to calibrate waste apWaation 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
4NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [:]Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
No
❑ 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
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 [,'ZNo ❑ NA ❑ NE
[:)Yes `ZNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes �K(No ❑ NA ❑ NE
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 anytother comments -s FY.
�I• . ��1 �o�o.-yes.
a. wuP revised � S lI �ein� rev 55PeCIG_ t
�. o2dlo C,alibrq4�ovNd_041Q4,� I/a61O'— bue is jour\ 6c:-ober- aoO
40/10/ 11 LLD45te. Ar)6j jsi5
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
LSD = I SI6.s_N
S 5 0 _ s a. I las . N
Phone:
Date: ' to Al I I
21412011

Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0. Emergency 0 Other ❑ Denied Access
Date of Visit: W o:t/v 0 Arrival Time: Departure Time: %� County: 51zCS M1Region: u`S�t7
Farm Name: skate k l 1' 'Fa rM rI I- Owner Email:
Owner Name: M o r kpp II IS • `o 1"r ' /I Phone: /D 5_67 - / I Sq
Mailing Address: Z331 hD�u�f Pei. WA AtJ Love- r% C, 2%O.SZ
Physical Address: SaM e-
,� I/
Facility Contact: A �t I�Ar k. 5 dart Title: Phone
Onsite Representative:
Certified Operator: ' 4�
Back-up Operator:
Location of Farm:
14wy ? Nor ., U Brook cove -
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: MO
® [� Longitude:
Dischar¢es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes *o ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA ❑ NE
❑ YesXNo
❑ NA ❑ NE
❑ Yes XNo
❑ NA ❑ NE
Page I of 12128104 Continued

� Facility Number: $ � Q • Date of Inspection OS OG fl •
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 I II Structure 2 Structure 3 Structure 4
Identifier: 4 d
Spillway?:
Designed Freeboard (in):
d
Observed Freeboard (in): _;?_0
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�o ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes )<No ❑ NA ❑ NE
❑ Yes><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? ❑ Yes XNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 13�o ❑ 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 XNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE
El Excessive Ponding El 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) CO r A LiLl Ue— C41r 1
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
I)d'Yes ❑ No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
T❑`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 ANo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes XNo
❑ NA
❑ NE
Comments (refer to question #): Explain any, YES answers and/or any recommendations or any other comments.
1.
Use drawings of facility to better explain situations. (use additional`pages;as necessary):
rA Lr 4 =t,
p tWr4- P
Reviewer/Inspector Name T5jga_ phone: 3G ^ —52Lf
Reviewer/Inspector Signature: Date: OS 06 O
Page 2 of 3 Vr t U 12128104 Continued

r
NA
Facility Number: g, j — 011 0 of Inspection
Required
Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes )No
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ YesXNo
❑ NA
❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21.
Does/ ee ing need improvement?
jj,..,,��
Yes ❑ No
❑ NA
❑ NE
_
l� Waste Application Weekly Freeboard Waste Analy s Soil Analysis
Rainfall Stocking Crop Yield onthly and 1"
Rain Inspections ether
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
XNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes)<No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes ❑ No
gNA
❑ 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 IONA
❑ NE
Other Issues
0'
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes XNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ YcsXNo
[INA
ElNE
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'gNo
❑ 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?
QQ No
�f��Yfff����❑////^^^^Yes/ `
ElNA
❑ NE
33.
Does facility require a follow-up visit by same agency?
o
❑ NA
❑ NE
Additional Comments and/or Drawings:
Z �, 2d�9 Soil 4,51 rZS,4/74 ? ' Ave 1 "A kwJ_ 1, t WIR I 04 rXj t[i's, CPU* k ark; •
%%�� / �/�l V 1 S t o
q L 'jam (il 1� CN
f� IaCt 1a. s C L v;r+
2•
far Q J�tir Z �Irn�� If on.C.orr\„
v Pa tub emu°
rC5
phiJ '� Wop PhN C�yv-e.�� c�.� e-�p r4 3 a r19-5�1 �o r«��d J�cd i,,s�,�pI^�14, 6a _ ��PI�40
fn W�s�e��an. MAy iz� a �df 4 W�ft�e�LAQi z4'10 oot'L �MI'.1I /�A= Sihrcy] ►�=�,3 1�11 �Z, or,e� ia►%� �4
Page
'p �j (� r s I \g 1 4 N v r K r I2/28/04

Division of Water Quality ._
Number Q� Division of Soil and Water Conservation
O Other Agency
Type of Visit
Compliance Inspection
O Operation Review O Structure Evaluation
0 Technical Assistance
Reason for Visit
loutine 0 Complaint
0 Follow up 0 Referral Q Emergency
0 Other ❑ Denied Access
Date of Visit: I (ply Arrival Time: Departure Time: of County: Region: LIDA 26
Farm Name:. nho rt v, h I r, r rn Owner Email:
Owner Name: • me It 1,) 6n —e n , Phone::t LW� S% 1— 7PS
Mailing Address: a1pp3Zl I�o�bLd I�(�1 V\1a hl)-i lJ�U2f N� 0270
Physical Address: S'ai 'e-
o - 3s T
Facility Contact: &Y' Title: Phone No —
Onsite Representative: QI AC V-- S 6 Q0, Integrator: J
�^ rS • CA
Certified Operator: Mb&-ir it Operator Certification Number: by 1 2 /3 1 �g
Back-up Operator: T�_ Back-up Certification Number: 4T
Location of Farm:
Latitude: I AIJ0
Longitude:
I4wy $ Noeth. J&- onto -BroolLoove_ Le-P -6rrb W4}fS
R ift4-+0t1+o f6s�bQ4 " .
Swine
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non-Layet
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)
m
Design Current
Cattle Capacity Population
LA Dairy Cow
El Dairy Calf
❑ Dairy Heifei
❑ 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: F
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 yNNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
0
❑ No
❑ NA
❑ NE
❑ Yes
9No
❑ NA
❑ NE
❑ Yes
>(No
❑ NA
❑ NE
12128104 Continued

.. ITacility Number: S - �9 • Date of Inspection I (n I y..� p'(� •
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: POR
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): J
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes p[J No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes O(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'? ❑ Yes O No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ yes �XN ❑ 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 �Jo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes YSI No ❑ NA ❑ NE
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 l0 lbs ❑ 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)
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
L
9No
/���,❑
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
No
N NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
ZNo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
WNo
❑ NA
❑ NE
IComments (refer to question ft 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):
IReviewer/Inspector Name (S ((jC PLC Phone: 7 1 I I
Reviewer/Inspector Signature: 1.4AA— 0/ & If> 4J Date:
CnMinnrd

Facility Number: — �e of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does r or keeping need implovement? Iyeg ehc�tr[jte apptopriHe �ow. ❑Yes No ❑ NA ❑ NE
W ste Applicaf n B�d/We ly Freeboard — aste Analysis Sod A ]ysis nra5renT arms x—
ainfall locking Crop Yield Monthly and 1" Rain Inspections Bather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0No ❑ 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 0 No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No X NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes X No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes VNo ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? 4 Y s ❑ 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 O No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes No ❑ NA ❑ NE
alqloq /
�� 1 � 1 • �; �� I r � P r
Ir
/
C► '
o�
Page 3 of 3 12128104

Type of Visit T Compliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit � Routine 0 Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: m Arrival Time: r%I •IOA Departure Time: County:.5f0M1eS Region: v
Farm Name: :� bore_ Oil 11 Far rn Owner Email: Q
Owner Name: _ m ary— Ere- Phone:V) Sq I —1 1$ I .
Mailing Address: r�i . 3 3 po5& 6L, A P-d . 1, U_ I n A 02o v\\\e f /v L
Physical Address: 2CLrA e- C — 35 a
Facility Contact: li IL 5 hone Title: Phone No: —qq I V
Onsite Representative:: " Lair V_ S hn r e
Certified Operator: 11'(1Qy- VL. S ho r e
�
Back-up Operator: �w (—IL bD r Lo
Location of Farm:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: ®o U, [�. Longitude: ®°©,
`6 N o ry In .
h•} o (\+o
f • oR�o �j V--Co v2 R6.
Rose
L e_�4 o ni o W0.t5 M.
Design
Current
Design Current
Design Current
Swine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
Dairy Cow $�
❑ Wean to Feeder
❑ Non -Layer
U Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Layers
❑ Non -Dairy
❑ Farrow to Finish
❑ Non -La ers
❑ Beef Stocker
❑ Gilts
❑Beef Feeder
El Pullets
El Boars
❑ Turke s
❑ Beef Brood Cow
nits
Number of Structures:EZI
=U]
❑ 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)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes XNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
%No
❑ NA
❑ NE
❑ Yes
10No
❑ NA
❑ NE
Page Iof3 12128104 Continued

1'
Facility Number: — 41 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?
Structur i` Structure 2 Structure 3 Structure 4
Identifier: �10L_g1P V6nb
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 910
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 tflo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes
pCJ No
❑ NA
❑ NE
❑ Yes
V 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? ❑ Yes *No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ElNA [INE
(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 �Cl No El NA El NE
maintenance or improvement? T`
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes l[SI No ❑ NA ❑ NE
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. 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 ? ❑ 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 [I NA ONE
LY No ❑ NA ❑ NE
XNo ❑ NA ❑ NE
0No [I 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):
3' a",e&tKt _ 766 SPh�
o
e
3. 0—kL C eft aQ
Reviewer/Inspector Name I L Phone: — 01
Reviewer/Inspector Signatur Date:
a
Page 2 of 3 . %. j " — - 12128104 Continued

Facility Number: = • Date of Inspection 5311 q I •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �*o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Lip No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Doe ecord keeping need i rovement? If yes, chec a appropriate box below. ❑ Yes 01No ❑ NA ❑ NE
aste Applic tion Wee Freeboard Waste Analysis Soilalysis n
bd Rainfall Ey stocking Crop Yield n " ^ "" ^ ^'^ ^ IyMonthly and I" Rain Inspections Bather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
J� No
El NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
/❑ No
XNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
XNA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
XNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
IdNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ 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
VNo
❑ 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
PqNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
$No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
ko
❑ NA
❑ NE
Additional Comments and/or Drawings:
al.
aowo a,nd a00-7 sot ( ,, J
CaC(bro'iior� Ave- 5CA-0ber aoo8
&'&� J'W� rl_�/
S11416 $
-#I =
6,V
4"-=
9.
S
'WW31, . Mt : �
Em
Page 3 of 3 1 V 12/2&04

Division of Water Quality
Facility Number Division of Soil and Water Ionservation
Agency
Type of Visit (XCompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit yRoutine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access pp��
Date of Visit: Arrival Time:® Departure Time: a-0-a-57 County: e S Region: bx t-V
Farm Name: M Owner Email:
Owner Name: re Phone: ri 1 � -7 I g l I
Mailing Address: a71 I as�bvd ^ W L� �Q �_ LA c/,� e
Physical Address:
Lq- 35�� yetl 0WI��yCQdE WtC�rA 1
Facility Contact: W Xrr K= nf� Title: Phoo o:
W
Onsite Representative: mar a �- J�ifP Integrator: 112
Certified Operator: 1 I - - Operator Certification
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude:
Design Current D
Swine Capacity Population Wet Poultry Ct
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feedei
Farrow to Finish
Other
❑ Other
Dry Poultry
KOM
;n , Current:,, "Desi
:ity. Population Cattle Capa
❑ 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?
LJ Beef Feeder �.
;. ❑ Beef Brood Cow
Number of Structures I 1 1'
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes LXI No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes 6 No ❑ NA FINE
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?
Structux I Structure 2 Structure 3 Structure 4
Identifier:_
Spillway?: S
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 ® No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes KNo ❑ NA ❑ NE
❑ Yes qNo ❑ 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? ❑ Yes t4No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes $No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ yes *0 ❑ NA ❑ NE
maintenance or improvement?
Waste Ap�Olication
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 Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN> l0%or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ vi/d�enpce�of�Wiipd Dri ❑ Application Outside of Area
12. Crop type(s) . ��.tL�'�,c 1 h" )1 j l..'tl'l/r'y" ('� /i✓/1G
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 ? ❑ 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
NNo ❑NA ONE
❑ No 1A NA ❑ NE
INEl NA ❑ NE
VNo ❑ NA ❑ 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):
Reviewer/InspectorName Q, I Phone:
Reviewer/Inspector Signature:
Date:

Facility Number: — 071 Ste of Inspection I_L_/dS/ 017 •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. Does ecord keeping needdiyimpprovement? a n}�xopl hire box below. ❑ Yes No ❑ NA ❑ NE
��Waste Application Wee Freeboard Waste Analysis Sooil Analysis raas aFs axifuatien
E Rainfall Stocking Crop Yield �a���.: MrMonthly and l" Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes O No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No INA ❑ 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 El No VIA ElNE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes L7(1 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes /❑ No �(NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 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) ��,,tt
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? El Yes No ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes %F�No ❑ NA ❑ NE
Additional Comments and/or Drawines:
al oot= a07 ooa = 9
C l laV1 - aq1 fc 4e4
&,,44(c)v
Page 3 of 3 12128104

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 850009 Facility Status: Active Permit: AWC850009 ❑ Denied Access
Inspection Type: Compliance Inspect on
Inactive or Closed Date:
Reason for Visit: Routine
County: Stokes Region: Winston-Salem
Date of Visit: 01/25/2007 Entry TIme:09:30 AM
Exit Time: 10:25 AM Incident #:
Farm Name: Shorehill Farm
Owner Email:
Owner: Mark F Shore
- Phone: [phone]
Mailing Address: 2331 Rosebud Rd
Walnut Cove NC 27052
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant
Integrator:
Location of Farm:
Latitude: 36°18'25" Longitude: 80°11'46"
Hwy. 8 north to Brookoove Rd. Turn right onto Brookoove Rd. Take left onto Watts Rd. Take right onto Rosebud. Farm between Watts
Rd. & Middlebrook Rd. on Rosebud Rd.
Question Areas:
Discharges & Stream Impacts Waste Collection
& Treatment Waste Application
Records and Documents Other Issues
Certified Operator: Mark F Shore
Operator Certification Number: 21438
Secondary OIC(s):
On -Site Representative(s): Name
Title Phone
On -site representative Mark Shore
Phone:
24 hour contact name Mark Shore
Phone:
Primary Inspector: Me' R sekrock
Phone:
oZSr O
InspectorSignature: Ak,
Date:
Secondary Inspector(s):
Inspection Summary:
21. 2006 soil samples have been sent. Check next visit
Records and operation look great!
1/12/07 waste analyses:
agitated=4.9 lbs. N/1000 gal.
non-agitated=2.7 lbs. N/1000 gal.
Page:1

Permit: AWC850009 Owner - Facility: Mark F Shore
Inspection Date: 01/25/2007 Inspection Type: Compliance Inspection
Regulated Operations
Facility Number: 850009
Reason for Visit: Routine
Design Capacity Current Population
Cattle
Cattle -Milk Cow 125 105
Total Design Capacity: 125
TotalSSLW: 175,000
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
aste Pond WASTE POND 18.00 40.00
Page:2

Permit: AWC850009 Owner- Facility: Mark F Shore Facility Number: 850009
Inspection Data: 01/25/2007 Inspection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yee
No
NA
NE
1. Is any discharge observed from any part of the operation?
❑
■
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
■
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
■
❑
❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
■
❑
❑
2. Is there evidence of a past discharge from any part of the operation?.
❑
■
❑
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a
❑
In
❑
❑
discharge?
Waste Collection, Storage & Treatment
Yes
No
NA
NE
4. Is storage capacity less than adequate?
❑
■
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (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 ❑
■
❑
❑
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? (Not applicable to roofed pits,
❑
In
❑
❑
dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑
■
❑
❑
improvement?
Waste Application
Yes
No
NA
NE
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenanceor
❑
■
❑
❑
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
Permit: AWC850009 Owner • Facility: Mark F Shore
Facility Number: 850009
Inspection Date: 0112512007 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Waste Application
Yes No NA NE
PAN?
❑
Is PAN > 10%/10 Ibs.?
❑
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
Fescue (Hay, Pasture)
Crop Type 2
Corn (Silage)
Crop Type 3
Soybeans
Crop Type 4
Small Grain (Wheat,
Barley, Oats)
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
Yes No NA NE
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ ■ ❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ In ❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Page:4

L
Permit: AWC850009 Owner- Facility: Mark F Shore Facility Number: 850009
Inspection Date: 0112512007 Inspection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents Yes No NA NE
Checklists? ❑
Design? ❑
Maps? ❑
Other? ❑
21. Does record keeping need improvement? ❑ ■ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
❑
Inspections after > 1 inch rainfall & monthly?
❑
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
❑
Stocking?
❑
Annual Certification Form (NPDES only)?
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
■
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
■
❑
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■
❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
■
❑
❑
26. Did the facility fail to have an actively certified operator in charge?
❑
■
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
■
❑
❑
Otherlssues
Yes
No
NA
NE
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
❑
■
❑
❑
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those
❑
■
❑
❑
mortality rates that exceed normal rates?
30. At the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air
❑
■
❑
❑
Quality representative immediately. '
Page:5

Permit: AWC850009 Owner- Facility: Mark F Shore
Facility Number:
850009
Inspection Date: 01/25/2007 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Other Issues
.................................................1..
Yes
No
NA
NE
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
00011
32. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
E
❑
❑
33. Does facility require a follow-up visit by same agency?
❑
■
❑
❑
Page:6

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 850009 Facility Status: Active Permit: AWC850009 ❑ Denied Access
Inspection Type: Comoliance Inspection Inactive or Closed Date:
Reason for Visit: Routine County: Stokes Region: Winston-Salem
Date of Visit: 04/25/2006 Entry Time:09:55 AM Exit Time: 11:10 AM
Farm Name: Shorehill Farm
Owner: Mark F Shore
Incident #:
Owner Email:
Phone: [phone]
Mailing Address: 2331 Rosebud Walnut - NC 27052
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm:
Latitude:36°18'25" Longitude:80'11'46"
Hwy. 8 north to Brookcove Rd. Turn right onto Brookcove Rd. Take left onto Wafts Rd. Take right onto Rosebud. Farm between Watts
Rd. & Middlebrook Rd. on Rosebud Rd.
Question Areas:
Discharges & Stream Impacts Waste Collection & Treatment Waste Application
Records and Documents Other Issues
Certified Operator: Mark F Shore Operator Certification Number: 21438
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
On -site representative Mark Shore Phone:
24 hour contact name Mark Shore Phone:
Primary Inspector: Mlig Rosebro�ckA ••.. ..-- (�� ' Phone: �C
Inspector Slgnature:D�IAW,/YtDDY1.�T.UC/ Date: o`-r o&
Secondary Inspector(a):
Inspection Summary:
7. Need to mow/spray broadleaf weeds on dam to encourage permanent vegetation.
15. Application fields look great.
24. Calibrations completed 4/1/06. Not due again until October 2008.
14. and 28. Need to add fescue hay to WUP.
21.2005 soils ok.
4/19/06 waste analysis= 9.3 lbs. N/1000 gal.
Page:1

•
Permit: AWC850009 Owner - Facility: Mark F Share
o'
Facility Number: 850009
Inspection Data: 04/25/2006 Inspection Typo: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current Population
Cattle
O Cattle - Milk Cow 125 114
Total Design Capacity: 125
Total SSLW: 175,000
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
aste Pond WASTE POND 18.00 120.00
Page:2

Penult: AWC850009 Owner - Facility: Mark F Shore
Inspection Date: 04/25/2006 Inspection Type: Compliance Inspection
Facility Number: 650009
Reason for Visit: Routine
Discharges & 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?
❑
■
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
■
❑
❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
■
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
■
❑
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a
❑
■
❑
❑
discharge?
Waste Collection, Storage & Treatment
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 (I.e./ large trees, severe
❑
■
❑
❑
erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a waste management ❑
■
❑
❑
or closure plan?
7. Do any of the structures need maintenance or improvement?
■
❑
❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits,
❑
■
❑
❑
dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑
■
❑
❑
improvement?
Waste Appk_gJOn
Yes
No
NA
NE
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or.
❑
■
❑
❑
improvement?
11. Is there evidence of incorrect application?
❑
■
❑
❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)? ❑
Page: 3

0 0
Permit: AWC850009 Owner -Facility: Mark F Shore
Inspection Date: 04/25/2006 Inspection Type: Compliance Inspection
Facility Number: 850009
Reason for Visit: Routine
Waste Application
Yes 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'
Com (Silage)
Crop Type 2
Fescue (Hay, Pasture)
Crop Type 3
Small Grain Cover
Crop Type 4
Small Grain (Wheat,
Barley, Oats)
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
■
❑
❑
Cl
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?
❑
Cl
In
❑
17. Does the facility lack adequate acreage for land application?
❑
E
❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
■
❑
❑
Records and Documents
Yea
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?
❑
E
❑
❑
If yes, check the appropriate box below.
WUP?
❑
Page: 4

•
Permit: AWC850009 Owner - Facility: Mark F Shore Facility
Number:
850009
Inspection Date: 04/25/2006 - Inspection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes
No
NA
NE
Checklists?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
❑
■
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
❑
Inspections after > 1 inch rainfall & monthly?
❑
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
❑
Stocking?
❑
Annual Certification Form (NPDES only)?
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
■
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
❑
■
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■
Cl
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
❑
■
❑
26, Did the facility fail to have an actively certified operator in charge?
❑
■
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
Cl
■
Cl
Otherlssues
Yes
No
NA
NE
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
❑
IN
❑
❑
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those
❑
■
❑
Cl
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: AWC850009 Owner - Facility: Mark F Shore
Inspection Date: 04/25/2006 Inspection Type: Compliance Inspection
Other Issues
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
32. Did Reviewerflnspector fail to discuss reviewrinspection with on -site representative?
33. Does facility require a follow-up visit by same agency?
Facility Number: 850009
Reason for Visit: Routine
Yes No NA NE
❑ ■ ❑ ❑
❑ ■ ❑ ❑
❑■❑❑
Page: 6

Type of Visit (%Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit %) Routine O Complaint Q Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit: Lj �s t/ L{�rrival Time: �S Departure Time: County: y���Z Region:WSw
Farm Name: { 5hme h t lll Earn Owner Email: 6
Owner Name: IV\i h Shore- Phone: S 1I —7 �g� F0.rYVy
Mailing Address: aZJq 3 1 �0. � Ud 2d 'yvat n U+ Co Vet NCB a 7 US
Physical Address: ►�/�� Q
Facility Contact: I r lu' 'f 5 kO r� Title: Phone o
Onsite Representative: Mtn 1rL4 S h0 r Integrator: �_—
Certified Operator: I K— V.— S ho f L
Back-up Operator: Roc" S ho r-e—
Location of Farm:
Operator Certification Number: d 1 7 J o
Back-up Certification Number:
Latitude: [o ®, [�, Longitude: EDe m E&
Nw y 04 N. R+ o r }o roo I -Co v 1-' . Le V+ o n+o w a S "�d.
-
Rk- oit-o Rosebud M -
Design Current
Design CUpren
UDesign Current
Swine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
[E]Wean to Finish
10 Layer I
DairV Cow
❑ Wean to Feeder
10
Non -Layer
Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ DryCow
❑ Non -Dairy
El Beef Stocker
❑ Farrow to Feeder
❑
El Farrow Farrow to Finish
❑ Gilts
❑ Non -Layers
El Pullets
❑Beef Feeder
El Boars
❑ Beef Brood Cow
❑ Turkeys
Other
El Turkey Poults
Number of Structures:
❑ Other
❑ 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)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes KNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes o
❑ YesJ�No
12128104
❑ NA ❑ NE
❑ NA ❑ NE
❑NA El NE
Continued
V

V
Facility Number: = • Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes No
❑ NA
❑ NE
.i Structure I S cture 2 Structure 3 Structure 4
Structure 5
Structure 6
D Identifier: PO
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): a
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes o
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
�I(
❑ Yes I](I No
[I NA
El 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? 1�7ip/ Yes El [I NA ❑ 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 ❑ Yes �I No El NA ❑ NE
maintenance or improvement? A
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes VNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes XNo ElNA ❑ NE
ElExcessive Ponding [IHydraulic Overload ElFrozen Ground ElHeavy 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
No ❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement?
IN
❑ Yes
No ❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑ No JXNA ❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
No ❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
No [I 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):"
Reviewer/InspectorName I 3 rock —Phone: 1 Sa$
Reviewer/Inspector Signatu e: Date: S d
Page 2 of 3 1 r I' t" 12128104 Continued

Facility Number: — Date of Inspection •
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. Does re�rd keeping need improvement? Ifyesrc atcbvx betow. ❑Yes LYl No ❑ NA ❑ NE
❑ Waste Application ❑ V�kekly Freeboard ❑ W to Analysis ❑ Soial is Q'tld35lE�T3aS1$rS' ❑
ainfall ❑ �ing ElCrop it leld 0-F3A ^� ^� ___.. i^^ ❑ Monthly and V Rain Inspections eather Code
22.
Did the facility fait 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
[I No
L14A
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
XNo
ElNA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
ElYes
[I No
�VA
El NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
LJQ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
I No
E�Y'(A
❑ NE
Other Issues
`y/
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
El Yes
Ir71 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
ElNA
❑ 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
jNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�(No
❑ NA
❑ NE
kdditional Comments and/or Drawings:
q/Iq Iote LkDt R.3 lbs. N /,«,© j
U ,
oc&i,&uat�-j 14v&t�j
\ 9NJA1
Page 3 of 3 12128104

❑ Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 850009 Facility Status: Active Permit: AWC850009 ❑ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Reason for Visit: Routine County: Stokes Reglon: Winston-Salem
Date of Visit: 0210912005 Entry Time: 09,15 AM Exit Time: 11:00 AM
Farm Name: Shorehill Farm Owner Email:
Owner: Mark F Shore Phone: [phone]
Mailing Address: 2331 Rosebud Rd Walnut Cove NC 27052
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm:
Latitude: 36.31 Longitude: -80.2
Hwy. 8 north to Brookcove Rd. Turn right onto Brookcove Rd. Take left onto Watts Rd. Take right onto Rosebud. Farm between
Watts Rd. & Middlebrook Rd. on Rosebud Rd.
Question Areas:
Discharges & Stream Impacts 0 Waste Collection & Treatment 0 Waste Application
® Records and Documents ® Other Issues
Certified Operator: Mark F Shore
Secondary OIC(s):
Operator Certification Number: 21438
On -Site Representative(s): Name Title Phone
24 hour contact name Mark Shore Phone: [phone]
On -site representative Mark Shore Phone: [phone]
Primary Inspector: Mary M Rosebrock Phone:[phone]
Ext.383
Secondary Inspector(s):
Phone:
Phone:
Inspection Summary:
3. Lots of leachale is coming from the lower silo. Is not entering surface water today.
18. Operator has two honey wagons that he shares with his brother, Tom Shore (3500 and 3000 gal.).
19. DWO to send another copy of the CDC and permit.
21. No soil analysis results for 2004. May need to resample due to postal problems. Check next visit (DSWC). "'After inspection,
operator sent DWQ the test results for 2004 samples. MMR 3/1/05
28. May want to add fescue hay to CAWMP.
2/3/05 waste analyses: LSD 001=3.3 lbs. N/1000 gal. and 4.0 Ibs N/1000 gal.
Page: 1

NCDA&CS Agronomic Division Phone: [phone] Web Site: www.ncagr.com/agronomi/
--Report No: 20480
Grower:
O� le S
Shore Mark
2331 Rosebud Rd.
Copies To:
�
I� . i. (�"i. 4V � t_ .• r
' f R
3lY:a..
.: y
Al,,
Test Report
Walnut Cove, NC 27052
r
FEB ' 6 zQQS
oil
Farm:q2?!t
Regional Office
2/8/2005
SERVING N.C. RESIDENTS FOR OVER 60 YEARS
Stokes County
Agronomist Comments
A -- 3, $, 12
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year Lime
N P205 K20
Mg Cu
Zn
B
Mn See Note
001
1st Crop: Corn,Silage 5T
180-220 0-20 0
.0 0
0
.0
0 3 •
2nd Crop: Corn,Silage 0
180-220 0-20 0
0 0
0
.0
0 3
Test Results
Soil Class HM%
W/V CEC BS% Ac pH P-I K-1 Ca% Mg%
Mn-I Mn-AI(1)Mn-AI(2) Zn-I
Zn-Al
Cu-,
S-I SS-/ NO3-N NH4-N Na
MIN 0.6
1.15 9.8 82.0 1.8 5.8 79 142 52.0 22.0
354 229 229 590
590
229
45 0.1
Field Information
`
Applied Lime
Recommendations -
Sample No. Last Crop
Mo Yr TIA
Crop or Year Lime
N P205 K20
Mg Cu
Zn
B
Mn See Note
002
1st Crop: Com,Silage 0
180-220 0-20 50-70
0 0
0
.0
pH$ 3
2nd Crop: Corn,Silage 0
180-220 0-20 50-70
0 0
0
.0
pH$ 3
Test Results
Soil Class HM%
W/V CEC BS% Ac pH P-I K-I Ca% Mg%
Mn-I Mn-AI(1)Mn-AI(2) Zn-1
Zn-AI
Cu-1
S-1 SS -I NO3-N NH4-N Na
MIN 0.36
1.21 9.1 91.0 0.8 6.5 74 73 61.0 27.0
608 374 374 575
575
177
30 0.1
Field'Information
J". ,
Applied Lime
..Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year Lime
N P205 K20
Mg Cu
Zn
B
Mn See Nole •
003
1st Crop: Fes/OG/rim,M 0
120-200 0 0
0 0
0
.0
0 12
2nd Crop: Fes/OG/rim,M 0
120-200 0 0
0 0
0
.0
0 12
Test Results
Soil Class HM%
W/V CEC BS% Ac pH P-I K-I Ca% Mg%
Mn-I Mn-AI(1)Mn-Al(2) Zn-1
Zn-AI
Cu-1
S-1 SS -I NO3-N NH4-N Na
MIN 0.56
1.10 10.3 84.0 1.6 6.1 82 123 55.0 24.0
158 110 110 677
677
522
56 0.2
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year Lime
N P205 K20
Mg Cu
Zn
B
Mn See Note
004
1st Crop: Corn,Silage 0
180-220 0-20 0-20
0 0
0
.0
0 3
2nd Crop: Corn,Silage 0
180-220 0-20 0-20
0 0
0
.0
0 3
Test Results
Soil Class HM%
W/V CEC BS% Ac pH P-1 K-I Ca% Mg%
Mn-I Mn-AI(1)Mn-02) Zn-I
Zn-Al
Cu"
S-I SS -I NO3-N NII4-N Na
MIN 0.51
1.16 10.0 84.0 1.6 5.9 79 117 50 24.0
157 113 113 444
444
176
46 0.2

NCDA&CS Agronomic Division Phone: [phone] Web Site: www.ncagr.com/agronomi/ Grower:
Shore, Mark
Report No:
20480
Pg.2
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205 K20
Mg Cu
Zn
B
Mn
See Note
005
1st Crop: Corn,Silage
0
180-220 0-20 0
0 0
0
.0
0
3
2nd Crop: Corn,Silage
0
180-220 0-20 0
0 0
0
.0
0
3
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-I Mn-Al(1)Mn-Al(2)
Zn-I
Zn-AI
Cu-1
S-I
SS -I
NO3-N NH4-N
Na
MIN 0.51 1.15
10.5 87.0
1.4 6.1 73 157
55.0 25.0
302 197 197
563
563
457
50
0.2
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205 K20
Mg Cu
Zn
B
Mn
See Note
006
1st Crop: Soybeans
.7T
0 110-130 0
0 0
0
0
3
2nd Crop: Soybeans
0
0 110-130 0
0 0
0
0
3
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-I Mn-AI(1)Mn-AI(2)
Zn-I
Zn-AI
Cu-I
S-I
SS -I
NO3-N NH4-
a
MIN 0.32 1.09
6.5 77.0
15 5.5 9 114
45.0 24.0 .
249 159 159
227
227
182
124
0.2
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205 K20
Mg Cu
Zn
B
Mn
See Note
007
1st Crop: Corn,Silage
0
180-220 20-40 0
0 0
0
.0
0
3
2nd Crop: Corn,Silage
0
180-220 20-40 0
0 0
0
.0
0
3
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-I Mn-AI(1)Mn-AI(2)
Zn-I
Zn-AI
Cu-I
S-I
SS-1
NO3-N NH4-N
Na
MIN 0.51 1.14
10.9 88.0
1.3 6.1 56 141
54.0 27.0
120 87 87
509
509
328
64
0.2
Field Information
Applied Lime
'Recommendations .
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205 K20
Mg Cu
Zn
B
Mn
See Note
008
1st Crop: Fes/OG/Pim,M
0
120-200 50-70 0
0 0
0
.0
0
12
2nd Crop: Fes/OG/l'im,M
0
120-200 50-70 0
0 0
0
.0
0
12
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-1 Mn-AI(1)Mn-AI(2)
Zn-1
Zn-AI
Cu-I
S-I
SS -I
NO3-N AWN
Na
MIN 0.41 1.03
9.9 88.0
1.2 6.3 33 153
54.0 26.0
131 91 91
368
368
298
46
0.2
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205 K20
Mg Cu
Zn
B
Mn
See Note
009
1st Crop: Fes/OG/Pim,M
0
120-200 30-50 0
0 0
0
.0
0
-
12
2nd Crop: Fes/OG/fim,M
0
120-200 30-50 0
0 0
0
.0
0
12
Test Results
Soa Class HM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-I Mn-AI(1)Mn-AI(2)
Zn-1
Zn-AI
Cu-1
S-I
SS-1
NO3-N MI4-N
Na
MIN 0.41 1.13
10.2 91.0
0.9 6.4 40 154
58.0 26.0
187 123 123
433
433
288
46
0.2

NCDA&CS Agronomic Division Phone: [phone] Web Site: www.ncagr.com/agronomi/
Grower:
Shore, Mark
Report No:
20480
Pg-3
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205
K20
Mg Cu
Zn
B
Mn
See Note
010
1st Crop: Fes/OG/rim,M
0
120-200 10-30
0
0 0
0
.0
0
12
2nd Crop: Fes/OG/rim,M
0
120-200 10-30
0
0 0
0
.0
0
12
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-1 K-1
Ca% Mg%
Mn-I Mn-AI(1)Mn-A1(2)
Zn-I
Zn-Al
Cu-I
S-1
SS-1
NO3-N NH4-N
No
MIN 0.36 1.13
9.6 89.0
1.1 6.4 53 146
54.0 27.0
204 133
133
357
357
265
42
0.2
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205
K20
Mg Cu
Zn
B
Mn
See Note
Oil
1st Crop: Fes/OG/rim,M
0
120-200 0
0
0 0
0
.0
0
12
2nd Crop: Fes/OG/rim,M
0
120-200 0
0
0 0
0
.0
0
12
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-1 Mn-AI(1)Mn-AI(2)
Zn-I
Zn-Al
Cu-I
S-1
SS-1
NO3-N NH4-
a
MIN 0.71 1.14
10.3 90.0
1.0 6.3 71 131
58.0 26.0
180 120
120
559
559
371
50
0.2
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205
K20
Mg Cu
Zn
B
Mn
See Note
012
1st Crop: Fes/OG/rim,M
4T
120-200 60-80
0
0 0
0
.0
0
12
2nd Crop: Fes/OG/rim,M
0
120-200 60-80
0
0 0
0
.0
0
12
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-I Mn-Al(1)Mn-A1(2)
Zn-1
Zn-AI
Cu-1
S-I
SS -I
NO3-N NH4-N
Na
MIN 0.41 1.11
8.7 83.0
1.5 5.8 27 88
54.0 24.0
96 75
75
407
407
184
56
0.1
Field Information
Applied Lime
'Recommendations -
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205
K20
Mg Cu
Zn
B
Mn
Tree Note
013
Ist Crop: Fes/OG/1'im,M
3T
120-200 0
0
0 0
0
.0
_ 0
12
2nd Crop: Fes/OG/rim,M
0
120-200 0
0
0 0
0
.0
0
12
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-I Mn-Al(1)Mn-AI(2)
Zn-I
Zn-AI
Cu-1
S-I
SS-1
NO3-N NH4-N
Na
MIN 0.51 1.19
9.7 81.0
1.8 5.9 96 121
54.0 22.0
272 180
180
461
461
221
41
0.2
.. ._.- <.
'_ ' '°
Applied Lime
. sue.. . - �.-
Recommendations
Field Information :
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205
K20
Mg Cu
Zn
B
Mn
See Note
014
1st Crop: Fes/OG/rim,,M
.6T
120-200 0
0
0 0
0
.0
0
12
2nd Crop: Fes/OG/rim,M
0
120-200 0
0
0 0
0
.0
0
12
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-1 K-I
Ca% Mg%
Mn-I Ma-AI(1)Mn-AI(2)
Zn-1
Zn-AI
Cu-I
S-1
SS-1
NO3-N NH4-N
Na
MIN 0.56 1.12
11.7 79.0
2.4 5.8 87 98
52.0 23.0
137 99
99
543.
543
258
98
03

NCDA&CS Agronomic Division Phone: [phone] web Site: www.neagr.com/agronomi/ Grower: Shore, Mark
Report No:
20480
Pg.4
Field Information
Applied Lime I
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205 K20
Mg Cu
Zn
B
Mn
See Note
015
1st Crop: Fes/OG/Pim,M
0
120-200 50-70 0-20
0 0
0
.0
0
12
2nd Crop: Fes/OG/Pim,M
0
120-200 50-70 0-20
0 0
0
.0
0
12
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-I Mn-Al(1)Mn-AI(2) Zn-I
Zn-Al
Ca-1
S-I
SS-1
NO3-N NH4-N
Na
MIN 0.22 1.26
6.7 88.0
0.8 6.3 34 84
51.0 30.0
143 98 98 126
126
125
37
0.2
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205 K20
Mg Cu
Zn
B
Mn
See Note
016
1st Crop: Fes/OG/Pim,M
0
120-200 0-20 0
0 0
0
.0
pH$
12
2nd Crop: Fes/OG/rim,M
0
120-200 0-20 0
0 0
0
.0
pH$
12
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-I Mn-AI(1)Mn-AI(2) Zn-I
Zn-AI
Cu-I
S-I
SS-1
NO3-N AW4-
a
MIN 027 1.20
9.4 89.0
1.0 6.5 57 107
53.0 31.0
158 104 104 183
183
128
45
0.2
.Field Information
Applied Lime
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205 K20
Mg Cu
Zn
B
Mn
See Note
017
1st Crop: Com,Silage
0
180-220 60-80 40-60
0 0
0
.0
pH$
3
2nd Crop: Soybeans
0
0 50-70 0-20
0 0
0
pH$
3
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-I Mn-AI(1)Mn-Al(2) Zn-1
Zn-Al
Cu-I
S-I
SS-1
NO3 N NH4-N
Na
MIN 0.32 1.19
8.7 93.0
0.6 6.6 33 78
59.0 30.0
1037 630 623 353
353
185
36
0.2
Field.Information
Applied Lime
Recommendations';
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205 K20
Mg Cu
Zn
B
Mn
See Note
018
1st Crop: Corn,Silage
0
180-220 30-50 70-90
0 0
0
.0
0
3
2nd Crop: Small Grains
0
80-100 20-40 20-40
0 0
0
.0
0
3
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-I Mn-AI(1)Mn-AI(2) Zn-I
Zn-AI
Ca-1
S-I
SS -I
NO3 N NHa-N
Na
MIN 0.32 1.20
7.7 83.0
1.3 6.0 48 57
54.0 25.0
680 425 418 249
249
108
43
0.2
Field Information
Applied Lune
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205 K20
Mg Cu
Zn
B
Mn
See Note
019
1st Crop: Small Grains
0
80-100 20-40 10-30
0 0
0
.0
0
3
2nd Crop: Soybeans
0
0 20-40 10-30
0 0
0
0
3
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-1 Mn-Al(1)Mn-AI(2) Zn-1
Zn-AI
Cu-1
S-1
SS -I
NO3-N NH4-N
Na
MIN 0.32 1.18
8.1 85.0
1.2 6.2 48 66
55.0 26.0
532 326 326 249
249
123
38
02

NCDAKS Agronomic Division Phone: [phone] Web Site: www.ncagr.com/agronomi/
Grower:
Shore, Mark
Report No:
20480
Pg 5
Field Information
Applied Lime
Recommendations
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P2O5
K20
Mg Cu
Zn
B
Mn
See Note
020
1st Crop: Fes/OG/rini,M
0
120-200 0
0-20
0 0
0
.0
0
12
2nd Crop: Fes/OG/rim,M
0
120-200 0
0-20
0 0
0
.0
0
12
Test Results
Soil Class HM% W/V
CEC BS%
Ac pH P-1 K-1
Ca% Mg%
Mn-1 Mn-AI(1)Mn-AI(2)
Zn-1
Zn-AI
Cu-1
S-I SS-1
NO3-N AW4-N
Na
MIN 0.32 1.27
7.6 78.0
1.7 6.0 95 85
50.0 22.0
151 108
108
217
217
158
33
02
Field Information
Applied Lime
Recommendations .
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205
K20
Mg Cu
Zn
B
Mn
See Note
021
1st Crop: Fes/OG/rim,M
0
120-200 0
0
0 0
0
.0
0
12
2nd Crop: Fes/OG/rim,M
0
120-200 0
0
0 0
0
.0
0
12
Test Results
Ah
Soil Class HM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-1 Mn-AI(1)Mn-AI(2)
Zn-I
Zn-AZ
Cu-I
S-1 SS -I
NO3-N NH4-
a
MIN 0.46 1.15
9.6 83.0
1.6 5.9 91 122
53.0 24.0
142 104
104
380
380
171
42
0.2
Field Information
Applied Lime
Recommendations ,
Sample No. Last Crop
Mo Yr T/A
Crop or Year
Lime
N P205
K20
Mg Cu
Zn
B
Mn
See Note
022
1st Crop: Fes/OG/rim,M
7T
120-200 0
0
0 0
0
.0
0
12
2nd Crop: Fes/OG/rim,M
0
120-200 0
0
0 0
0
.0
0
12
Test Results
Soil Class IIM% W/V
CEC BS%
Ac pH P-I K-I
Ca% Mg%
Mn-I Mn-AI(1)Mn-AI(2)
Zn-I
Zn-AI
Cu-1
S-1 SS-1
NO3-N NH4-N
Na
MIN 0.6 1.11
10.6 81.0
2.0 5.7 110 129
51.0 24.0
179 124
124
475
475
191
46
0.2
•

;P't
❑ Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 850009 Facility Status: Active Permit: AWC850009 ❑ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Reason for Visit: Routine County: Stokes Region: Winston-Salem
Date of Visit: 02/09/2005 Entry Time: 09,15 AM Exit Time: 11:00 AM
Farm Name: Shorehill Farm Owner Email:
Owner: Mark F Shore Phone: [phone]
Mailing Address: 2331 Rosebud Rd Walnut Cove NC 27052
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm:
Latitude: 36.31 Longitude: -80.2
Hwy. 8 north to Brookoove Rd. Turn right onto Brookcove Rd. Take left onto Watts Rd. Take right onto Rosebud. Farm between
Watts Rd. & Middlebrook Rd. on Rosebud Rd.
Question Areas:
0 Discharges & Stream Impacts 0 Waste Collection & Treatment Waste Application
0 Records and Documents Other Issues
Certified Operator: Mark F Shore
Secondary OIC(s):
Operator Certification Number: 21438
On -Site Representative(s): Name Title Phone
24 hour contact name Mark Shore Phone: [phone]
On -site representative Mark Shore ^ Phone: [phone]
1.
Primary Inspector: MaryM Rosebrock
Secondary Inspector(s):
Phone: [phone]
Ext.383
Phone:
Phone:
Inspection Summary:
3. Lots of leachate is coming from the lower silo. Is not entering surface water today.
18. Operator has two honey wagons that he shares with his brother, Tom Shore (3500 and 3000 gal.).
19. DWQ to send another copy of the COC and permit.
21, No soil analysis results for 2004. May need to resample due to postal problems. Check next visit (DSWC).
28. May want to add fescue hay to CAWMP.
2/3/05 waste analyses: LSD 001=3.3 lbs. N/1000 gal. and 4.0 Ibs N/1000 gal.
Page: 1

permit: AWC850009 Owner- Facility: Mark F Shore
Facility Number: 850009
Inspection Date: 02/09/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current Population
Cattle
A Cattle -Milk Cow 125 120
Total Design Capacity: 125
Total SSLW: 175,000
Page: 2

Permit: AWC850009 Owner - Facility: Mark F Shore Facility Number: 850009
Inspection Date: 02/09/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste Structures
Num Desc
Close Dt Start Dt Designed Freeboard Observed Freeboard
WASTE PO I Waste Pond I 1 1 18.00 1 49.00
Page: 3

Permit: AWC850009 Owner -Facility: Mark FShore
Facility Number: 850009
Inspection Date: 02/09/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Dischemes & Stream Impacts Vac No NA NF
1, Is any discharge observed from any part of the operation? ❑ 0 ❑ ❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
N
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
0
❑
❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
E
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
N
❑
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a discharge?
❑
yae
0
No
❑
NA
❑
NE
Warta Collection_ Storage & Treatmpnt
4. Is storage capacity less than adequate?
❑
N
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Led 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?
❑
0
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks
❑
E
❑
❑
and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑
.
❑
❑
improvement?
Waste AnnliCation
vas
No
NA
NE
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement?
❑
❑
❑
❑
11. Is them evidence of incorrect application?
❑
❑
❑
❑
If yes, check the appropriate box below
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10 h/10 lbs.?
❑
Total P2O5?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drill?
❑
Application outside of application area?
❑
Crop Type 1
Corn (Silage)
Crop Type 2
Small Grain (Wheat,
Barley, Oats)
Crop Type 3
Soybeans
Crop Type 4
Crop Type 5
Page: 4

1_`
Permit: AWC850009 Owner • Facility: Mark F Shore
Facility Number:
850009
Inspection Date: 02/09/2005 Inspection Type: Compliance Inspection
Reason for Visit:
Routine
Vae No
NA NF
Waste Anplinatian
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)? ❑
0
❑
❑
15. Does the receiving crop and/or land application site need Improvement?
❑
s
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
❑
N
❑
❑
17. Does the facility lack adequate acreage for land application?
❑
0
❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
Vas
0
No
❑
NA
❑
NF
R nnrds and Documents
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?
N
❑
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
0
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
Inspections after> 1 inch rainfall & monthly?
Waste Analysis?
❑
Annual soil analysis?
0
Crop yields?
0
Stocking?
❑
Annual Certification Form (NPDES only)?
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
IN
❑
❑
23. If selected, did the facility fail to Install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
❑
E
❑
24. Did the facility fail to calibrate waste application equipment as required by the pemtit?
❑
0
❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
❑
0
❑
26. Did the facility fall to have an actively certified operator in charge?
❑
■
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑
0
❑
Page: 5

PF
0
Permit: AWC850009
Owner • Facility: Mark F Shore
Facility Number: 850009
Inspection Date: 02/09/2005 Inspection Type: Compliance Inspection Reason for Visit:
Routine
Other Issue:y
Vac No
NA
NF
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
❑ 0
❑
❑
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those mortality
❑ 0
❑
❑
rates that exceed normal rates?
30. At the time of the inspection did the facility pose an air quality cencem? If yes, contact a regional Air Quality
❑ No
❑
representative immediately.
31, Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
32. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
33. Does facility require a follow-up visit by same agency?
Page: 6

Division of Water uaiity •
agility Number = •Division of Soil and Water Conservation
Agency
Type of Visit C mpHance 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: �T iArri+va+l Time: [ Departure Time: County:S� Region: �5 (W
Farm Name: ��t1/AA11n�,�V1{III FQ)hM o Owner Email: C
Owner Name: 1 V lt�`^' l`— S i' IV I1(,,L (� Phone: 3 3 J ' -1 F
Mailing Address: a 3 3 ( Rg5e. (Oua 1`(.t' •., W e I in UA 'Nkje / N � a 7 os
Physical Address: �Sa� q 1 Facility Contact: A V J < t° Title: �— Phone No: 4 ` _ 4Q
f
Onsite Representative:i�n.,) �i Integrator:
Certified Operator: auc L Vi&o-L Operator Certification Number: (
Back-up Operator: - Back-up Certification Number:
Location of Farm: Latitude: IMo 1111 of Longitude: ®o I // l
NO, fwy �6 of tbl t �Qt�covrP, KQ y f n I'idht I.e t onto 1+�1a- W.F-+. Onto (aS�IQ �¢I.
Design Current Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population C the Capacity Population
❑ Layer I I IC&DairyCow JjQs
❑ Non -La er Dair Calf
Other
❑ Other
Discharges & Stream Impacts
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
U Beef Feeder
❑ Beef Brood Co I
Number of Structures:
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?
❑ 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)?
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
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
yes
'�• No
ElNA
❑ NE
other than from a discharge? --
12/28/04
Continued

Facility Number: — • Date of Inspection I oNV /n.Sf •
Waste Collection & Treatment T�
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
ta. If yes, is waste level into the structural freeboard?
Identifier:
ructute I/"� Structure 2 Structure 3 Structure 4
e. t9l\
Spillway?:
2 5
Designed Freeboard (in):
Ia
Observed Freeboard (in):
31+ 13(
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 I No
Structure 5
❑NA El NE
❑ NA ❑ NE
Structure 6
❑ Yes )(No ❑ NA ❑ NE
❑ Yes �(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? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ICI 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/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes �j1 No El NA [I NE
El Excessive Ponding El Hydraulic Overload El 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 Drifl ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes N No ❑ NA ❑ NE
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[--] Yes ❑ No
17. Does the facility lack adequate acreage for land application? ❑ Yes No
18. Is there a lack of properly operating waste application equipment? Cl Yes No
Tiao hp n� WGU ,ao(35do 3oos to 44A-m
I,otS 4Ieo c ho�#0-e. rum low+zr 51 to . Ts rot -U*q-ny\j
Wai -St however- .
El NA ❑NE
MNA ❑ NE
!❑NA ❑NE
❑ NA ❑ NE
Reviewer/Inspector Name C!`;
.& "N 1'` . Phone: �% — 11161
!
Reviewer/Inspector Signature: fi j_AjP_ 14ed JA .t7 A Date:

Facility Number: — Dief Inspection •
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
kYes ❑ No
❑ Yes �No
❑ NA ❑ NE
❑NA ❑NE
21. /!Does record keeping need imp ro ment? If yes, check the appropriat box below. Yes ❑ Now� fj /D NA ❑ NE
y ❑ Waste Applicati n ❑ Weekly Freeboard ❑ Waste Analysis Soil
Analysis Waste Transfers ❑ AifJhCertification
XRainf. It ❑ eking KCrop Yield ❑ 1z0 jvJinute Inspeclio M'Onthly and I" Rain Inspections Xeather Code
DAt�� Tt )'` 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 Z NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Wo
!❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
XNA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
XNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
';<NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
XJo
❑ 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
TTT"`
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'o
(�
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
N� o
❑ NA
❑ NE
Additional Comments and/or Drawings:
00a,nop _Pj a00 ev d ��
L Sw c
wC Vint ? so ?
Wastf- u\4 si 58 -5 l ys N 100O 8 31 0
ai3�osDoo6s.0 �Io qIz810a �luoo -0Ne-

0
/ o -fir / y r-.
eA�lam-
w� IS-0 PAN

nical Assistance Site Visit
Natural Resources Conservation Service
Soil and Water Conservation District
Other...
Facility Number 85 - Date: 7/13/04 Time: 13:25 Time On Farm: = WSRO
Farm Name Shorehill Farm
County Stokes Phone: [phone]
Mailing Address 2331 Rosebud Rd Walnut Cove, NC 27052
Onsite
Representative Mark & Rocky Shore Integrator
Type Of Visit Purpose Of Visit
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ No Animals -Date Last Operated:
❑ Operating below threshold
❑ Swine ❑ Poultry ® Cattle ❑ Horse
Design Current
Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
[]Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
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
® Dairy1
❑ Non -Dairy
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
® Dairy1
❑ Non -Dairy
® Dairy1
❑ Non -Dairy
125
100
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes ® no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached ❑ yes ® no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees, ❑ yes ® no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes ®no
requiring DWQ notification?
5. Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes ®no
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes ®no
Structurel Structure 2 Structure 3 Structure 4 Structure 5
Identifier WSP
Level (Inches) 18 71
CROP TYPES Fescue -graze j jAlfalfa Corn, Sila e
SPRAYFIELD
SOIL TYPES MnS MnC MoB2
PcB2
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

•
4
Facility Number 85 - 9 Date:
7/13/04
PARAMETER
p No assistance provided/requested
❑ 8.
Waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9.
Waste spill contained on site
10.
Level in structural freeboard
25. Waste Plan Revision or Amendment
El
Cl
❑ 11.
Level in storm storage
26. Waste Plan Conditional Amendment
❑
❑
27. Review or Evaluate Waste Plan w/producer
❑
❑
[112.
❑ 13.
Waste structure integrity compromised
Waste
28. Forms Need (list in comment section)
❑
structure needs maintenance
29. Missing Components (lust In comments)
❑
❑
❑ 14.
Over application >= 10% & 10 lbs.
❑
❑
❑ 15.
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
❑
❑
Reaulatory Referrals
41. Site evaluation
❑
❑
❑ Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
Irrigation designlinstallation
❑
❑
ElOther...
43. 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 evaluationlrecommendations
❑
❑
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 85 - 0 Date: 7/13/04
COMMENTS:
Waste analysis: 5-20-04 LSD 3.2 Ibs.N/1000 gals. B
Soil samples dated 2-05-04 looked good.
/ provided Mr. Shore with some slurry 11 forms.
TECHNICAL SPECIALIST lRocky Durham
SIGNATURE
Date Entered: 7/14/04 Entered By: lRocky Durham
3 03/10/03

vision of Water Quality
vision of Soil and Water Conservation
O Other Agency
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 85 9 Uate of Visit: 1/29/2004 Time: 0930
O Not Operational O Below Threshold
0 Permitted 0 Certified 0 Conditionally Certified 17 Registered Date Last Operated or Above Threshold : .............
Farm Name: S.ha[ehill.F.atm...................................................................... CountyStRkt..................................... YY,S.R-Q...--.
Owner Name: Jriark_._._._._._._._._._ Sbora._.-•-•-•-•-•-•-•-•-•---•-•-• Phone No: 33k S9]:7189-(Garrol----------•-•-•---._..
Mailing Address: 233J..Rosebud.13d................................................................................ WAIjjILt..CQ.y.C...NC ............................................... 27.052,..............
Facility Contact: MarkRtorr.......................................Title:............................................... Phone No: 33G.591,49J..&JR)...........
Onsite Representative: D7 tl7k,'lO1lROR1CY,STIRC¢-•_•_--,--_•_•_•---•-•-•_•-- Integrator: ----------------------•---•---•-•-•-------..
Certified Operator: M.alrk.F.................................. SjXQr.0 ................................................. Operator Certification Number: 2J.438.............................
Location of Farm:
Hwy. 8 north to Brookcove Rd. Turn right onto Brookcove Rd. Take left onto Watts Rd. Take right onto Rosebud. Farm A
3etween Watts Rd. & Middlebrook Rd. on Rosebud Rd.
[]Swine []Poultry ®Cattle []Horse Latitude 36 • 18 25 °a Longitude F 80 •F 11 46
Design Current
Swine Capacity Population
❑ Wean to*Feeder❑
Feeder tFarrow
tFarrow
tFarrow
t
❑ Gilts
❑ Boars
Number of Lagoons
1
Discharees & Stream Impacts
Design Current Design Current
Poultry Capacity Population Cattle Ca acity Po wlation
❑ Layer I I Dairy 11251 92
❑ Non -Layer 1 1 airy
❑ Other
Total Design Capacity 125
Total SSLW 1 1
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 Bow 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 19 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 SlmClure 3 Structure 4 Structure 5 Structure 6
Identifier:.....WAstaP_pad.--...---------------------- ----------------------..--..-..-.-...-.--..-.......-.......--.-......-.--.-.
Freeboard (inches): 46
12112103 Continued

Facility Number: 85-9 • Date of Inspection 1/29/2004
5. Are there any immediate threats to the integrity of any of the structures observed'? (ie/ trees severe erosion, ❑ Yes • ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ® No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
® No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
® No
elevation markings?
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
®No
11.
Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
®No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12.
Crop type Fescue (Graze) Fescue (Hay) Corn (Silage & Grain)
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
®No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No
15.
Does the receiving crop need improvement?
❑ Yes
®No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
®No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below []Yes ® No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional []Yes ® No
Air Quality representative immediately.
e is efer o o Qxplain an. a and or an. eomme dation o an, o e o m t.
win s of ar ette a plain ituu ' n , di Iona a es a ne ary : ❑Field Copy ®Final Notes
attle have not been moved back to the area below the new crossing. OK for now.
1230peratorvsent
in 2003 soil samples in December 2003 and is awaiting results. Once received, operator is to send resultsto DWQ.
Waste leel in the storage pond got above the maximum liquid mark a couple of times last year. Need to contact DWQ as required
ypermit.
11/26/03 waste analysis: 4.9 lbs. N/1000 gal.
WSRO received copy of the soil report dated 215104. Per .soils lab, they were at least 6 weeks behind on analyzing .so it it probable
that the sample was taken in 2003. Metals, pH, P, looks ok. MR
Reviewer/Inspector Name Meliss osebrock n.
Reviewer/Inspector Signature: it ki Date: Ut
12112103 1 1 I Continued

Facility Number: 85-9 1)) A Inspection 1/29/2004 •
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 31-35)
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
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes OR No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
12112103

Facility Number 85 9 Date of visit: 1 1/29/2004 1 Time: 0930
Not Operational Q Below'1'hreshold
i� Permitted N Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold : .............
Farm Name: Shaechill.Fat'm...................................................................... County: StakRS..................................... l!',SR.Q......
Owner Name: Mgrk................... S.bOl£._.-._.-.-.-.-.-._--------_-- Phone No: 336.:S9]_]189.(Lerml----------------------
Mailing Address: 33i.RRSRbtld.Rtt................................................................................ f1a110.ad.. D.Y.S...(............................................... Z70.52 ..............
Facility Contact-. Mar1[S igra........................................title:............................................... Phone No: 33b.59 49.1b.(.H)...........
Onsite Representative: Mar1iROSlRDf1(Y,S6lttt¢............................ Integrator:
Certified Operator: 5 ark.F................................. SLXQjr.c ................................................. Operator Certification Number: 2J.438.............................
Location of Farm:
Hwy. 8 north to Brookcove Rd. Turn right onto Brookcove Rd. Take left onto Watts Rd. Take right onto Rosebud. Farm
3etween Watts Rd. & Middlebrook Rd. on Rosebud Rd.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • 18 25 Longitude F 80 Is 01-1,F46
Design Current Design Current Design 6 rrenen[ i
Swine t' Ga aci P,o ulation poultry Ca aci P,o ulation Cattle Ca aci P,o ulationr .:
❑ Wean to Feeder ❑Layer ®Dairy 125 92
❑ Feeder to Finish ❑Non -Layer ❑Non-DairyI 1,ii
❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity 125
❑ Gilts
❑ Boars Tofal SSLW 175,000
m;.
Number. of Lagoons 0 Solid Trans L—i--J
Sol
Trans
Poffids
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ®No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ®No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway ❑ Yes ®No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:..._WAstaPm&............................................................................................... .......................................
Freeboard (inches): 46
12112103 9a7 � / Continued

Facility Number: 85-9 • Date of Inspection 1 1/29/2004
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees severe erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ®No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ®No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ®No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ®No
❑ Excessive Pending ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type Fescue (Graze) Fescue (Hay) Corn (Silage & Grain)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement? []Yes ® No
16. Is there a lack of adequate waste application equipment? ❑ Yes ® No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ® No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ® No
Air Quality representative immediately.
7Operator
te on E lain eny a ado eny ecomme anon t a . eo IN ette ex leln tua ion . d Clone pe a as neces ry : ❑ Field Copy ® Final Notes
not been moved back to the area below the new crossing. OK for now.
nt in 2003 soil samples in December 2003 and is awaiting results. Once received, operator is to send results to DWQ.
l in the storage pond got above the maximum liquid mark a couple of times last year, Need to contact DWQ as required
11/26/03 waste analysis: 4.9 lbs. N/1000 gal.
r
Reviewer/Inspector Name jMeIijjq Rosebrock _
Reviewer/Inspector Signature: Date:
12112/nt Continued

Facility Number: 85-9 1) 0' Inspection 1/29/2004 •
Required
Records & Documents
21.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
®No
22.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
®No
23.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
® No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ® Soil Sampling
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
®No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
® Yes
❑ No
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
28.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
® No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

Division of Water Quality
• Division of Soil and Water Conservation
� Other Agency
Type of Visit yyC,,((ompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ?j Routine Q Complaint O Follow up O Emergency Notification 0 Other ❑ Denied Access
Facility Number
Dateof Visit I_11.7-'1101-ITime:
Permitted 0 Certified - , Of Conditionally Certified [3 Registered
Farm Name: S1I lore k'j ` Farm
Owner Name: ���,,(� k— �hl7re—
Mailing Address:
Facility Contact: r
Onsite Representative:
Certified Operator: _
Location of Farm:
Date Last Operated Tor(Above Threshold:
County: `.5 6 �`-4< d
Phone No: _15-! I • / 7I
21n u+ dove -lit LX- a_ _5 2—
Phone No: "% / e•
Integrator: (��
Operator Certification Number: ,1`��
rn (`I
❑ swine iJ
Poultry
[Cattle ❑Horse LatitudeC3�p,
®�
®�� Longitude EM, ®"
Design, ,.Current =tea;
Design
Current ,
Design Current
Swine
Capacity Population Poultry
Capacity
Population Cattle =.
Capacity Po uletioh
❑ Wean to Feeder
1LJ Layer I
I Dairy
❑ Feeder to Finish
ILJ Non -Layer I
I No-Dairy
+.
li ❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
a_
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
❑soars
I��
t.
Total SS LW
(% , 000
U Subsurface Drains Present
Discharges & Stream Impacts
1, Is any discharge observed from any part of the operation? ❑ Yes i[J 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 f',,���, No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 1&I No
Waste Collection & Treatment / ,
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway ❑ Yes IN No
btru.c4urc IP Structure 2 Structure 3 Structure 4 Structure 5 Structure
Identifier: w
Freeboard (inches):
05103101 Continued

rk�shrL
Facility Number: —
by Cow I. co rnm
Date of Inspection
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 46 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?
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do anv stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Aonlication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑
12. Crop type
❑ Yes A No
❑ Yes XNo
❑ Yes �No
❑ Yes .�JNo
❑ Yes N'Ivo
❑ Yes jVNo
o
Overload ElYes
13.
Do the receiv ng crops differ with those designated in the Certified Animal Waste Management Plan (CAN+MP)?
❑ Yes
XNo
14.
a) Does the facility lack adequate acreage for land application?
❑ YesJNo
No
b) Does the facility need a wettable acre determination?
❑YesNo
c) This facility is pended for a wettable acre determination?
❑ Yes
15.
Does the receiving crop need improvement?
❑ Yes
No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
WNo
Renuired
17.
Records S Documents
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ✓• vj ✓-'
❑ 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?
❑Yes10
22.
Fail to notif}' regional DWQ of emergency situations as required by General Permit?
(ic- discharge, freeboard problems. over application)
(Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
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
0
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
Field Coov ❑ Final Notes
' i F—�ul. vG" �) ��'I�_A��_/�. ��.�C�! (�.�'�[J�hJL,t` >•yf�r/''} ,,� �--�C..�t �X J/
40
Reviewer/Inspector Name
Date:
05103101 ` ` L' ' Cors6nued
p
I � I WO_3 �j �E�S I �/ /I o vo

Facility Number. — Date of Inspection •
Odor Lum
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?
Iq . a063 5o t Is 7 w-a.,4-1k
I � • Lk)o s+6 re c-o rd 5 I n ?
❑ Yes o
❑ Yes No
G i 6
3C�ro55l r e- �.I-+-CA o� C,re2 . C`c$, '��
05103101

Assistance Site Visit
• Diln of Soil and Water Conservational
O Mal Resources Conservation Service
O Soil and Water Conservation District
O Other...
Facility Number 1 85 - I Date: l27/03 Time: 13:15 Time On Farm: = WSRO
Farm Name Shorehill Farm County Stokes Phone: [phone]
Mailing Address 2331 Rosebud Rd Walnut Cove, NC 27052
Onsite
Representative Mark Shore Integrator
Operation Review
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ No Animals -Date Last Operated:
❑ Operating below threshold
❑ Swine ❑ Poultry ® Cattle ❑ Horse
Design Current
Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
[]Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
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
Caoacitv Population
❑ Layer
❑ Non -Layer
R Dairy
❑ Non -Dairy
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
Caoacitv Population
❑ Layer
❑ Non -Layer
R Dairy
❑ Non -Dairy
R Dairy
❑ Non -Dairy
125
90
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands?
❑ yes
® no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached
❑ yes
Ono
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees,
❑ yes
®no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding
❑ yes
®no
requiring DWQ notification?
5. Is there evidence of improper dead animal disposal that poses a threat to the environment
❑ yes
®no
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes ® no
Structural Structure 2 Structure 3 Structure 4 Structure 5
Identifier WSP
Level (Inches) 12
CROP TYPES Fescue -graze kffaffa I ��
SPRAYFIELD
SOIL TYPES MnB MnC MoB2
PcB2
7. What type of technical assistance does.the onsite representative feel is needed? (list in comment section)
03/10/03

A
Facility Number 85 9 Date:
8/27/03
PARAMETER
Q 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)
❑ 13.
Waste structure needs maintenance
29. Missing Components (list in comments)
❑
❑
❑ 14.
Over application >= 10% & 10 lbs.
❑
❑
[115.
Over application < 10% or < 10 lbs.
30.21-1.0200 recertification
❑ 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
❑
❑
[123. 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 DVVQ 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 work/evaluation
❑
❑
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
❑
❑
G
58. Crop/forage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

Facility Number Date: 8/27/03
COMMENTS:
Waste analysis: 4-30-03 LSD 6.9 Ibs.N/1000 gals. B, 12-27-02 LSD 7.1 Ibs.N/1000 gals. B
Soil analysis dated 8-01-02
Records look good.
" Remember to get your 2003 soil samples.
Need to pump the waste pond as soon as possible. Waste is nearing the maximum liquid level.
TECHNICAL SPECIALIST lRocky Durham
SIGNATURE
Date Entered: 9/2/03
Entered By: [Rocky Durham
03/10/03

Facility Number 85 9 Date of visit' S/31/2002 Time: a900
0 Not Operational O Below Threshold
E3 Permitted 0 Certified E3 Conditionally Certified E3 Registered Date Last Operated or Above Threshold:
FarmName: S1nt'e6if1.E'arm...............................:.....:::...:..:............................................... County: SIQUA................................................. IYS.RO........
OwnerName: Mark ....................................... Shtat:e............. :.............................................. Phone No: 336e591-.7.1$9....................................::.::.:................
Mailing Address: 2333..1R.mbmd.Iid................................:::.............................................W..alnul.G.ove....N.C.............................................. 2.7952 .............
FacilityContact: N.1arkSGRAe...................................................Title:................................................................ Phone No:...................................................
Onsite Representative: Ma rk..aadAWky-Sbm........................................................ Integrator:....................................................................... ...............
Certified Operator:Mark.l.................................. sjwre ................................................ Operator Certification Number: 21438.............................
Location of Farm:
Hwy. 8 north to Brookcove Rd. Turn right onto Brookcove Rd. Take left onto Watts Rd. Take right onto Rosebud. Farm
between Watts Rd. & Middlebrook Rd. on Rosebud Rd.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • 18 25 '• Longitude F 80 • 11 46
Discharges R Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes ®No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
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 storm storage) less than adequate? ® Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
® No
® Yes
❑ No
❑ Yes
® No
Structure fi
Identifier: ..... Y✓.aste.P.ond.....
Freeboard (inches): 22
05103101 Continued

Facility Number: 85-9 • Date of Inspection 5/31/2002 r
a
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ tree evere erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ® Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes IN No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Fescue (Graze) Fescue (Hay) Corn (Silage & Grain) Soybeans
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ® Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents I I .
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ® Yes ❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
❑ Field Copy ® Final Notes
Section of creek below the new crossing is still impacted due to streambank and streambed erosion caused by cattle traffic. This area
to be logged within the next year and a new fence will be installed on this section to keep cattle out of stream. Other fencing has been
7. Continue efforts to control groundhogstand burrow holes in dam.
13. and 25. Most recent CAWMP doeVist fescue hay, corn, and soybeans as crop options for waste application. Need to add these to
CAWMP as soon as possible since operator is applying waste to these crops.
19. Waste analysis was not within 60 days of Fall 2001 waste applications (approx. 100 days). _
25. Ask SWCD about vear round application of waste onto fescue. _ _. I
Reviewer/Inspector Name iMelis Rosebrock
Reviewer/Inspector Signature:op 11A&
Date:
05103101 Continued

Facility Number: 85-9 D0f Inspection 5/31/2002 •
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 pernament/temporary cover? ❑ Yes ❑ No
Have technical specialist add "rendering" to mortality checklist.
Fescue PAN on operator's records (SLR-2 PAN=150) doesn't match CAWMP (PAN=75). Need to revise CAWMP as soon as
draw beneath the waste storage pond is now buffered and cattle fenced out. Other fencing has been repaired. Cattle crossing,
and heifer area looks great!
05103101

9A�
Type of Visit 0) Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit k Routine 0 Complaint O Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit Time:
�[ Not Operational Below Threshold
Permitted 0 Certified 1_0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: 7�Shore. 1III_ rnrm County: 576l1—� t pCJ
Owner Name: M a r It s h e. —Phone No:
,, \ 3360 e s91° I l 6
Mailing Address: P_3, 1 I t ` os ud a )a l n u e6 U� . /V � a 7 d S12 �_
Facility Contact: VAQM,r I& SI' ff_e Title: Phone No:
Onsite Representative: �.tn� I OLV 1L" Shoy-'e— Integrator: O•
Certified Operator:l06--cF— b•{Le-- Operator Certification Number: I 3 0
Location of Farm:
(Co 0 Y'O-
y-7 no 4& brocUoJe ke rljhi-.
10566U4
L e on f o wa
ly
6ntn
-
❑ swine ❑ Poultry
Cattle ❑ Horse Latitude ®� �'"
Longitude
Design Current .Design
Current
Design``' Current
Swine
Capacity Population Poultr Capacity
Population C the
Ca aci Po ulation
❑ Wean to Feeder
❑ La er
PS Dairy
)
❑ Feeder to Finish
1 10 Non -Layer I
ILI Non -Dairy
❑ Farrow to Wean
-
- -
❑ Farrow to Feeder
❑ Other
,.
❑ Farrow to Finish
Total Design Capacity
I RT
❑ Gilts
❑ Boars
Total SSLW
�s
Ponds /Solid Traps
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. if discharge is observed, what is the estimated Flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or op tential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway
Struc ore Structure 2 Structure 3 Structure 4 Structure 5
Identifier. �A
Freeboard (inches):
05103101
❑ Yes A
No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
[:]No
❑ Yes
WNo
0 Yes
❑ No
❑ Yes IXI No
Structure 6 7�
Continued

Facility Number: — • Date of Inspection •
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, El�/ Yes I19 No
seepage, etc.) / `
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes 0KNo
(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? 1�6 Yes ,,,...yy:1 No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes I� No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level /��,,,//
elevation markings? El Yes LYNo
Waste ARplication /!!�``
10. Are there any buffers that need maintenance/improvement? ❑ Yes No,
11. Is there evidence of over pplication? ❑ Excessive P ailing ❑ PAAN,w, [:1 Hydraulic Overload ❑ Yes No
12. Crop type -
13. Do the receiving crops differ with those designated in the CcrtirA Animal Waste Management Pl (CAWMP)? Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes tNob) Does the facility need a wettable acre determination? ElYesoc) This facility is pended for a wettable acre determination?❑ Yes15. Does the receiving crop need improvement? ❑ Yeso
16. Is there a lack of adequate waste application equipment? ❑ Yes
Reauired
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
Sym
[9-m)
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
- -90
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
�o
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
o
24.
Does facility require a follow-up visit by same agency?
❑ Yes
to
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
9Yes
❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments,(refer to que,don 11,: Explain any AYES answers any irge me d`etions�or any"o her comments.. A
Hof better,explain 'pages
Use drawings facility to situations.jusereddihonal as necessary). Field Copy ❑Final Notes
..,. .. t
_ f"'__I �Nt,cc""( c-ClZ✓ l"r/�.e-� ����-Z�-(Y L.CJ dGCJ�-� v(.Ci V.y-ve%�
V)
01'a
ZA, li
Lp
Reviewer/Inspector Name
k V 4 1 4 JZ & Date:
Reviewer/Inspector Signature: LA11
05103101 1 1 4 1 Continued

Facility Number: S— Date of Inspection ISM0I— •
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?
05103101
❑ Yes XNo
❑ Yes ONo
❑ Yes No
❑ Yes gNo
'Y7^-*es
a

I Facility Number 85 9 � Date of Visit: 6/27/2001 Time: 12:45
rO Not Operational O Below Threshold
0 Permitted ® Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: S.horch!I1..F.a[ut............................................................................................. County: S.tukgs................................................ W..SRQ........
'236
Owner Name: Hark; ....................................... ShQxe..Q............./.,................n............................. Phone No:A.1ll-S.41..7.189..............................
...............
..............
MailingAddress:'til1- 6'... 3........!`-!!�.&d.....F...al.................. ..............................................2.7.05.2..............
Facility Contact:
Title:
Phone No:
OnsiteRepresentative: lMAr.k.S.hare................................................................................. Integrator:......................................................................................
Certified Operator:Mark...................................... Sh.Qxe ................................................ Operator Certification Number: j1.4.3.d.............................
Location of Farm:
Hwy. 8 north to Brookcove. Take left onto Brookcove. Take left onto Watts. Take right onto Rosebud. Farm between
Watts Rd. & Middlebrook Rd. on Rosebud Rd. in Rosebud Community.
[]Swine ❑ Poultry ®Cattle []Horse Latitude 36 • 18 25 Longitude 80 • 11 f 46
Design Current
Swine Canacitv Ponulation
❑
Wean to Feeder
❑
Feeder to Finish
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Number of Lagoons
Holding Ponds / Solid Traps
Design Current Design Current
Poultry Capacity Population Cattle Ca acity Po ulation
❑ Layer ® Dairy 125 120
❑ Non -Layer 10 Non -Dairy
❑ Other
Total Design Capacity
Discharees & 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?
Total SSLW
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated Flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
125
175,000
ipray Field Area
❑ Yes ®No
❑ Yes ®No
❑ Yes ®No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes ® No
❑ Yes ® No
Structure 6
Identifier:
Freeboard (inches): 40
05103101
Continued

Facility Number: 85-9 Date of Inspection 6/27/2001
r„=
5.
Are there any immediate threats to the in rity of any of the structures observed? (ie/ trees, vere erosion,
❑ Yes
®No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
®No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
® Yes
❑ No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
® No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
®No
11.
Is there evidence of over application? ❑ Excessive Pending , ❑ PAN ❑ Hydraulic Overload
❑ Yes
®No
12.
Crop type Fescue (Graze)
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
®No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
®No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
®No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
®No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
®No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
®No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
®No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
®No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
®No
10 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
Use drawings of facility to better'ezplaiu'sII ituatiotts. (use' additional pages as necessary): I`Y Fleld Copy ❑ Final Notes '
8. Has not fixed fence by creek. Has put in 2 stock trails. Still Needs to put in heifer lot improvements. Plan to cut/control weeds on
buffer area around feed area. Need to fill in and seed waterways.
26. DWQ put improvements on timetable and will be back to check.
Reviewer/Inspector Name Margaret O'Keefe
Reviewer/Inspector Signature: Date:
05103101 Continued

racilitySNumber: 85-9 1 D*I Inspection F6—/2-7/-2001-1 •
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
AdditionaLCo an ors rawings v'� iry �i u�typlll!P<<<'�ofq�!Ih!I�f�1��III�dIit6'VliN��I;NI?NII�'dd II"IMV'itildl!6I�4Rhl'911h1�l�?i�i'1�In11'��d'R'o6idp;l-ii Ifn'��i46�11u4$ltldiiti47��l1Fh;6
7F1D111111
7F1D111111

Facility Number 85 9 Daic of Visit: 2/27/2001 Time: 1300
Not Operational 0 Below Threshold
❑ Permitted ® Certified 13 Conditionally Certified E3 Registered Dale Last Operated or Above Threshold: .........................
Farm Name: Shart:hillYat'm.............................................................................................. County: Sf,Ao................................................. .W.SIiO.......
OwnerName: Mark ...................................... shp.rg .......................................................... Phone No: 3.36-591.7189 ..........................................................
MailingAddress: 23M.RoAcbutl..t d............................................................................... WA1xttAt,.C9.xg...NC .............................................. Z7.9.52 ..............
FacilityContact: Mar:k.Sh.Q.r:.....................................................Title:................................................................ Phone No:....................................................
OnsileRepresentative: HarkShork................................................................................ Integrator:.......................................................................................
Certified Operator:Uqrbc...................................... Shat:t:................................................. Operator Certification Number: 21438............................
Location of Farm:
Hwy. 8 north to Brookcove. Take left onto Brookcove. Take left onto Watts. Take right onto Rosebud. Farm between
Watts Rd. & Middlebrook Rd. on Rosebud Rd. in Rosebud Community.
❑ -111
Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • 18 25 Longitude 80 • 11 46
=
Des
f en
flea
' k
-meL
Ca atcit
P,o ut Lion
q
ac ty Ro tattoo
Ca Zec Po 20 nf'
❑ Feeder
0 Larer
Y
®Da ry
❑ Feeder to Finish
❑Non -Layer
❑Non -Dairy
❑ Farrow to Wean
?-
❑Other
❑ Farrow to Feeder
c:
Total Design Capacity 125 t
❑ Farrow to Finish
❑ Gilts
Total S$I
❑ Boars
Nub®r of Lagoons =0 M ❑ Subsurface Drains Present ❑ Lagoon Area JOSprayFieldArea
Holding Ponds /Solid Traps 1�=❑ No Liyuid Waste Management System
Discharges & Stream Facts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
it. 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
O1/01/01 Continued

Facility Number: 85-9 • Date of Inspection 2/27/2001
Waste Collection & Treatment
4.
Is storage capacity (freeboard plus storm storage) less than adequate? N Spillway
❑ Yes
N No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:..... \Y.rite.oAmd................................................................................................................ ......................................................................
Freeboard(inches): ............... 24 ............... .................................... ................................... .................................... .................................... ....................................
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe 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?
N Yes
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
N Yes
❑ No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
N No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
N Yes
❑ No
11.
Is there evidence of over application? ❑ Excessive Ponding N PAN ❑ Hydraulic Overload
N Yes
❑ No
12.
Crop type Fescue (Graze)
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
N No
c) This facility is pended for a wettable acre determination?
❑ Yes
N No
15.
Does the receiving crop need improvement?
❑ Yes
N No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
N No
17.
Are rock outcrops present?
❑ Yes
❑ No
18.
Is there a water supply well within 250 feet of the sprayfield boundary? ❑ Unknown
❑ Yes
❑ No
❑ On -site ❑ Off -site
Repaired
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
N No
21.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
N Yes
❑ No
22.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
N No
23.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
N No
24.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
N No
25.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
N No
26.
Does facility require a follow-up visit by same agency?
❑ Yes
N No
27. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes N No
Odor Issues
28. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below N Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
29. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes N No
01/01/01 Continued

Facility Number: 85-9c of Inspection 2/27/2001 •
30. Is there any evidence of wind drift during 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: 2/27/2001
❑ 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.
•om cents r,efe to quest o xplain an Y 'S answe s and/or an ecommendations or an other comments.
Us rawings of facility to Beintte exp aituatio use additional pages a nee ar ❑Field Copy ®Final Notes
3. and 8. Getting some silage juice run-off from pile of rotten silage into drain which goes to creek. Need to spread this pile as soon as
T
possible.
3. and 10. No buffer at heifer lot. Fence needs to be re -installed as there is some soil erosion occurring from pasture to creek. Breeding
heifer lot has some waste/soil erosion, owner plans to put in stock trails.
5. Continue efforts to control groundhogs on dam. A couple of small holes were noted.
11. Operator applied over his WUP PAN value of 75 lbs. on T-2745 F-5 (approx. 140 was applied). He misread and used wrong table i
UP
19. Several fields on 2000 soil analysis report zinc at 700 or greater.
December applications were outside of application window by two weeks.
3497 F-4c in WUP reads "tobacco." Field had soybeans in it last year and it will be in corn this year. WUP needs to be revised.
26. Not a problem or concern on this fans.
Reviewer/Inspector Name Melissa RosebFock
Reviewer/Inspector Signatur Date: (�
r
01/01/01

PM
Type of Visit ACompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit x Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
-71
Facility Number Date of Visit: oZ 6 Time. Ob
O Not O erational O Below Threshold
0 Permitted [Certified 13 Conditionally Certified 0 Registered pate Last Operated
+ or Above Threshold: .........................
FarmName:....6.kQra...1ill........ Q I.Ni.................................................. county: ...._w /./ Q. .(%`....................p............................
Owner Name: ............. Shore
(11.:..S:J•.r1.r.....7.I. F.) ......................
......� I�,.............�.t••Y-�r�................................................ Phone Nu:...
FacilityContact:.........t"•1.i�..►.r..if.-...........5... 6.Cle........ Title: ................................................................ Phone No:...................................................
�1 Y (� ...4 j n.u.........C.O.Velt",(�,)C......a. ................ .�.
Mailing Address:.....U. 1.......... Q.,4..ec.6J..�,!. ............. '................... ..... .
Onsite Representative:....... �L.....
�56..c.e............................................... Integrator: .........................................................................Q..�..........
Certified Operator;,,,,,,,,, a:�!'.1...-_F... ho„r,Qi.... Operator Certification Number:,,_..,,,,!
......................
Location of Farm:
orrf0
[]Swine ❑ Poultry ❑ Cattle []Horse Latitude ®' ®</ « Longitude ®' =' [W«
t
Swine
Current
Pnmilntinn PoUItrV I
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons r
Holding Ponds / Solid Traps
Current
❑ Other
TWA Design Capacity
Total SSLW
Present JJ❑ Lagoon Area
viscnarees w atream tmpac[s
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made"?
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated Flow in galhnin?
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 storm storage) less than adequate? lA Spillway
\� �Strru}y,,tur,Pj Str2 Structurc 3 T' Structur5 e 4 Structurc
Identifier: .Y.0 a...1.Q.�...............ucturc ......................................................................................................................
Freeboard (inches):
5100
❑ Yes [ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes $No
XYes ❑ No
❑ Yes �No
Structure 6
Continued on back

Facility umber: — C1 I Ak Date of Inspection Printed on: 1/9/2001
5. Are there any immediate threats to thegrity 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? El 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 14No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes i`p'tj No
Waste Application
10. Are there any buffers that need maintenance/improvement? Yes ❑ No
It. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes /gNo
12. Crop type O
13. Do the receiving crops differ with tole des' nated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes O'No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes jXNo
b) Does the facility need a wettable acre determination? ❑ Yes No
c) This facility is pended for a wettable acre determination? ❑ Yes gNo
15. Does the receiving crop need improvement? ❑ Yes Wo
16. Is there a lack of adequate waste application equipment? ❑ Yes gNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? 1p
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 7 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 ONO
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? lyyyyJJJJ
(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 P ;No
iyq Yigl �ipgs:oj• dgfjcpepcies •were ppte�• djlri�g thjs;vpsjt;• y 0:wiA ecgiye ljo fu�til�r. •: •: • .
•comes 6idence.aboti[this:visit::::::: ::::::: :::::::::::•:•:•:•::•:•:•:•:
Comments (refer to question #); Explain any YES answers and/orany iecommendatioas of any ot6ei eomtnenta '
Use"drawings;of facility to better explain situations. (useadditionePpages as riecessary):' r," I .(9) •'""
9-I�. 1���Fe r a h21 jod +1 e,re.� . F•e4ce, nee�lS 6 be re- ns5
15 56A4- S lIPvo516n 6 c C u rrip.�% brarn S�u� d
Cf'eZOL� gr � tea) ��iye� �0� h0,5 $6fV�\t, WO-S fe)501) '�-�''0510
S b �n�e II Or eoh 1 �raunothn�s� d� P � �` tls,
SM A.I, l �10� es w �2, ✓10 i-e d
Reviewer/Inspector Name t, s=I)�
Reviewer/Inspector Signature. Date: % 0 cNa

Facility Number: — to of Inspection I I Printed on: 1/9/2001
Odor Issues ON
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 j 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 Wlo
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?
A44109impl,"mmentsan or rawings:
No4-es : ei r� l of Jen ud �e d e' Ve- e-lau+el n Q a -dam ; -
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e 64ta
w U Pa

�ivision of Water Quality '•
ivision of Soil and Water Conservation
0 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 85 y D:de of Visit: 9/20/2000 Time: 14:45 Printed on: 2/15/2001
0 Not Operational 0 Below Threshold
13 Permitted ■ Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ......................
FarmName:&lforchill..F.,mu............................................................................................. County: S.Cokes................................................. W5.RQ........
OwnerName: Hark ....................................... Mome ........................................................... Phone No: 9.19n59.1:709 ...........................................................
FacilityContact: ..............................................................................Title:................................................................ Phone No:...................................................
Mailing Address: lit...1... Box.32..6....................................................................................... Walaat.C.Qve....Nc.............................................. Z7.05.2 .............
OnsiteRepresentative: 1Rjrk..S319rY................................................................................. Integrator:......................................................................................
Certified Operator:Maa:kf.................................. Shut:................................................. Operator Certification Number: 21435.............................
Location of Farm: _
Hwy. 8 north to Brookcove. Take Vt onto Brookcove. Take left onto Watts. Take right onto Rosebud. Farm between
Watts Rd. & Middlebrook Rd. on Rosebud Rd. in Rosebud Community.
❑ Swine ❑ Poultry ® Cattle [I Horse Latitude 36 • 18 25 Longitude 80 • I1 46
Design Current
Swine Canarity Pnmdalinn
❑
Wean to Feeder
❑
Feeder to Finish
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Design Current Design Current
Poultry Capacity Population Cattle Ca acit Po ulation
❑ Layer ®Dairy 125 103
❑ Non -Layer ❑Non -Dairy
❑ Other
Total Design Capacity 125
Total SSLW 1 175,000
Number of Lagoons 0 ❑ Subsurface Drains Present ❑Lagoon Area 1[:] 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 0 No
c. li'discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes 0 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 0 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......................................................................................................................................................................................................................
Freebiwrd (inches): 30
5100 Continued on back

' Facility Number: 85-9 Date of Inspection 9/20/2111)0 Printed un: 2/15/2001
5.
Are there any immediate threats to the grity of any of the structures observed'? (ie/ tre . , severe erosion,
❑ Yes
® No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
® Yes
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
® No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
® No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
® No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12,
Croptype Fescue (Graze)
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
® No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit 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
IS No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
No violations: or:deticiencie,s were noted :during this; vis.iC::You:will receive no fu.rther
corresuotideitee abouf this.visit.::.....:...... .
Johnson grass too high. Keep height of vegetation at 18" or less to allow for eay visual inspection.
Heifer lot bare spot surrounded by grass, enough to act as a filter strip.
Need to pump ASAP.
Reviewer/Inspector Name ,M
Okeefe
Reviewer/Inspector Signature: Date: 5100

Facility Number: 85-9 I]ry of Inspection 9/20/2000 • Printed on: 2/15/2001
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
ttrona ommen an or rawtngs:
5/00
5/00

Facility Number
Date of Visil: 5/11/2000 Time: 0900 Printed on: 5/25/2000
85 09
C Not Operational Q Below Threshold
0 Permitted S Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: Slit rchill.FAIM.............................................................................................. County: S.tpkCj ................................................ IY,SRQ........
OwnerName: Hgrk....................................... 91IQr.c ........................................................... Phone No: 33.6. A1.-.7.i&9...........................................................
Facility Contact: N.tat'k.Shon.................................................... Title: .Q..w.ner................................................ Phone No:
Mailing Address: 2.3j.Ra:iehttd,RgAd........................................................................... ll airtttt.Gave .. NG.............................................. 2.7.05.2 .............
Onsite Representative: Jy ark..S.itatf:................................................................................. Integrator:
Certified Operator:Jar..k..F.................................. SILQ.rg ................................................ Operator Certification Number: 21Q3#.............................
Location of Farm:
❑ Swlne ❑ Poultry ®Cattle ❑ Horse Latitude F-3-6-�*F-18-11F 25 1, longitude F 80--l*F-I-17. F 46 ..
a ;: Design
's�Swfne
Current
Design Current Des'rgn`Q Current
,
Ca acit
P,o ulation
Poultry Ga acit P,o ulation Cattle Ca actf 4�sP.o ul lion-,;
❑ Wean to Feeder
❑ Layer
® Dairy 125 100
❑ Feeder to Finish
JE1 Non -Layer
I❑Non-Dairy
❑ Farrow to Wean
❑ Other Ma" ?
❑ Farrow to Feeder
Total Design Capacity 125
❑ Farrow to Finish
❑ Gilts
❑ Boars
Total SSLW 175,000
EEJNumber of Lagoons 1r ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps [ ❑ No Liquid Waste Management System
Discharges & Stream Impact
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 I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......................................................................................................................................................................................................................
Freeboard (inches): 92 -#-309l'
Continued on back

Facility Number: 85-09 Date of Inspection 5/11/2000 printed on[ 5/25/2000
5. Are there any immediate threats to the in�rity of any of the structures observed? (ie/ Vee�'S`evere erosion,
❑yes
®No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
® Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
® Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
® No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
®No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12. Crop type Fescue (Graze) Timothy, Orchard, & Rye
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
No violatigtis;or deticiencie9 were poted during this; visit: ;You;will receive n0 ft' kh;er ;
corresooridence about this visit::: : :
Dam needs to be mowed (See SWCD review 7/99, also.).
Replacement heifer lot needs to have vegetation established.
Reviewer/Inspector Name �Meli Ro brock Jenny Rankin
Reviewer/Inspector Signature: p /j�'� ( �q/i ,�� Date: 7oU Od

Facility Number: 85-09 �ut' Inspection 5/11/2000 • Printed on: 5/25/2000
Odor " te'
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?
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

q t9m
Facility Number I Date of Inspection r7,$� D
Time of Inspection 24 hr. (hh:mm)
E3 Permitted X Certified ff 3 Conditionally Certified 0 Registered Not O erational�Daate IL�ast Operated: ..........................
FarmName: .....�Q.re..Y.1.1.��.......... G..tC�.lr.in............................................. I........ County: .........t..?.fi.I�:.�5.................p....Q.........................
OwnerName: .......m.lL:............I.,..,.-.1.... b.r:................................n................ Phone No:....JJ�iO..:.SQ../:..7..O...L..........................
Facility Contact: ...I V l t(% r. ��...((J��J1��.IS?..rL..................... Title:.......lJ.l l�.h P�........................... Phone No:...................................................
Mailing Address: ... {�j.j......E` ffi...:..........................................�A �4� �.I i.( %7........5
...Onsite Representative:..Na ,C.... i$rPl.......................................... Integrator:...................................................................................
Certified Operator: ... tar..; ....... E.... 5 D ................................................ Operator Certification Number: ......... 'Z;,I �3.�
.........................
Location of Farm:
Desr p--
��
Current'-
3 1�. 11
o t �r it lei r
De's�gn �I�iCq�rent'r �� i I�� i r Desrggi Current
'
ISwine lta aci
JI g)
' f-Po ulatrom Poultry...
Y.A': 1 r II if 21 f 4 �.
Ca actt Po olation
,,
. r,Cattle
❑ Wean to Feeder
10 Layer
Dairy
❑ Feeder to Finish
10 Non -Layer I
❑ Non Dairy {w_
�.j❑Farrow to Wean
�,;..,'^�•
..
.,�, 'gnu ,'d ,+� rn��pl�l ', �', �l��i'i= '��arr',"
`' ❑Farrow to Feeder
- ;'❑Other
,i
' Farrow to Finish
Total Design Capacity;.:
r []Gilts
t i11 tRr r i
�i�❑BoarsiMjotal'SSLW�`i
Number of Lagoons <. n
❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area ao
-r _
Holding:Ponds /Solid Trapsid�� ❑ No Management System Liquid Waste
.,.Otit,IQI1
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 ycs, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated Flaw in gal/min'?
d. Does discharge bypass a lagoon system? (Il' ycs, 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 00
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? �] Spillway ❑ Yes PNo
Structure t Structure 2 Structure 3 / ' Structure 4 Structure 5 Structure 6
Identifier: G� ^ I
Freeboard(inches): .......................................................................................................................................................................................................................
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 (Ot +- 1(t I Continued on back

Facilit Number. — e of Inspection
6.
Are there structures on -site which areloproperly addressed and/or managed through waste management or
closure plan?
❑Yes
ANo
(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?
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
��t�,,,,ffffYes
Yes
❑ No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
/XNo
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
XNo
lllWo
11.
Is there evidence of over application? ❑ Excessive Ponding El PAN
❑ Yes
12.
Crop type Q Ure_
13.
Do the receiving crops differ with those designated in the Certified Animal 4aste Management Plan (CAWMP)?
❑ Yes
No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
o
b) Does the facility need a wettable acre determination?
❑ Yes
IXNo
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
XNo
Renuired 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
ko
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
!!!(�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
XNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
El Yes
)(No
Iq•vi91'a4i¢tis;oj• ilQTjcienc9e$ •iugre pQCe�1• iljtritig 4hjs;visjt; •You ;wilj•Secgiye ijo; futth¢r. •; •;
::
corres' ondence: abotif this :visit: • : •:::::::::::::::::::::::::::::: :
Comments•(refer to question ; Explain any;YES answers and/or itny recor I ., ,lions or any other comments Il'+ u,, l . p a s
1( '•''
i I i I f ", { SN IL{ 5
Use drawings'lof facility to betterlezplain situations (use;hdditiohaldpageslis necessary). ;''; f1 ; �, tk
vq
i 4 1 t�
�1 1, l� _ �i i, -
l"'
�,;
. ,..[.• .Y iiI {-4 `i�l 1 '+1 +V N. r•�
•�e place mex�j Inei�e, Ib�- ►1 s `f-o have ife e2
•
4_1 Q
-Jam hee� S 6 rW u_)ed . (See S LO I'e vi tt J
Reviewer/Inspector Name ,'I
Reviewer/Inspector Signature:
Date:
.;

Facility Number: S �e of Inspection (IL / ///(/(JI •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond /o�r lagoon fail to discharge at/or below ^Q-;z;;�^-, o
liquid level of lagoon or storage pond with no agitation? 6 M 17- g6co
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes xNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes >1�0
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 NUf 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
No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? OM 17- aCM ^-�JC
At
J

/18/2000 13:22 919-715-604.8 - DWO NON DISCHARGE BR PAGE 02/08
FR
-- -
Initial fvaluation Follow-up Evaluatiou CJ Denied A,ccees 13w Fa
cility Require aFollow-up
r
Fa-d- ty Number ,T Date of Evaluation b 00
�L Tuue of Evaluation 24 hr.
❑ Permitted �y-l;ertified M Registered 13 Non -Registered Inactive Facility Date Last Operated: _,,,,_........
Farm Name:.:�S�ar� :h11a_:_LarR r ..._._.:._.:.:...-----•"_.. County:
Owner Name: ...... ..I11�.iY....._....._._:_:...::................__........_... Phone No: _..... .. ...__.... .........-...._.... __..._
�i la 9: �' 7 LBO.
Facility Contact ..MLili.1 .._.�11Q� ..,IStle: �(��n.Q/r- ---. Phone No
Mailing Address: i' :; .r " _. I YI. U �6 jr2 �G ._.......-----..
Srs2
Onelte I2epxesenkatived._...i_..:........_.......:... ............. _.......... ......... L..... ,......... _._:.. Integrator, ......
Location of Farm:
Dlscharm & Stream Impaca
1. Is any discharge observed from any lagoon? ❑ Yes ❑ No
a. If discharge is observed. Was the conveyance men -made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
2. Is there evidence of past discharge from any lagoon'.!
Wy Collectlon & Treatment
3. Fstimate Freeboard Level:
Structure I Structure 2
Freeboard(incbes):............................. --..................... _.
❑ Spillway
Structure 3 Structure 4 Structure 5
❑ Yes ❑ No
[] Yon ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
_- - -
Reviewer/Ins Reviewer/Inspector t:x•..r.�s:" !. .:,.: a,i..;.gw{t.:ir�t'' M..'.: !'
or Name =*',u'!t�,*'".!us!r,.,,-�•'..;rrMt_iT.nyy ,:n' _}]-;.-_. k_.,,:i'-':Ni..:':Wv�.?i.!c!p1.J;:�i
P t t: e;'S .:.:Ib_: #1,1, U_. r o-S• ,t Si n'u:Sal/.,
L .I..^.u:u-ee..,:.n.:?: !:a.aki n trio5in�:lx5!q;-
ReviewedlAspector Signature: - Date:

01/18/2000 13:22 919-715-6048 DWO NON DISCHARGE BR
Site Sketch Shoving All Actived Inactive Lagoons 0
PAGE OU08
:r
ILEF
1/12/00
2
L ..

n/18/2000 13:22 919-715-6048 DWQ NON DISCHARGE BR PAGE 04108
*active Lagoon Field Data Sheer GPJ F i le #f
Facility Number: IT -t =- ] . Inactive Lagoon Nwnber:
Latitude 3jo I % ' 2� Longitude 4S0 (� 'tip O
GPS []Map
4. Waste Last Added (mnt/yy) Owner ❑ Estimated
5. Estimate of lagoon surface area (acres)
6. Effective height'of embankment (feet)
7. Distance to Blue Line or Intermittent. Stream (feet) < 250 ❑ 250 - 1000 ❑ a 1000
10 Determined From Field Measurement ❑ Map
8. Down Gradient Well
to
a Is there a down gradient well located within 250 feet? ❑Yes No
b. Is an intervening stream not located between any part of the lagoon and the nearest well? ❑ Yes KI No
9. Distance to WS waters or HQW (mi.)
10: Does the representative know of overtopping from outside waters?
11. Appearance of Lagoon Liquid
Q . Sludge Near Surface
b. Lagoon Liquid Dark, Discolored e"
c. Lagoon Liquid Clear
12. Embankment condition
a Poorly Built, Large Trees, Erosion, Burrows, Slumping, Seepage, Tile Drains, etc.
b. Construction Specification Unknown But Dam Appears in Good Condition
a Constructed and Maintained to Current NRCS Standards
13. Outside Drainage Area
a. Poorly Maintained Diversions or Large Drainage Area not Addressed in Design
b: 'Has Drainage Area Which Is Addressed In Lagoon Design
c. No Drainage Area or Diversions Well Maintained
14. Liner Status
a. High Potential for Leaking, No Liner, Sandy Soil, Rack Outcrops Present, etc.
b. No Liner, Soil Appears to Have Low Permeability
c. Meets MRCS Liner Requirements
15. Application Equipment and/or Sprayfield Not Available
16. Contact could not be made with on -site representative
urns
vtvoo
I
[7<5 05-10 ❑>,10
❑ Yes J&v ❑ Unlmown
an
2
❑ Yes. No ❑ Unknown
-71
❑ Yes No

01/18/2000 13:22 919-715-6048 DWI) NDN DISCHARGEI "BR
Comments (Refer to Question #): Explain any Yes answer and/or any other comment.
FRe--�50511►4A
14q�A5
10yds C3oFt�
I 2785
PAGE 05/Q2 .
z --�>

o Division a= and Water Conservation - Operation Re '
13 Division o 1 and Water Conservation •Compliance I*tion
Division of Water Quality - Compliance Inspection
13 Other Agency - Operation Review
10 Routine 0 Com taint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number 85 9 Date of Inspection 12/14/99
rTinic of Inspection 24 hr. (hh:mm)
0 Permitted M Certified 0 Conditionally Certified 0 Registered Not O erational Date Last Operated: ..........................
Farm Name: Sbotellill.facm.............................................................................................. County:
\ R.0........
OwnerName: Mark ....................................... Sttore........................................................... Phone No: 33.6.59.1-1189 ...........................................................
Facility Contact: M,9c1c.Short..................................................... Title: Q.wner................................................. Phone No: 33.6-59.0189 .......................
MailingAddress: 1tt..1.1o;K22.6 ....................................................................................... lX.altlul.Goye...N.G.............................................. 2.7.052 .............
Onsite Representative:
Integrator:
Certified Operator: l.ax.k..F.................................. Shwe ................................................. Operator Certification Number: U.430.............................
Location of Farm:
Latitude 36 • 18 24 {f Longitude 80 • 11 48 ..
Swine t.nnnelty Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Ca tacit Po ulation
❑ Layer ® Dairy 125 100
❑ Non Layer I 1 10 Non -Dairy
❑ Other
Total Design Capacity
Total SSLW 1 1
125
I Number of Lagoons I 0 I I❑ Subsurface Drains Present Ij❑ Lagoon Area I❑ Spray Field Area
Holding Ponds / Solid Traps 0 ❑ No Liquid 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 galhnin?
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 llection & 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): ................3.....................................................................................................................................................................................................
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
Printed on 12/16/99

Facility Num bAL 85-9 1 • of Inspection 12/14/99
6. Are there Ft tures on -site which are not properly addressed and/or managed through a ste 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 ❑ Yes ® No
12. Crop type Fescue (Graze)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application'? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No
15.
Does the receiving crop need improvement?
❑ Yes
® No
16.
Is there a lack of adequate waste application equipment?-
❑ Yes
®No
Reunited
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
19 No
®' No viola,tions:or d hdc ne es were:noted:dtiring this: visit::Ytiu:will' receive ito further
correspondence. abouf this.visit:... .
last applied summer '99
Reviewer/Inspector Name (David C. Russell
Reviewer/Inspector Signature: Date:
on

Facility Nu 85-9 led' Inspection 12/14/99 I.
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
Printed on 12/16/99

Of
Agency'
Facility Number Date of Inspection 2./
Time of Inspection � 24 hr. (hh:mm)
Permitted bi Certified E] Conditionally Certified [3 Registered 0 Not O erational Date Last Operated:
1 )�
FarmName: ..!:�R!%1!.�r/..................�7:1...................................................................... County: ....�VUiC�S......... .......................... .......................
{yJ j q
OwnerName: ..../..!Lh/.,�2k..4�tf/u/_......................................................�..%............... Phune No: �. 1.. ./.. ...... ._S..r.......................
Facility Contact: !!( / Q/'^/.`C�..�.............................Title:......V..../"/.�2/................................ Phone N/o:.....IA A..✓..Q.........................
.....
Mailing Address: ,{� (.� .. .aX.04,1& 6 W N•" .S']�
........................................ ..
Onsite Representative: ... !//g/L� � f-......................................................... Integrator:
Certified Operator:
Location of Farm:
LatitudeLongitudes
Design
Current`' Design
Current
Design ' Current �9
. Swme,� vt . _ Capacity
Population Poultry: i_ Capacity
,Population' Cattle
Capacity Po ulation.i�,v
_,
❑ Layer
'�. ❑Dairy ,.,..
5'0 I,,.
"�' ❑ Non -Layer
F�,' ❑ Non -Dairy
j'�
r
❑ Other
Total Destgn "Capacity
ni
;it
"i"
;i {
TotalSSLW
l
Dumber of Lagoons,
❑ Subsurface Drains Present ❑ Lagoon Area
❑ Spray Field Area "
13oldmg'Ponds /Solid Traps
❑ No Liquid Waste Management System
.,,,+..
❑ Wean [o Feeder
❑ Feeder [o Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
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
h. 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? ❑ YesANo
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 aaaaaa��w�w/
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ®Vo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): ............................................................................................................................................. .
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
3/23/99 Continued on back

Facility Nun S- • .e o1Inspection Z/
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
El 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
o
GGGGGG
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
7ELNo
11.
Is there evidence of over applications? ❑ Excessive Ponding ❑ PAN
❑ Yes
XNo
[[CCCC�YY
12.
Crop type cUr 464- /NQe
S
13,
Do the receiving crops dif er with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
t
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
�Vq
gl No
15.
Does the receiving crop need improvement?
❑ Yes
)4No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
ANo
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
L
15Q/No
77"
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
fie/ WUP, checklists, design, maps, etc.)
❑ Yes
)QNo
CM
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
jo No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
81 No
22,
Fail to notify regional DWQ of emergency situations as required by General Permit?,
(ie/ discharge, freeboard problems, over application)
❑ Yes
ioNo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
W 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
o
o •yiolafigris:o'r deficienci8s were pptet1• d�rring tpis:v�sit; • Yoit :wit! i ecgiye no: fut they; • ; • ;
corresuotideitce: about: this visit-'.'.::::::::::::::::::::::::::: :
Jseldrawings of facility;to better explatn'situahous. (use additional pages as,necessary) .' t {, yI u, v ';
i
u MN.a.. 91
Reviewer/Inspector Name
Signature: A& d L k:�,� Date:

Facility Nuu of Inspection
Odor Is_ i
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes )Vo
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
o
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
pp,,
yy No
N��f
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?
El Yes
No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
`E"'
KNo
3/23/99

19 Routine O Complaint 0 Folio" -up of DWQ inspection O Follow-up of DSWC review 0Other 1
Facility Number 85 9 Date of Inspection F 7/13/99
Time of Inspection 9:00 24 hr. (hh:mm)
E3 Permitted M Certified 13 Conditionally Certified 13 Registered Not O erational Date Last Operated: ..........................
Farm Name: Sbxtrcltill.Eitral.............................................................................................. County: SIQU5 ................................................ WSRQ........
OwnerName: Mat[1t....................................... 5110M ........................................................... Phone No: 910_59.1-71119 ..........................................................
FacilityContact: ..............................................................................Title:................................................................ Phone No:...................................................
MailingAddress: lit...1..BQx.32(t....................................................................................... W.01AMI.C.Q.n.-Ac .............................................. 2.7.052 .............
OnsiteRepresentative: Mar.k.S.hm................................................................................ Integrator:......................................................................................
Certified Operator:' arkE.................................. S.h9m:................................................ Operator Certification Number:2,1.43;A.............................
Location of Farm:
Latitude 36 • 111 24 Longitude g0 • 11 48
1" Design
Swore Ca tacit
Cun�ent
P,o ulation
Design Current
Poultry Ca Tacit P,o mlation
+ D`esig`ny
'Cattle Ca aci anMo
Current
ulation
❑ Wean to Feeder
❑ Feeder to Finish
❑Layer
®Dairy
125
❑Non -Layer
❑Non -Dairy
❑ Farrow to Wean
❑Other f •,
Total Design Capacity 125
Total SSLW 175,000
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons
Holding Ponds /Solid Traps
0 [[]Subsurface Drains Present ❑ I-agoon Area 10 Spray Field Area
� ❑ No Liquid Waste Management System
Discharges X 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
It. 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 it 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 I@ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): ................ I.$ ............... .................................... ................................... .................................... .................................... ....................................
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 5/9/2000

Facility Num 85-9 • of Inspection 7/13/99
6. Are there structures on -site which are not properly addressed and/or managed through a to 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?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type Fescue (Graze)
N Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ No
N No
N No
® No
® 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
N No
c) This facility is pended for a wettable acre determination?
❑ Yes
N No
15.
Does the receiving crop need improvement?
❑ Yes
N No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
N No
Rcyuired
Records & Documents
17.
Fail to have Certificate of Coverage & General 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.)
N Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
N Yes
❑ 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?
N Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
N No
No violatitins:or iieticiencie$ were noted ;duiin.'this: visit::You:will receive no further
corresuotidehce. about this visit: :
18. No application windows or nitrogen balance table, need to reformat WUP.
4 & 24. Is about 6" over start pumping, plans to pump within a weeks time.
7. Need to mow and keep the height of the vegetation at 18" or less to allow for easy visual inspection.
19. Need a waste sample analysis within 60 days of any waste application date.
Reviewer/Inspector Name Margaret O'Keefe Ken Martin
Reviewer/Inspector Signature: Date:
0
on 5/9/2000

Facility Nu 85-9 �ol'Inspection 7/13/99 .
Odor Issues .
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ® No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
® No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
® No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
® No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
®No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
®No
32.
Do the Flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
®No
Wdditiilij—AMU�ftatnfeun ri or gaw ngst
Printed on 5/9/2000
Printed on 5/9/2000

DSWC AniffiWeedlot Operation Review 1
DWQ Animal Feedlot Operation Site Inspection
lWoutine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Facility Number
(� Date of Inspection ff Og 0
j
1 Time of Inspection ©24 he (hh:mm)
E3 Registered f Certified 0 Applied for Permit 0 Permitted JE3 Not Operational I Date Last Operated:
Farm Name:......5. - Q .C\_9._ .............. 1!`.h`.................................... C:ounty:....... S.... S.0.ke�5 ........................ .
(honer Name: .... 1..(_k.i i ......../.............................................................. Phone No: �3.3.W......1:......7.1.. 0..1..................
Facility Contact: ..%%! ! �'....�NUA2 ............................ Title:................................................................ Phone No:...................................................
Mailing Address,... ,......�......... j_a ..3 (�. �1.�r� .i .._c�.�¢ N' �7oSv
Onsit'e Represent:dive:.........V.I.N_...... P.Kqg&........................................ Integrator:
Certified 0perator,,....0.0.JA%,Z,K.. .......(.�......................_1......................... Operator Certification Number:.f�.,,%..T -Q
LocationofFarm:O/V PO,4QID4.%(� P1 , 11,36 , 6.4 191:A04,- nnk PA.
I�311f IS IMIN �4i�� ■1� L°i'.1
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Cattle
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons / Holding Ponds 10 Subsurface Drains Present ❑ Lagoon Area
❑ No Liquid Waste Management System
[[]Spray Field Area ^I
General
I. Are there any buffers that need niainten:mce/improvement'?
Cl Yes
No
2. 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 Surface Water? (IP yes, notify DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated flow in g:d/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
El Yes
No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
�fNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require
Cl Yes
No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
No
7/25/97 3-q �/
Continued
LL
on back""

[Facility,Nu — ,
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
6NO
Structures (Laioons.liolding Ponds. Flush Pits, etc.)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
�No
ff ��t : ure t S cture 2 Structure 3 Structure 4 Structure 5
Pouf
Structure 6
Identifier: F +���
Freeboard(ft): ......... �.......................................................................................................................................................................................................
10.
Is seepage observed from any of the structures?
❑ Yes
No
It.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
No
12.
Do any of the structures need maintenance/improvement?
❑ Yes
cC o
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
�*o
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type .. p..S. 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
n
18.
Does the receiving crop need improvement?
❑ Yes
PNo
19.
Is there a lack of available waste application equipment?
❑ Yes
o
20.
Does facility require a follow-up visit by same agency?
❑ Yes
o
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
22.
Does record keeping need improvement?
❑ Yes
1'No
[I o
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
t:�No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
o
2
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
No
INwviolkions or deficiencies.were ntited during this. visit. .You:will i•eceive-ntrfurtlier:
:. corres'pot)deitce about this'visit.,',

Facility Number 85 9 i
0 Registered N Certified 0 Applied for Permit E3 Permitted
low -up of DSWC review O Other
Date oflnspectfon 8/20/98
Time of Inspection 13:10 24 hr. (hh:mm)
10 Not O erational Date Last Operated: ..........................
Farm Name: Shiarehill.Fartu.............................................................................................. County: $.tQ&5 ................................................ WS.RQ........
OwnerName: 1Y.1.ark....................................... Share ........................................................... Phone No: 910_59.1-..09...........................................................
Facility Contact:
Title:
Phone No:
MailingAddress: R.t...Ij).Qx.j2.6....................................................................................... WalatiI.Coxe,.N.0 .............................................. 1,.7.QS.7,..............
Onsile Representative: MaS'k.ShRrc................................................................................. Integrator:
Certified Operator: Mar.t..F.................................. ShArt:................................................. Operator Certification Number:21.43$ .............................
Location of Farm:
Latitude 36 • 18 24 " Longitude 80 •F 11 ' F 48
Swine tt
De`sfgn
C_a_pacity
Gui—ift
P,opulatibn
Poultry
*§igia` "Current
C_apacrty P,opulatton
'* ;' � tr,. D, est11 g11 n Curr
Ca ttle�,yCapacrty ?Pgpulation
❑ Wean to Feeder
❑Layer
®Dairy 125 I IS "
❑ Feeder to Finish
❑Non -Layer
❑ Non Dairy
M ❑ Farrow to Wean
❑ Farrow to Feeder
❑Other
v
❑ Farrow to Finish
tt'
�� 1 i
Tcotal Des—fgn�@apacity 125
I 'US Tote ISSLV1 175,000
a - ❑ Gilts
❑ Boars
Number of Lagoons / Holding Ponds JI ❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
❑ No Liquid Waste Management System
General
I. 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 mum -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 gal/min?
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
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
® Yes
❑ No
❑ Yes
® No
❑ Yes
® No
❑ Yes
I@ No
❑ Yes
®No
❑ Yes
®No
❑ Yes
® No
❑ Yes
® No
❑ Yes
®No
❑ Yes
® No
Continued on back

Facility Num 85-9 Date fespection 8/20/98
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes ® No
Structures (Lagoons.Holdine Ponds. Flush Pits. e1c.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
......................................................................................................................................................................................................................
Freeboard(h):.................a................ ......................................................................................................... ......................................................................
10. Is seepage observed from any of the structures? ❑ Yes N No
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes ® No
12.
Do any of the structures need maintenance/improvement?
❑ Yes
® No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
® No
Waste
Application
14.
Is there physical evidence of over application?
❑ Yes
® No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ....................... F..t SCue...............................................................................................................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
®No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
® No
18.
Does the receiving crop need improvement?
❑ Yes
N No
19.
Is there a lack of available waste application equipment?
❑ Yes
® No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
22.
Does record keeping need improvement?
® Yes
❑ No
For
Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
® No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
®No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
®No
No:violfitions or. deficieutiies:were rioted dtiritig:this visit.: Yoti wilt receive:no:fnrther: :
correspondence: about_ this.visit: ::.::.:. :: : ::::: ::: ::: :: ::: :::::
2. Has dates, fields and laud numbers. Need to use Irr-2 forms. Send in sample and pull sample within 60 days of pumping.
. Need a stream crossing and put up stream fencing where down.
115 & 65 dry cows.
Reviewer/Inspector Name 'Margaret O'Keefe Ken Martin
Reviewer/Inspector Signature: Date:

`.ilE.3E.3i:3:1i.#t'aE.&a��"x.'x2ruT;u22h' �4<sr£E;�+<3.t�<M h3..'"<t"iF.dk.2F.ix;iaxiFslEiSi>k.t33xtkt£�iFa>.' `' ix a?F 2a4mTa�3 z3 c�Z .3 msx;
st,: 3 x 4'x M "a❑Division of Soil ater Conservation ❑Other Ag� x;�„3 3'� i�33�.3�§�; ���as�� ���•
'3.3.43@3A,a:.: j`5:4°`®Division of Water Quality
s.F ��'!.�'si:\Qai .:x2ae>...._ui.:>.o,...: � .<�` .. Aiw: .cSbx;.a...io .ie\..MR : •• •F •2 ?....a..�`._Y9 i`eRo,R.,,a.. >.. Cy .' 4.R ..>w ? .` U.
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::4' :: wa3a��?:%`.o<,a>4, as ,,,>c>£4�,?:.«... .4: cs;, :. ,.n3..: :.:�xsc a.>�.>..Y:3a: ^�.3'a3x: >.a>.�3a:..,: <•.:y.:u`: a : .yt:`.".' a:3.::3aD�1t; Y.�3��. a:3�:3�
....•>.. .s«xa xMx e.xaxuxa4F3:23<££x£E..aa�n?i2>222.:a%m'S2:>i£'�'«::.�:�a2�2a::�,ae°�-.a�:>n<v .. i,ax..:F<xx«xxa<�>:sifxTu �r �:aiaf'i...x:.. ?a<,aFFx2..3aaF.x<a:<��,ai '>FFF:cFR x< . xxxAxaznsxxtz2::4
Date of Inspection 9/4/97
Facllity Number 85 9
Time of Inspection 10:15 24 hr. (hh:mm)
Farm Status: ® Registered ❑ Applied for Permit (ex:1.25 for 1 hr 15 min)) Spent on Review
❑ Certified ❑ Permitted I or Inspection (includes travel and processing)
NotOperational Date Last Operated: ................................................................................................................................................
FarmName: Sharehill.Fam............................................................................................... County: Bit&m ................................................ W..S1 O........
OwnerName: Mark ...................................... Shore........................................................... Phone No: 59.1:Z11i4....................................................................
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
Mailing Address: RL.L.Box.326 ..........................................................................................alnut.Caxe,..1WC.............................................. 17.052 .............
OnsiteRepresentative: MarkShore................................................................................. Integrator:......................................................................................
Certified Operator: Mark ..................................... Sham ................................................. Operator Certification Number: 11.43S ............................
Location of Farm:
Latitude 36 • 18 24 Longitude 80 •r 11 48
General
I. Are there any buffers that need maintenance/improvement? ❑ Yes H No
2. 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 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 10 No
3. Is there evidence of past discharge from any part of the operation'? ❑ Yes 0 No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes ® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes H No
maintenance/improvement?
4/30/97

. Facility Number: 85-9
in in the time design*
❑ Yes
H No
6.
Is facility not compliance with any appl a setback criteria effect at of
7.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
0@ No
8.
Are there lagoons or storage ponds on site which need to be properly closed?,
❑ Yes
® No
Structures (Lagoons and/or Holding Ponds)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
❑ No
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
10.
................................................................................................................................................................................................................................
Is seepage observed from any of the structures?
❑ Yes
H No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
H No
12.
Do any of the structures need maintenance/improvement?
❑ Yes
®No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
❑ No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
CM No
(If in excess of WNW, or runoff entering waters of the State, notify DWQ)
15.
Crop type............................................................................................................................................................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
®No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
®No
18.
Does the receiving crop need improvement'?
❑ Yes
® No
19.
Is there a lack of available waste application equipment?
❑ Yes
®No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
®No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
H No
For Certified Facilities Only
22.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
❑ No
23.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
24. Does record keeping need improvement? ❑ Yes []No
Reviewer/Inspector Name : ;
Reviewer/Inspector Signature: Date:

Facility Number
Farm Status: "" Registered ❑ Applied for Permit
❑ Certified❑ Permitted
Date of Inspection
Time of Inspection /I 5 124 hr. (hh:mm)
Total Time (in fraction of hours
(ex:.L25 for 1 hr 15 min)) Spent on Review L
or Inspection (includes travel and nrocessinol
❑ Not Operational Date Last Operated:......_ ........................
Farm Name:.._S.0 u Qe.l.r.`>1.....fogoeox...................................
�.. ............................
Land Owner Name: ... !�l���!`�.`..... �/.'^..'......__......__......._....._......_._......._......
Facility Conctact.............
!3.................. _........... Title:................:..
Mailing Address:....... .f...I ..... -!o........................................... __----
Onsite Representative:.. `^�C/ /A ................. ................................ ......
Certified Operator: ..... .%�lZ/'J,.!C............. ....................... _...... _..............
Location of Farm:
County:...."!°..^....`...�........._...................
Phone No:
Phone No:.........
Eve o.c. z
Integrator:
Operator Certification Number:
Latitude (3�J• 1IT L= " Longitude ®o • /[ ' ®«
i,enerai
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 gal/min?
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 X No
❑ Yes kNo
❑ Yes KNo
❑ Yes �No
❑ Yes �,No
❑ Yes IMo
❑ Yes 0Io
❑ Yes �4No
Continued on back

Facility Number ................ —............. .
6. Is facility not incompliance with any aable setback criteria in effect at the time of? ❑Yes �No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes No
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes �jqo
titructares R,agoats and/or Holding a)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes ❑ No
Freeboard (ft): Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
A9
......................__.. ............................ ............................ ............................ .................. _........
10. Is seepage observed from any of the structures? ❑ Yes) No
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes Wo
12. Do any of the structures need maintenance/improvement? ❑ Yes �Io
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or ma liquid level markers? ❑ Yes ❑ No
Waste Application M'9''�n-S AAC db pe paGlt iN U 0Ao6 -C
14. Is there physical evidence of over application? U ❑ Yes )ZfNo
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type .ok.,-Ir t/U...................................................................................................................................................... C�
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes ��.N0
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes )gNo
18.
Does the receiving crop need improvement?
❑ Yes VINO
19.
Is there a lack of available waste application equipment?
❑ Yes 6 No
20.
Does facility require a follow-up visit by same agency?
❑Yes I0
21.
For
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
Certified Facilities Only
❑ Yes 'ONO
22.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes ❑ No
23.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ❑ No
24.
Does record keeping need improvement?
❑ Yes ❑ No
[�fouY Nr S 1evt/ /.a> zs t`�s eQ
Reviewer/Inspector Name " v�vr'pF�WS1 �t • , t I
Reviewer/Inspector Signature: w✓'4X 1.• Date: /
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97