860029_INSPECTIONS_20171231

Facility Number:
860029
Inppection Type:
Structure Evaluation
Reason for Visit:
Other
Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Status: Active permit: AWS860029 ❑ Denied Access
Inactive Or Closed Date:
Date of Visit:
05/03/2017 Entry Time: 12:30 pm
Farm Name:
Double E Farms 2
Owner:
Eddie Johnson
Mailing Address:
502 White Rd
Physical Address: 502 White Rd
County: Surry Region: Winston-Salem
Exit Time: 1:00 pm Incident #
Owner Email:
Phone: [phone]
Elkin NC 28621
Elkin NC 28621
Facility Status: ❑ Compliant N Not Compliant Integrator: L & H Farms
Location of Farm: Latitude: 36' 24' 08" Longitude 80° 46' 14"
White Road. 1124 1/2 mile south of Zephyr Rd. Approx. 2 1/2 miles west of Dobson.
Question Areas:
Dischrge & Stream Impacts Waste Col, Star, & Treat
Certified Operator: Thomas E Johnson Operator Certification Number: 20034
Secondary OIC(s):
On -Site Representative(s): Name Title - Phone
24 hour contact name Eddie Johnson Phone: [phone]
On -site representative Eddie Johnson Phone: [phone]
Primary Inspector: Melissa Rosebrock Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Spoke with Eddie Johnson on 5/1/2017 stating that the waste level in the lagoon was one inch above maximum even though the
lagoon was pumped on 4/29/2017. Non -compliant.
Today's visit (5/312017) was to check waste level in the lagoon. There is 22 inches between lowest part of the dam and the waste
level and the spillway is 12 of those inches. This leaves 10 inches of freeboard below spillway. Noncompliant.
Follow-up Communication offer inspection:
Received message and photo from Eddie Johnson on 5/4/2017 which showed that the waste level was five inches below the top
of the marker. Compliant.
Call from Eddie Johnson on 5/10/2017 stating that the waste level was one inch below the maximum again Compliant.
page 1

0 0
Permit: AWS860029 Owner - Facility: Eddie Johnson Facility Number. 860029
Inspection Date: 05/03/17 Inppection Type: Structure Evaluation Reason for Visit: Other
Waste Structures
Designated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon LAGOON 10.00
Discharaes & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
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. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
110
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes
No Na Ne
4. Is storage capacity less than adequate?
M
❑ ❑
❑
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./ Iarc
❑
0 ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
page 2

Inspection U Operation Review
for
Referral
Other U Denied Access
Date of Visit: 11 Z./1 Arrival Time: f Q Departure Time: Z County: �1,rr1,
Farm Name: Di a L. t-L' �M S Owner Email:
Owner Name: 1' I J t { Phone:
Mailing Address: 5_3Z- W 0,f KcL -
Region: W-W
Physical Address: reed L_D�_ L^ rt ,
Facility Contact: EM++iiG Qr 9jile„ Title: Phone:: 336'366—r725'1/
Onsite Representative: f__dj, f �� Integrator:
l _i�
Certified Operator: �j pMt/ li , cf a Lwn J (', Certification Number:
Back-up Operator:
Location of Farm:
Certification Number:
e� /
Latitude: 36o ZV' OF "'Longitude: O oa 4(o
i`..
Y:
db ctx
� .y}.�i^ e'bt�AT.±��'�L
Y
ct
"�+ MY
kG"Y� i�{�'■���
4
3 ':
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DW R)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify 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 10 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
iTjCj\/No
❑ NA
❑ NE
Page I of 3 214120I5 Continued

21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysi
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I"
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Page 2 of 3
Facili •Number: • jDate of Inspection: 2
Waste Collection & Treatment ��_,((
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes p� � No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ✓❑ No ❑ NA ❑ NE
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 1 Structure 2
A.
Z
Structure 3 Structure 4
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?
Structure 5 Structure 6
❑ Yes p[I No ❑ NA ❑ NE
❑ Yes tX No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR IXI 7. Do any of the structures need maintenance or improvement? Yes r[❑(No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? E j Yes IX I 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 IX I No ❑ NA ❑ NE
maintenance or improvement? /"�
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes KNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN> 10%or 10lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): SM41 A/-wh + eo PA q f14 �A
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other: p����JJJ
❑ Yes IRNo ❑ NA ❑ NE
s ❑ Waste ransfers ❑ Weather Code
Rainfall Inspections ❑ Sludge Survey
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No NA ❑ NE
21412015 Continued
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes 6No ❑ NA ❑ NE
❑ Yes No
❑ NA ❑ NE
❑ Yes No ❑ ❑ NA NE

Facility Number: SP& - • Date of Inspection: Z I
qW
�24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes XNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ f Yes No ❑ NA ❑ NE
Other Issues ���ff(
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes �X� No ❑ NA ❑ NE
and report mortality rates that were higher than normal? �C
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes �No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately. ���(([
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility/? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/storage Pond ❑ Other: �,J
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? I ✓��"`•• IXI Yes ❑ No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑CCC Yes No ❑ NA ❑ NE
34. Does the facilityrequire 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.
.. -._, .
Ilse drawings of facilitv4o better explain situations (use additional paces as necessary). - ,
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32,�2'%�`� Pnl� %.l't� It G►Gtw4— NJ fr �%t WkP �
e,t r d'
Zl
tl 2gl(o' Ncx� d"`e 2O1� P -
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e' Z.53 Ib IJ
Reviewer/Inspector Name: f cd-4','l7k Al r ",I I
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
214/1015

for Visit: V Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: 'j 0 Arrival Time: ® Departure Time: County: SU if Region: WS Rn
Farm Name: _bn 1p, i; Foxm 5 Owner Email:
Owner Name: Eddied. SOtjn50r) Phone:
Mailing Address: S12— Old . , Gil king N C- .1 s6 I
Physical Address:
Facility Contact:
Vd le 0V- C II?.V%, Title:
OnsiteRepresentative: �i�lle. �klhltl5p►'1
Certified Operator: �T6Mt'[S E. J0111h<Ak1 . 7JA_70
Back-up Operator:
Integrator:
Phone: 3'' 11b 366 7,;1S
Certification Number: 0Z0o321
Certification Number:
Location of Farm: Latitude: , U
30,;,1% z Longitude:
T-77 N Zghy r
Rd
Wit) l e_
ivarm
cn
L-
Design
Swine Capacity
Wean to Finish
Current
Pop.
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean [o Feeder
Non -La er
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Layers
Design
Current
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
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 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 Ko ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
❑ Yes ,No ❑ NA ❑ NE
Page I of 3 21412015 Continued

Facili Number: V - • Date of inspection: 7
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 `"`❑F"'"'] No ❑ NA ❑ NE
1 I-- Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
1t� Identifier: Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [%No ❑ NA ❑ NE
(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 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 �dNo ❑ 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 Nlo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes XNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ONo ❑ 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
Crop Type(s): 1
,
10
`Q
13. Soil Type(s):
112.
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
2fNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
V No
❑ NA
❑ NE
Required Records & Documents
�j
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
I � jJq,
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check QQ Yes o ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklist ign❑Maps Lea ❑se Agreements ❑Other:
21. Does record keeping need ij�provement? , elow. ❑ Yes �No ❑ NA ❑ NE
Waste Application U w kly Freeboard ❑ Waste Analysis Soil Analysis ❑ q'a�rP T��^^r'-• Bather Code
[]/Rainfall Stocking Crop Yield ❑ 120 Minute Inspections Aonthly and 1" Rainfall Inspections Judge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes XNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ;eNA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: • Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permitff ? ❑ Yes ly No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a 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?
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? Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
❑ Yes
❑ NA
El NE
❑ Yes
Ko
No
❑ NA
❑ NE
❑ Yes
� o
❑ NA
❑ NE
[-]Yes �o ❑ NA ❑ NE
❑ Yes D�fNo ❑ NA ❑ NE
❑ Yes A No
eo Q NA
❑ NA
❑NA ❑NE
❑ NE
❑ NE
❑NA ❑NE
nments (referto question ft Explain any YES answers and/or any additional recommendations or any other comments. I
drawings of facility to better explain situations (use additional pages as necessary).
0M e3"1i5hed on ¢op of dome yy esa z h JOY 5d%�l heeds
w-Doreen ree15 Bali braked i✓I�ISIyeS,dv� o•-10.tha01-Te
aCAU Slu y�rJet1? Coat�le+ecc� �� ao14. C� &I
S veS� 51 L e 5VJ'V Q-Y,4-"5)aor) o
D319- T- a-73(op Pull #3a-#7�/ �1eeci {o b� �d�ec� ��uP
(U-10141C dore 15) * T
CA)
Acaee' loco to
��►o�Zal(� c S - �. z�/!ss N�/000�Q
Reviewer/Inspector Name:
Reviewer/Inspector Signatm
Page 3 of 3
Phone:3A___'Mb-9t'z 99
Date: -7/)) 12 oleo
21412015

r,
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint e Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: - I -Z((OI / Arrival Time: ® Departure Time: ® County: 5i.,.. r-r4 Region: W " `0
Farm Name: �'�O%t p//HS Owner Email:
/ C Imo,
Owner Name: of /c /GH �,1 t4*" Phone: Q %
Mailing Address: Soy [ii�N • J' �o• -llc',
Physical Address:
Facility Contact: './/c rfnrn Title: Phone: 3 3�61' ? - 72.57
Onsite Representative: 41O i6 Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Imuacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of
❑ Yes ❑ No ❑ NA Q NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
[Q NE
❑ Yes
❑ No
❑ NA
® NE
21412014 Continued

Facili Number: - Z Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
F,<LNo
❑ 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
tr
Identifier: Le f
Spillway?: 7i
Designed Freeboard (in):
Observed Freeboard (in): 3y
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
0 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
❑ No
g] 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
❑ 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
0 NA
❑ 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
❑ No
® NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [—]Yes ❑ No
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [—]Yes ❑ No
the appropriate box.
❑WUP ❑Checklists []Design ❑Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a min gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[—]Yes ❑ No
❑ Yes ❑ No
NA ❑ NE
®NA ❑NE
]NA ❑NE
❑ Weather Code
❑ Sludge Survey
® NA ❑ NE
® NA ❑ NE
Page 2 of 3
21412014 Continued

Facility Number: 9 ofI Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes ,® No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes [21 No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail 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 ❑ No
Q NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes ❑ No
® NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes ® No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes Z 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
P=] 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
Q No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
S No
❑ NA
❑ NE
Comments (refer to question ft. Explain any YES answers and/or anyaddtttonal recommenoanonsor-auy..ornerrcommenrs..
Use drawings of facility to better explain situations I(use additional pages as necessary). (1
)1111' ,� cr c .V" /h65 L4',e� 'rei �oI es,9we.f sptG S,
ge.G,.rCN`^��o.,... uH„ /IaS p2e^ iC �'IfG/` & 1.�1tlll�� Y
Reviewer/InspectorName: Z.v fh Phone: 3?17?Z Mf_
rl
Reviewer/Inspector Signature: Date: ��/��G a�
Page 3 of 3 21412014

Type of Visit: 'Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: - IB- f5 Arrival Time: 00 rh Departure Time: S County: _-Z r, Region: A4a
Farm Name: '/oi blc E %'� ^ S Owner Email:
Owner Name: ` Ille A 7.,
Mailing Address: ri 0 L AA "�_ 47
Physical Address:
Facility Contact: Title:
Onsite Representative: ip/'/dl l L
Certified Operator: 'G
Back-up Operator:
Location of Farm:
Latitude:
Phone:
//c 2T-iz/
Phone: 3�G-yu- 7257
Integrator:
Certification Number:
Certification Number:
Longitude:
Swine
Wean to Finish
Design
Capacity
Current
Pop.
I
Wet Poultry
ILayer
Design
Capacity
I
Current
Pop.
Desigtt Current
Cattle Capacity Pop.
Dai Cow..
Wean to Feeder
7
03
Non -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
I) , P,oulh.
Layers
Design
Ca aci
Current
P,o ,
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
T ey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ,No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
[:]Yes Q No
❑ Yes jj3,No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Page 1 of 3 21412014 Continued

Ell a Division of Water Resources01
Facility Number ©- Z 0 Division of Solt sari Water Conservation
0 Other Agency
Type of Visit: O Compliance Inspection 0 Operation Review Structure Evaluation Q Technical Assistance
Reason for Visit: O Routine O Complaint 8 Follow-up O Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: y7� Arrival Time: lot eb Departure Time: to t2o/}wl County Region: W;
Farm Name: '/.4-�_ r.'� 5 Owner Email:
Owner Name: E)Jft k- 01t x 1 Phone:
Mailing Address: 5-0 Z L' U i-C L.) � �^'�- 4) G Z g 6 z
Physical Address:
Facility Contact:
OnsiteRepresentative: EjIc- Td�.�s•--
Certified Operator: Z/td.t
Back-up Operator:
Location of Farm:
Title: Phone: 331 "-19- 7167
Latitude:
Integrator:
Certification Number:
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
I
Wet Poultry
ILayer
Design
Capacity
I
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
74670 1
INon-Layer
I
Dairy Calf
Feeder to Finish
Farrow to Wean
I) . P,oul , +
Layers
Design
Ga act
I
Current
$o
Dairy Heifer
Dry Cow
Farrow to Feeder
Farrow to Finish
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
NJ Other
Turkeys
Turke Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[-]Yes [-]No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[—]Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
Page 1 of 3 21412014 Continued

lFacility Number: 496 - 27 19 jDate of Inspection: — 8 New
rS
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard?
❑ Yes
2 No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: /alrn
Spillway?: y #5
Designed Freeboard (in): / g
Observed Freeboard (in): / Z
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
R] 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
,R] No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
�2 Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
® Yes
❑ No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[:]No
JR] NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
[:]No
,Z 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
J4 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
❑ No
® NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
1g NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
R 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
[—]No
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
❑ 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

�j
0
-A

[Facility Number: Tb - 2 • I Date of Inspection: , ¢ S
24. bid the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes MM No Xg NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes rNo ® NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ❑ No 0 NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes ❑ No ® NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ❑ No ® NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
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 .® No ❑ NA ❑ NE
❑ Yes ji No ❑ NA ❑ NE
❑ Yes ❑ 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?
0 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).
7 �ae-rsS dl(� 57.11 retrt.....s,n / ;11,' y, /Iyue S/�i//wwy l✓1 /170VA,
►�GLrrtu� �NM /vl�a Si /I ON Op A/t W1 fV/ �/%gSJS D✓1 /T � Si5/lf
J o G
3 // w l t11j;j • Wj'11eonii4,-e_
Reviewer/Inspector Name:
Phone: 336 -77G-'7d? %
Reviewer/Inspector Signature:
Page 3 of 3
Date: 7- 5"' 70/5
21412014

Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint do Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Arrival Time:
Departure Time:
County: suf!:�
�—
Region: M /�O
� -1NS
Farm Name:
E
I :,er4 S
Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Soz w1M k
TJ. Sr^
Phone:
/( "?_
Facility Contact: J s" Title: Phone: 'f g' U�- 71 S 7
Onsite Representative: Integrator:
Certified Operator: EJ)-t. Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet PoultnY
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dai Cow
Wean to Feeder
$'U
Non -Layer
Dai Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder -
Farrow to Finish
D . P,oul
ILayers
Design
Ca aci
I
Current
P,o ,
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
I
Beef Feeder
Boars
Pullets
I Beef Brood Cow
Other
Other
I I
Turkeys
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 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 Jallo ❑ NA ❑ NE
[-]Yes []No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes
® No
❑ NA
❑ NE
[-]Yes
Ea No
❑ NA
❑ NE
Page I of 3 21412014 Continued

Facili Number: T6 - Z • jDate of Inspection: 7 !-
Waste Coliection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
JS] 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. �ay ovn
Spillway?: i
Designed Freeboard (in): / a
u
Observed Freeboard (in): �3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Q 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
a No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
I® Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
El No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
Yes
❑ No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
® NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
❑ No
® NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved
Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
® NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
® NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
® NA
❑ 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
❑ No
JK NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
2) NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ No
0 NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[—]No
® NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[-]Yes
❑ No
® NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
NA
❑ NE
Page 2 of 3
21412014 Continued

Facili Number: - • Date of Inspection:
24. bid the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No IB NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No EG NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ❑ No 2 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 ❑ No ]DNA ❑ NE
❑ Yes Q No ❑ NA ❑ NE
❑ Yes Q No ❑ NA ❑ NE
❑ Yes ❑ No Nr NA ❑ NE
❑ Yes [g No
❑ Yes J�j No
® Yes [—]No
ons:or any: other;
Ise drawings of facility to better explain situations (use additional pages as necessary)..
se
I. �' XC�SS Q" r lClttie.� S rA SR//�j rn 7'.L S4'^j-
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Iments.
9 �GGirttc��i.� /trSh/Ife /S,5/7i�/<�9,`du��J/J(' /GGrtr�lw� p'�It iA/I!e+"�f is
CuyyCnr`"`t 7 �a.��O� fit
e,l�G 4-rrr Wtft i-o pu MrJ LVe— btt,R ��Stoprtso� % 17�/oJSIJ en 4
do iI — I—Jocgl.
vtsJO w,'ll <. 1t �, 10W`1_ fe,J „d
Reviewer/Inspector Name:
Phone: 7 34(-77i 74W
Reviewer/Inspector Signature:
Page 3 of 3
Date: 7'6— Z=/S
2/4/2014

Type of Visit: 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: O Routine O Complaint O Follow-up O Referral & Emergency O Other O Denied Access
Date of Visit: 6- 9 to/S Arrival Time: Departure Time: County: Su/� Region: W SA O
Farm Name: d,01 /lt F / ^r-ol S Owner Email:
Owner Name: l_ 46g dl 4 // J
//t^
Mailing Address: 50 Z y//i 4
Phone:
46,
Physical Address: -�
Facility Contact: ��� J d �i� Sd 17 Title:
Onsite Representative: //
Certified Operator: Ep'l
Back-up Operator:
Location of Farm:
Latitude:
0ii�3` !a-7,ZS7
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
zoos
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
La er
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
DairyCow
Wean to Feeder
]Non -Layer
DairyCalf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
I) , P,oul
Layers
Design
Ca aci
Current
P,o ,
Da' Heifer
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
lBeefBroodCow
Other
Other
—TurkeyPoults
Turke s
Other
El
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[-]Yes
55 No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes 2 No
[:]Yes KNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3
21412014 Continued

Facility Number: VWX - 2 • Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure Structure 6
Identifier. 0/1
Spillway?: e 5
Designed Freeboard (in): /71 1/
Observed Freeboard (in): /0 u
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
MNo
❑ 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
JZ No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
EgLyes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
® Yes
❑ No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
❑ NA
CjJ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[:]Yes
[:]No
❑ NA
AT 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
Q NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
[RNE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
❑ NA
ONE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
14 NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
❑ NA
NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ No
❑ NA
IRINE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other.
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ,KNE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a min gauge? ❑ Yes ❑ No ❑ NA KNE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ANE
Page 2 of 3 21412014 Continued

Facility Number: • Date of inspection:Af-7—OE
24.'Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA EINE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA ONE
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 JNE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NA ;,NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [:]No ❑ NA KNE
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
JNo
❑ 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
IRZNo
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
I, NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
allo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
g'No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
aYes
❑ No
❑ NA
❑ NE
Zomments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Jse drawings of facility to better ex/plain situations (use additional /pages as necessary). r
q 1,SJ l b l r"t d /e ,ed ;-+r; ^- lO f rl.' 5�.��^ evri
a//. !bG /Wos A ovL irlal(/ rOu�
�d�Ie !. // d.s�t eH I G/s/zo<11s f4i T a/G/H1G lift w,s%•s/r/+�w)< N,.� ! %�.� %•S pu rp
r�t.01 bro�f �u� Ww�d b! ��v.w /•G�ari %� „43 5� frc//�dp,rGCG�VrC-
7'�,ti / s S t�// �X!<5S C�///� Jso��lo/ I H t�/ �//1✓,7 ° I— f w1 r I S 4 aT
tr�rrt+��
IS 1, ffl y A.1) ;WAHrnr`L <joG4- 6rn.T qlt/S To 6t Y<//°./to' Iv r1. �..,.•./ {Nt�unct
119pvn15
museg
�,. rf G� �i»y %�t, �Or tl �o /'tlrrlusGa� G✓o5 f° I
/+ on .i%r.�✓
So ¢rts�l�/q �/ S avrr,' �O6,t uSt�W�•G� i5 adid'�� ��
qw«�< Iv fltPar,� k � 1on3sess
3ti 1 411,w L, 141d
r�A- �%� ✓���t Will l�,�a�, ,� a>.,teken
QF rrr5 4, d 0� � /agpoA.
I rw. vwn
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: 3f6l,-731 /&// /
Date: &I -
Page 3 of 3 1 1 21412014

FacilityNumber: ( - 2 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus stone storage plus heavy rainfall) less than adequate? ❑ Yes No
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 1 Structure 2
e an st
Ys
/ 9�'
❑ NA ❑ NE
❑ NA ❑ NE
Structure 3 Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
to 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
Ja 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 DWR
7. Do any of the structures need maintenance or improvement?
10 Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
0 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
Q No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes JEg No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. �❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): _5 lae lore
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.
❑ WUP ❑Checklists [—]Design ❑ Maps ❑ Lease Agreements
[:]Yes
0 No
❑ NA
❑ NE
❑ Yes
jg]-No
❑ NA
❑ NE
❑ Yes
.0 No
❑ NA
❑ NE
❑ Yes
,fallo
❑ NA
❑ NE
❑ Yes ; jallo ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
[—]Yes K[ No ❑ NA ❑ NE
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
,Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes XLNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No KNA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: 6 - IDate of Inspection: fs�
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes JKNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 4ELNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes IS No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑Yes E§_No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes ONo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes F1 No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes KNo ❑ 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 ®-'o ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes jKNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes .tom No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes allo ❑ 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).
,q7. D,14 ,"
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: T d - 77V `%M
Date: 9—Z-c'-2PS
214,12014

Type of Visit: *Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ,/IIf-jor Arrival Time: ,, ooa"� Departure Time: //,, de County: Region: lV S�O
Farm Name: Oulllt?II. I ct,-,w S jj Owner Email:
Owner Name: C_)" k g IYt O Tno J ^ sow / Phone:
c9re, //- 336-W 7 257-
Mailing Address: 50 Z in1 N � � lQgj � M,^ A/ee z o O 2
Physical Address:
La.
Facility Contact: rj),trOf// lC/LGyt Title:
Onsite Representative: Gjil e- /
Certified Operator: �fid�/gS G/ . J-61450,1- /.
Back-up Operator:
Location of Farm:
Phone: f%- 336-3W- '98pZ 7
Integrator h (- N
Certification Number: 'g 003
Certification Number:
Latitude: 36 Z / �� Longitude: 0
7-77 t/ i1 Ze,Ayr "R , R
Q ,
&,-,"
on lam/
Design Current
Design
Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish I
ILaycr I
I Dairy Cow
Wean to Feeder 4/ 1
lNon-Layer I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design Current
Dry Cow
Farrow to Feeder
I)r P,oul
Ca aci
P,o P.
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullers
Beef Brood Cow
Turkeys
Other
Turkey Points
El Other IOther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes J& No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑Yes
❑No
❑NA
❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
g No
❑ NA
❑ NE
❑ Yes
Callo
❑ NA
❑ NE
Page 1 of 3
21412014 Continued

Facility Number: Date of Inspection: S--/
o/
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[E 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: a Y70 rL
Spillway?: YG S
Designed Freeboard (in):
Observed Freeboard (in): nr/S
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
2 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
0 No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
El Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[:]Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
',� No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
;allo
❑ 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): / o r ^-
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Z 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
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
.O No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
IN No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Jallo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
410-No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement ❑ Yes Z No
L?rWaste Application [2<eekly Freeboard �aste Analysis oil Analysis E] Waste +mnsfers
Rainfall ❑ Stocking Crop Yield 120 Minute Inspections E3Vonthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes QN
❑ Yes ❑ N
❑ NA ❑ NE
[ eather Code
❑ Sludge Survey
o ❑NA ❑NE
o TjjNA ❑ NE
Page 2 of 3 21412014 Continued

[Facility Number: Date 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 ❑ 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? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphors loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Otherlssues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes C,No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
❑ Yes ® No ❑ NA ❑ NE
❑ Yes JK No ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes allo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes Qallo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ED_To ❑ 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).
-% wi 11 ra,rk t�/rry/a/r,C- /teed dtiihefwre 121s1Izo15 Aij OJ24
O7�re)4L_frt¢4 reels J14C to 701s
ZS - 51udyc- SUriley g,e.✓!
Z PAAI g. /9 rn CUrI�/rwlCJ? `%C s
3 z -Ls nJ/r`r/1 {-O a 101/r ka'S{'e �'"1 SP/�np/o-//y SNSNN1af
7- I l ew� �, v�1 o,a oa/M �- res«�9 f _ f
014" 2-6k G/ofe
Reviewer/Inspector Name:
Phone: X� — 771
_ M
Reviewer/Inspector Signature:
Date: S —11— 2
Page 3 of 3 r r 21412014

Type of Visit: Qk Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: "�FLIy Arrival Time: separtureTime: County: Burr
Farm Name: Double: 6 F&r IY►,5 Owner Email:
Region: b
Owner Name: � 1�'1y���1 J-Ohn'50r) Phone: *Ae11 3&tto - 7 :157 bddle
Mailing Address: S t7o2 WV,-, to R.o ad 1 E I K-i n) tQ C. zcd 6 a-1
Physical Address: Fed LO-V L r% - `/
Facility Contact: E M► e- or 6 1 kPYI Title: Phone: 9 36 do - 1/ a a" 7
Onsite Representative: F aA l t:
Certified Operator: ' p c m s E. fo h n so n
Back-up Operator:
Location of Farm:
Integrator:
Certification Number:
Certification Number:
,,L ' Q 11
Latitude: ��a a T Q � r/ o Longitude: OD �� )
Z--77 NIB za�ptiy r RA Whi+e- R
• /
rm on
Swine
Wean to Finish
Wean to Feeder
Desigu Current
Capacity Pop.
Q O
Wet Poultry
La er
Non -La er
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
DairyCow
DairyCalf
Feeder to Finish
Farrow to Wean
D . P,oultr. •
Layers
Design
Ca aci
Current
P,o P.
DairyHeifer
Dry Cow
Farrow to Feeder
Farrow to Finish
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
I Beef Brood Cow
Other
El Other
Turkeys
Turkey Pouets
Other
Discharges and Stream Impacts
Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ICI No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes
ONo
❑ NA
❑ NE
❑ Yes
Wo
❑ NA
❑ NE
Page of No D— ;?-oI q— PC — V, / 21412014Continued

Facility Number: Vp Date of Inspection:
Waste Collection & Treatment Mr
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? AYes ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes )KrNo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: % /101n
Spillway?:
Designed Freeboard (in): T
Observed Freeboard (in): 7/
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes J)jj< ❑ 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 DWR
7. Do any of the structures need maintenance or improvement?
KYes ❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
E 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 XNo
[3 NA
❑ NE
maintenance or improvement?
7777'""
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No
❑ NA
❑ NE
❑ Excessive 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): DW-DL I! q--r Q I n , (',or11 4 rat N
13. Soil Type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes W No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes XNo
❑ 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 tR1go
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes 1�[ No
❑ NA
❑ NE
Required Records & Documents
T
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes y]No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes I � No
""
❑ NA
❑ NE
the appropriate box.
777
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
VWoa'ste
s record keeping need i provement? i€�esrche a be>fbel ❑ Yes No ❑ NA ❑ NE
Application Weekly Freeboard Waste Analysis Soil Analysis ❑aVesfer+sfers Weather Code
ainfall Stocking Crop Yield 120 Minute Inspections Soil
and V Rainfall Inspections ❑Sludge Survey
22. Did the facility fail to install and maintain a min gauge? ❑Yes No NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No KNA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: • Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes J�No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 40 No ❑ NA ❑ NE
the appropriate box(es) below. / J
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels /� J
❑ 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, ceboard problems, over -application)
❑ Yes X No
❑ Yes >�<o
❑ NA ❑ NE
❑NA ❑NE
❑ Yes eW ❑ NA ❑ NE
❑ Yes T 17d No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
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?
FYes
❑ No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
EJI�o
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Io
❑ NA
❑ NE
(Comments (refer to question !I): 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).
(-I , *1 l i n s pi II w" neamo ved ? N D — NUD
, L PAN Cr Sma-tl gr-6it n corvrnrmec� ? No — nC+ 4e-l'o Could be-
J ova o f 1
025 Stu 0- 5urv8jj 4 rm cory P 4r ao 13 ? ivo+ �{-a �1 7
1 P
EA4 • (;Q 11 b rri o r of redo g re�l'1 rem{ S d e on o101 S. r Cope
3� hest-1�
No 0
i ao � A 5= a. q Ilas. N 1000
� ^1
Reviewer/Inspector Name: I l r L Phone: 336.7 %C ', J or
Reviewer/Inspector Signature: Date: o�
Page 3 of 3 2/4/2074

for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: a 0 Arrival Time: Departure Time: County: U r r Region: 1052 6(1
Farm Name: DO V io le, 6 Far rn S Owner Email: I ,
Owner Name: CAd.lt: + C(IPA1-Toh11SOn Phone: tt 316 to ? 2-S­ 7 El�d�'✓
Mailing Address: Lj o X \o l i-2_ P_ocA i E I Y-- t I^ t t, cG
Physical Address: E2p—A UA (,c-n2
Facility Contact: T
EAA k /P�_ n r Fi (I � Title:
OnsiteRepresentative: T Ybom_o .s JD k r\so )
Certified Operator: J/
Back-up Operator:
Location of Farm:
Phone: //36 6 - 4 FS R_
Integrator: L d 14
Certification Number:
Certification Number:
Latitude: 3 b C a2 q 1 0Q 1 / Longitude: 100 y 6 / IV t/
I-l'► N� 7,4-PVI4r (L .1
W K t e- �,� flaarn2 on
DesiINS-urren[
Desigp
Current
Design Current
Swine
Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
Da' Heifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
I) . P,ouI
Ca a_city
Po
Non -Da
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
Turkey Poults
Other
I I
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 M No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes []No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 21412011 Continued

Facility Number: - a- • 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 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 00A
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
CN�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
tbireat, notify DWQ
7. Do any of the structures need maintenance or improvement?
W Yes
N+7 o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
XNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
CeNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
L es
❑ No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ;KrPAN > 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): ✓J�d Q� , ('
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
gNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Dpo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
KNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
C�'No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
T5�No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
k No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
N No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑O er.
21 ing need i provement? I€3�es,.ch [ebe VYes ❑ No f�IA ❑ NE
Waste Applic on eekly Freeboar Waste Analysi Soil Analysis ransfcrs Weather Code
[�'R4infall Stocking Crop Yield �20 Minute Inspections Monthly and 1"Rainfall Inspections d Sludge
Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes VNo ONA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes ❑ No 96 NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: Date of Inspection:
24. Did the facility fail to calibrate waste app0iion equipment as required by the permit?
❑ Yes
No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a 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
[KNo
❑ NA ❑ NE
Other Issues
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
P(No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
['No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
�/
I XNo
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
7`�
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
kNo
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
CVNo
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
'DNo
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other, comments.
771
Use drawines of facility to better explain situations (use additional Daees as necessarv).
LA�r 1
, 2-613I / .� i ✓ �l ,
/ I i
`0OJS
.
` t ,
/
Reviewer/Inspector Name:
Phone: '1 7 1- S a 8 9
Reviewer/Inspector Signature:
Page 3of3 3/2;L/13 Slvrr�{ = la.V
S w.i = �2' (
Date: 11 /o'LOl a p ( -3
21412011

z
IType of Visit: C�1 Qompliance Inspection O Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emereencv O Other O Denied Access
Date of Visit:
I �/ l,3 /I za
Arrival Time:
Departure Time: ,r County: SK�
Farm Name:
T)o L,
6 Le,
E_E �. MI
Owner Email:
Region: I-j-'s go
Owner Name: F_(C 4
61l en
T40
o n
Phone:
N 31,6 --7 257
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
L,n,
chttt Title:
Certified Operator: _rLm t­� 97• jo v 0 E n
Back-up Operator:
Location of Farm:
Phone:(*) 366-- •7 F 2-7
Integrator• L4r4_
Certification Number:
Certification Number:
Latitude: 3Ce 7Y,0 Longitude:
Swine
Wean to Finish
Design
Capacity
rJ67
Current
Pop.
1
Wet Poultry
ILayer
Design Current
Capacity Pop.
I
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
I
jNon-Layer
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D , P,oult .
Layers
Design Current
Ca aci P,o
Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
Stream Impacts
j
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
!4
a. Was the conveyance man-made?
❑ Yes
[:]No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
[—]No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
�No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
gNo
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3
21412011 Continued

l Facility Number: 9C y • 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 fE] No ❑ NA ❑ NE
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
%Structure 1 Structure 2
%72i
Structure 3 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 0
No ❑ NA ❑ NE
❑ Yes Zbo 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 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 I Y I No
❑ NA
❑ NE
maintenance or improvement?
777�ttt[
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes IXI 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): 4!�,/rA
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes o❑
NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yeso❑
tNo
NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ NA
❑ 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 No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes [� No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? ❑ Yes No ❑ NA ❑ NE
� Zal[� ZOI2.
I rl W ste Application eekly Freeboard ante Analysis Sod Analysis B wmtc+iartsfeta— Weather Code
Rainfall Stocking Crop Yield 120 Minute Inspections Monthly and 1" Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of Z1412011 Continued

,
,i Facili Number: • Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes I YI No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes %r No ❑ NA ❑ NE
the appropriate box(es) below. 111 CCCC'
❑ 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 [DNA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues �/
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes M No ❑ NA ❑ NE
and report mortality rates that were higher than normal? TC'
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes IYI No
If yes, contact a regional Air Quality representative immediately. f'�'
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes �No
permit? (i.e., discharge, freeboard problems, over -application) 111111�TTTTTT/
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes �/j No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWW?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
[—]Yes M/No ❑ NA ❑ NE
Comments (refer to question ft 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).
zy & 11A-h�v� j nil. Zol1. 414- � �►� 6o �." Utz. N � . zoly
2S, ZDIl )16 iL, rve, Gv b/1 ? (6taQlekl 6'f Zol Z ,
7, Mow pi�t�-.lcMevv tr 4- -krsti- I� ",-eW vy 4 r bra SQL tR-� w��s
WNTEAVA�
Vzf/n =
8/z9/1= z,y,6n)
Il/I0//1 = 2,5-IbAl
31OSI/Z = Z,/ ld/j
7/u/IL = 2, s /1 N
Pt�rM 7;WhC
8/iP/2-= 2,97/.
Reviewer/Inspector Name: �Lj -1( 11-4< M;kk I / Phone: 67WI)SZYS
Reviewer/Inspector Signature: Date: / j '/ Z-
Page 3 of 3 21412011

Type of Visit U Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit )f Routine Q Complaint Q Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: ( County: U r r Region: w-
Farm Name: T)OU b I.e. E rQ rmo Owner Email:
Owner Name: el d F i e . ra h n.5 R Sr Phone 13� � � 7
Mailing Address: n I �� �a-�
Physical Address: Fo tgA-1 n e—
Facility Contact: E4a ii Qe_ Of e l kY1 Title: Phone No:
Onsite Representative: (o� Integrator: L`hH
Certified Operator: I ry0ilkQS 1Ohn,soO,, Jf Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: M o ® I U81 Longitude: ®o ® ,
- = Design
Current ) Design m ,„',, , Design ';..,Curren[
Somme Capacity
„Current
Population ` Wet Poultry "Capacity Population
Cattle Population
„ yrCapac�ty
Wean to Finish
-7 (p43 01
k. ❑ Layer I
❑ Dairy Cow
Wean to Feeder.
❑ Non -Layer
,, ❑ Dairy Calf
❑ Feeder to Finish
:'°;;, ❑ Dairy Heifer
5j -]Farrow to Wean
- ElD Cow
Dry Poultry t
❑ Farrow to Feeder - - -
❑ Non -Dairy I
A" El Farrow to Finish
❑ Layers
+' ❑ Beef Stocker
❑Gilts
El Non -Lavers
` ❑ Beef Feeder
ElBoars
•_ El Pullets
❑ Beef Brood Co
❑
�: Turkeys
Other Turkey Poults
❑ Other+
1'z [I Other
NumlierofStructures
x k
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?
•qe l of 3
❑Yes 0No [I NA [I NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
0
❑ No
❑ NA
❑ NE
❑ Yes ,, NNo El NA [I NE
❑ Yes ? No ❑ NA ❑ NE
12128104 Continued

Facility Number: (p — d • Date of Inspection 3 1 •
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
ElYes
0 No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
ElYes
❑ No
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: 0. 00n
Spillway?: 5
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[(No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
[)�No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes KNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes XNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ONo ❑ 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 9No ❑ NA ❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) TTTTTT���
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window P Evidence of Wind Drift [ Qpjlcuat�p Outside of Area
12. Crop type(s)
13. Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
X'?
❑ NA
El NE
15.
Does the receiving crop and/or land application site need improvement?
El Yes
o
❑ 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
9No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
MNo
❑ NA
❑ NE
i!5 oa ✓how LLtDt� -
i5 ` lzuv --�- C�oLk) hu prior+b P[0JA �,q ; ac S
No _
Reviewer/Inspector Name S^J b Phone: W 7 7 1 Sa�
Reviewer/Inspector Signature: Date: I
Page 2 of 3 12128104 Continued
.m

0
0

2
S�IN�
Facility Number: — a of Inspection 3 •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes IbI No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes /�(J No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other l
21. Djo s record keeping need i rovement? ❑Yes ❑ No NA ❑ NE
ste A lic ion Wee Freeboard Waste Anal sis E'7 .,.__. T _
pp y y ❑ Soil A Iys' �:crs
Rainfall IJ Stocking Crop Yield 120 Minute Inspections onthly and 1" Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
No
ElNA
❑ NE
ElYes
ro
❑ No
VNA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
No
El NA
❑ NE
❑ Yes
o
❑ NA
❑ NE
❑ Yes
CXNo
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
$No
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
PfNo
❑ NA
❑ NE
❑ Yes
tgNo
❑ NA
❑ NE
ddi 'oval Comments and/or Drawings
aoo CQl�bra3poh ? ao(o �n.a.olb
•.
e +C
ao o100tSlovld1 c{260S,1u"1 r�v e�g+?5 ?e5do'l1V•oF&%A-
-e
ow !
99.1 114111 uo e<4 = a .9 l 6iNll000 SPA
(e l S • N/ foiv ,
v/
6
Page 3 of 3
12128104

V
Division of Water Quality
Facility Number Division of Soil and Water Conservation L A j 6
t Other Agency J tV
Type of Visit
Compliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
YRoutine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: 7L 1 al Arrival Time: ® Departure Time: '--t--1-1--xj County: 5 r r Region: A_696
Farm Name:' F� FOLM 5 Owner Email:
C
Owner Name: 1 i ie— U h l,,s 0 n . Sr' Phone: �t 1 3 6 4 — Y � � % /1 \�
i
Mailing Address:
Physical Address: FO lg& Piri nci l e- LQ n e-
Facility Contact: CAA li? ,�o r E t ten Title:
LE Representative: d GCi P_
Certified Operator: �Vao M 0.s (. J 1) h rwso nT r.
Back-up Operator:
Location of Farm:
Design Current
Capacity Population
Other
❑ Other
Latitude: FIln0
Phone No:
Integrator: T_" + H
Operator Certification Number:
Back-up Certification Number:
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & 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)
Longitude: ® °
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes
�(J No
t❑,
❑ NA
El NE
El Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
0
❑ No
❑ NA
❑ NE
❑ Yes [���(((No El NA ❑ NE
El Yes l No ❑ NA ❑ NE
121810`4 Continued

Facility Number: — • Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: Lq oon
Spillway?:
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 XNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes [(No ❑ NA ❑ NE
❑ Yes p(1 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 El NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes I R No ❑ NA [I NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) 7—`
9. Does any part of the waste management system other than the waste structures require ❑ Yes XNo ❑ NA El NE
maintenance or improvement? / _
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes o [INA ❑ NE
maintenance/improvement? //[[__
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ 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?
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
Wo
❑ NA
❑ NE
0 No
❑ NA
❑ NE
Vo
❑ NA
❑ NE
ANo
❑ NA
❑ NE
we
❑ 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):
IT
Reviewer/Inspector Name �j `p
Phone:
Reviewer/Inspector Signature:
Date:
/v�/000 3� 1'a0 10 12128104 ' Continued

Facility Number: $ — Date 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. ❑ Vweckly
WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does ecord keeping neerovement? If yes, check t e appropriate box low. ❑ Yes �(No ❑ NA ❑ NE
aste App�licpnon Freeboard., M aste Analysis Soil alysis O'asfe�s€eFs 19,,�6dmtt ^cc+i;,s 'on
Rainfall i� Stockingop Yield Lld'120 Minute Inspections Monthly and I" Rain Inspections / 1LJ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes f R.No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes T❑�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 O((No [I NA El NE
26. Did the facility fail to have an actively certified operator in charge? El Yes I,$ No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes VNo ❑ NA ❑ NE
Other lssues�,,t!
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 El Yes ICJ No [I NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application) 7
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? El0 Yes No ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes o ❑ NA ❑ NE
Additional Comments and/or Drawings:
a goo Njo Ko15t a 'ImtAlog+e- c
ab t o �b i Q f ? Nit deu� �e c mz�y -Vail . U
Po ? Po A
-
r 5� a8 US i- �1c3w2 Cvrm 655 ue les
No
Q PP�� c+,a�-=► o n � -�"o � Corn
a
W4Si�P1ap tS File,_ oV• �zoo3
Page 3 of 3 12128104

oaoFti^'ArEROG Incident Report
� =y
O `c
Report Number: 201001656
Incident Type: Non -Compliance Reporting
Category: APS -Animal
Incident Started:J01/24/2010
County: Surry
City: Elkin
Farm #: 08"029
Responsible Parry:
Owner:
t_P rt it:-3AWS860029
Facility: Double E Farms 2
First Name: Eddie
Middle Name:
Last Name: Johnson
Address 502 White Rd
City/State/Zip: Elkin NC 28621
Phone:
Material Category: Estimated Qty: UOM
DD:MM:SS Decimal
Latitude
Longitude:
Location of Incident
Address:
City/State/Zip
Report Created
White Road
05/14/10 01:27 PM
bd -;Dlo- PC, -o5g5
On -Site Contact:
FirsUMid/Last Name:
Company Name:
Phone:
Pager/Mobile Phone: /
Reported By:
FirsUMid/Last Name:
Company Name:
Address:
City/State/Zip:
Phone:
Pager/Mobile Phone: /
Chemical Name Reportable Qty. lbs. Reportable City. kgs.
Position Method:
Position Accuracy:
Position Datum:
Page I

Cause/Observation:
Action Taken:
Incident Questions:
Did the Material reach the Surface Water? Unknown
Surface Water Name?
Did the Spill result in a Fish Kill? Unknown
If the Spill was from a storage tank indicate type.
Containment? Unknown
Cleanup Complete? Unknown
Directions:
Comments:
Water Supply Wells within 1500ft: Unknown
Access to Farm Animal Population
Structure Questions
Conveyance:
Estimated Number of fish?
(Above Ground or Under Ground)
Groundwater Impacted: Unknown
Spray Availability
Report Created 05/14/10 01:27 PM Page 2

Access to Farm
Farm accessible from the main road?
Animal Population
Confined?
Depop?
Feed Available?
Mortality?
Spray Availability
Pumping equipment?
Available Fields?
Structure Questions
Breached?
Inundated?
Overtopped?
Water on outside wall?
Poor dike conditions?
Waste Structure Type Waste Structure Identi inches
Lagoon LAGOON 15.00
Event Type
Incident closed
Requested Additional Information
Report Received
Referred to Regional Office - Primary Contact
Report Entered
Incident Start
Event Date
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Plan Due Date Plan Recieved Date Level OK Date
2010-05-11 01:18:29
2010-01-24 08:00:00
Report Created 05/14/10 01:27 PM
Due Date Comment
Page 3

Standard Agencies Notified:
Agency Name Phone First Name M.I. Last Name Contact Date
Other Agencies Notified:
Agency Name Phone First Name M.I. Last Name Contact Date
DWO Information:
Report Taken By: Report Entered By: Regional Contact:
Melissa Rosebrock
Phone:
Date/Time: 2010-05-11 01:18:29 PM
Referred Via:
Did DWO request an additional written report?
If yes, What additional information is needed?
Report Created 05/14/10 01:27 PM Page 4

Type of Visit IR Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit li Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit:
Arrival Time: Departure Time:
County:
Region: .4
1.d.y
Farm Name:
owe
F,
Owner Email:
/
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: *P! t1C 11017 Title:
Onsite Representative: f---0fol
Certified Operator:
Back-up Operator:
Location of Farm:
Fq 346 - ?zs-,7
Operator Certification Number:
Back-up Certification Number:
Latitude: ®o ®I FaRl„ Longitude: ®o®, 3�11
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes b No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
kNo
❑ NA
❑ NE
❑ Yes
�lo
❑ NA
❑ NE
I
12128104 Continued

I
Facility Number: — 02 . Date of Inspection •
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes KNo ❑ 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
IdeaSpillwway?:y?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
fKNo ❑ NA ❑ NE
8. Do any of the smcmres lack adequate markers as required by the permit? ❑ Yes
VNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require El Yes
//
L7tl No ❑ NA [I NE
maintenance or improvement?
,
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
[ Io ❑ NA [I NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ] 0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
No ❑ NA ❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
Comments (refer to question #). ~Explain any YES answers and/or any recommendation c an` y o her, commentsy
Use drawings of facility to better explain situations (use additional pages as ne ssary) 4 -
Reviewer/Inspector Name I Phone: —
Reviewer/Inspector Signature: Date:
i
12129104 ' Cdntinued

Facility Number: — Date of Inspection Bigrm
r l
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 ❑ Desi gn El Maps El Other
21. Do s record keeping needim/pfovement?• stabs ❑Yes I N No ❑ NA ❑ NE
waste Application Lid Wee y Freeboard Waste Analysis Soil .alysis 9-Vdastr^T'rmts'11'PS 7,
p2Rainfall Stocking Crop Yield 120 Minute Inspections �onthly and V Rain Inspections >rweather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
H.
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ NA [INE
ElYestNo
o ❑ NA ❑ NE
❑ Yes
DZNo
❑ NA
❑ NE
❑ Yes
Id No
T[yNo
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes A, No
El Yes AU No
❑ Yes ICI No
❑ Yes NO
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
[I NA ❑NE
❑ NA ❑ NE
•
11/18104

Facility Number
Type of Visit Com
Reason for Visit X,R(
Date of Visit: I
Division of Water Quali"I
Division of Soil and Water
Other Agency
5WI&
Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Time: ® Departure Time: County: V r Region: b35,n�
Farm Name: 1 ) Lit-) KJ I t✓ L:i • t--QV' m_�) Owner Email: �. )
Owner Name: Lj.d I E �,r0 b rr -,, ti Sr - Phone: 366 — 4 'Z6 a -7
Mailing Address: 6—o a wjA li e_. F i t L a� b off/
Physical Address: F0 I tA.4rgrf Ind L? Laln P_
Facility Contact: ��.(I(1p�J �OV_ � _ Title: Phone No:
Onsite Representative: ' l_.GIL.E7t�ka ^r- Integrator: L+R
Certified Operator: o v- v o h n S� r Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: B(A I W-Y L� Longitude:
Design Current Design Current
Swine Capacity -Population Wet Poultry Capacity Population
Wean to Finish JE1 Layer
�JWean to Feeder II ❑ Non -Layer
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design.
Cattle Capacity
0
❑ Dai Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: E
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 'Io ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
[ &No
❑ NA
❑ NE
❑ Yes
b(No
❑ NA
❑ NE
Pagel of 12128104 Continued

Facility Number. — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1
Identifier: Laq min
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3
Structure 2 Structure 3 Structure 4
❑ Yes Lb No
❑ Yes ] No
Structure 5
El NA ❑NE
❑NA ONE
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) TTT��K
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes P<0 ❑ 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
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
._/No
No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
El Yes
,,yy����,//////
�$No
❑ NA
El NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground El Heavy Metals (Cu, Zn, etc.)
//
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
C
❑ Outside of Acceptable Crop Window ❑ Evidence
e
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those
Drift ❑ Application Outside of Area
15. Does the receiving crop and/or land application site need improvement?
Yes ❑ No ❑ NA ❑ NE
❑ Yes 4 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ���rrr No ❑ NA [I NE
17. Does the facility lack adequate acreage for land application? El Yes No El NA ❑ NE
18. Is there a lack of properly operating waste application equipment? [Yes '❑`No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use addi ' nal pages as necessary):
Re ewer/Inspect ame I ) —sa Phone:
Reviewer/Inspector Signature: Date: 0
Page 1 of 3
12128104 Continued

0

CA
LIV
Facility Number: — *Date of Inspection ,Z.6 •
Reouired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes o El NA El NE
W 20. Does the facility fail to have all components of the CAMP readily available? If yes, check ❑ Yes tNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Do 's record keeping need ' rovement? If yes, check [ appropriate box be w. ❑ Yes No ❑ NA ❑ NE
/write Applic ion NJ Weekly Freeboard rite Analysis Soil alysis n
A! , infall pt7 Stocking Crop Yield 120 Minute Inspections f�onthly and I" Rain Inspections eather Code
22. Did the facility fail to install and maintain a rain gauge? A+ ✓1 o V—,;e, ❑ Yes KNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes El
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? .n /(l fte,&LMS ❑ Yes �y�.//No [I NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes L _No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes (KNo ❑ NA ❑ NE
Other Issue
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ��ttt,,, No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours an document ❑ Yes /pI`No ❑ NA ❑ NE
and report the mortality rates that were higher than normal? I���,,,(((_
30. At the time of the inspection did the facility pose an odor or air quality concern? El Yes t�,�Io El NA El 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 IN 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 [X,,No ❑ NA ❑ NE
AVitional Comments and/or Drawings:
v+
WA
L a�
G
:a
Page 3 of 3
12128104

Facility Number
Division of Water Qualit+
Division of Soil and Water
Other Agency
Type of Visit
Compliance Inspection
O Operation Review O Structure Evaluation
0 Technical Assistance
Reason for Visit
( Routine O Complaint
O Follow up O Referral O Emergency
Q Other ❑ Denied Access
Date of Visit: 9 TT3 0 Arrival Time: I^ a o Departure Time: Q� County: Sit rry Region:
Farm Name: L.) e E Farrns Owner Email:
Owner Name: as I e. `T't lririnoyo 1 J r. Phone) 3& �P — qg a- 7
Mailing Address: 50 7-W 1NIke, Pd -I e � KI Yl . N C I
Physical Address: Fo ke V 6 r t Yili l2 1.G1k1
Facility Contact: -en Title. Phone No: C� 3 4, to _ 1 a S 7
Onsite Representative: Integrator:
Certified Operator:DYYlt315 E Soh n5orl� J Y • Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Other
❑ Other
Back-up Certification Number:
Latitude: o ®4g Longitude:
11
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
l to p 1 $'q ❑ La er
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
a
Design Current
Cattle Capacity. Population
❑ Dairy Cow
E]Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: F1 11
.
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 ko ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[]Yes
0
ONo
❑ NA
❑ NE
❑ Yes f)"o
' No El NA [I NE
❑ Yes ` ❑ NA ❑ NE
12128104 Continued

Facility Number: — . Date of Inspection I y ►6�
Waste Collection & Treatment �,/
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? El Yes k 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: LAI
cor
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): /
5. Are there any immediate threats to thethhee integrity of any of the structures observed? El Yes I� No El NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) ,.!"J
6. Are there structures on -site which are not properly addressed and/or managed El Yes LjQNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ,,[�����..$No El NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes Lp No ❑ NA El 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 P6No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10.
Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
No [INA ElNE
0
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes
,�y(
I.p.No ❑ NA ❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 Ibs ❑ 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) r
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP? El Yes
���(((
No ❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
'
XNo ❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
�6 No ❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
XNo ❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment? Dd Yes
❑ No ❑ NA ❑ NE
Comments (refer to question ff): 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):
wlte4-11. {2ee1S re air 1 re- Calibres}eci,che��e(� a Tfo'ce in aootop
ra 2onn'e-,In-
evrewer/Inspector Name Im e.l l ,Sso \ &.o h rry V _ Phone: -7-1
Reviewer/Inspector Signature: JILA ) IAA A— I /JhT/ I -0 A At, 9r Date:

10.
Rom
Facility Number: lip Date of Inspection •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes k No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 4No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check !hpappropriate box below. El Yes No [I NA El NE
['Waste Application eekly Freeboard D<aste Analysis soil Analysis u�
Ej"R3 � �
ainfall ►G��ocking Crop Yield 120 Minute Inspections M- onthly and 1" Rain Inspections M'hlreather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 9No ❑ 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 No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes No El NA El NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes No rrr❑ NA El NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? El Yes El No 'KNA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes C9 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 I)(1 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
Additional Comments and/or Drawings:
kipz_
co-1 5611 %e5t re5u I+s ?
n'E jP
a60_1 Sluage- �;�rvet, 2 RQ-%v��ed eery yeaIr L --e aoob to �co
Ca-
aoo� Cc; l'ilorci�ior, dct}ea 9 �9 ( bra-hon
e-b0%red every-oV1ne,r NjQaur.
aoo-4 Qorh�7) Coop �ieldS ?plc 14
°� �.¢ � N W u P o U
_* PfU8.19' _W
Fe_k -- No✓
�9107 co - = c2. 1 I b s . N , 600
!/ 17 JaAo_7 = a tl�s. �►��000�-P.
12128104

.._
_
y
K
.
;
_.
�.
!.
__
I
`'
_-
q
9
a-

•
C1
Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 860029 Facility Status: Active Permit: AM860029 ❑ Denied Access
Inspection Type: Compliance Inspection
Reason for Visit:
Inactive or Closed Date:
County: Sum Region: Winston-Salem
Date of Visit: 10/31/2006 Entry Time:09,20 AM Exit Time: 12:00 PM Incident #:
Farm Name: Double E Farms 2 Owner Email:
• .rr
Phone: [phone]
Mailing Address: 502 White Rd Elkin NC 28621 .
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator
Location of Farm: Latitude: 36°24'08" Longitude: 80°46'14"
White Road. 1124 1/2 mile south of Zephyr Rd. Approx. 2 1/2 miles west of Dobson.
Question Areas:
Discharges & Stream Impacts Waste Collection & Treatment Waste Application
Records and Documents Other Issues
Certified Operator: Thomas E Johnson
Secondary OIC(s):
On -Site Representative(s): Name
On -site representative Eddie Johnson
24 hour contact name Eddie Johnson
Operator Certification Number: 21416
Title Phone
Phone: [phone]
Phone: [phone]
Primary Inspector: 1111��� i sa RlIoseebrrock Phone:
Inspector SignatureA Date: 10131 11 O O
Secondary Inspector(s):
Inspection Summary:
20. Need to perform calibration again with rain gauges and dear field. Will also need specifications added to CAWMP by irrigation
specialist (psi, nozzle size, Bow, etc.). This second calibration may "count" for 2007.
8/18/06 waste analysis=2.4 lbs. N/1000 gal.
Page: 1

Permit: AWS860029 Owner- Facility: Eddie Johnson Facility Number: 860029
Inspection Date: 10/31/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current Population
Swine
O Swine - Wean to Feeder 7,680 6,227
Total Design Capacity: 7,680
Total SSLW: 230,400
Waste Structures
Type Identifier Closed Date Start Date Desianed Freeboard Observed Freeboard
lagoon LAGOON 20.00
Page: 2

' Permit: AWS860029 Owner- Facility: Eddie Johnson Facility
Number:
860029
Inspection Date: 10/3112006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No
NA
NE
1. Is any discharge observed from any part of the operation?
❑
■
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
■
fl
fl
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?
❑
■
D
D
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a
❑
■
❑
❑
discharge?
Waste Collection, Storage & Treatment
Yes
No
NA
NE
4. Is storage capacity less than adequate?
❑
■
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large trees, severe
❑
■
❑
❑
erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a waste management ❑
■
❑
0
or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
■
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits,
❑
■
❑
❑
dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑
■
❑
❑
improvement?
Waste Ap licp ation
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

r-I
L-A
r-�
L-A
Permit: AWS860029 Owner -Facility: Eddie Johnson
Inspection Date: 10/312006 Inspection Type: Compliance Inspection
Facility Number: 860029
Reason for Visit: Routine
Waste Application
yes No NA NE
PAN?
❑
Is PAN > 10°/n/10 lbs.? -
❑
Total P2O5?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑ -
Application outside of application area?
❑
Crop Type 1 Small Grain (Wheat,
Barley, Oats)
Crop Type 2 Com (Silage)
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste Management
❑
■
❑
❑
Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
■
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
❑
■
❑
❑
17. Does the facility lack adequate acreage for land application?
❑
IN
❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
IN
❑
❑
Records and Documents
yes
No
NA
NE
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
■
❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
■
❑
❑
❑
If yes, check the appropriate box below.
Page: 4

Permtt: AWS860029 Owner- Facility: Eddie Johnson Facility Number: 860029
Inspection Date: 10/31/2006 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?
❑
■
❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
■
❑
❑
26. Did the facility fail to have an actively certified operator in charge?
❑
■
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
■
❑
❑
Other Issues
Yes
No
NA
NE
28. Were any additional problems noted which cause noncompliance 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: AWS860029 Owner -Facility: Eddie Johnson
Inspection Date: 10/31/2006 Inspection Type: Compliance Inspection
Facility Number: 860029
Reason for Visit: Routine
Other Issues
Yes
No
NA
NE
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
■
❑
❑
32. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
■
❑
❑
33. Does facility require a follow-up visit by same agency?
❑
■
❑
❑
Page:6

Division of Water'Quatity
Facility Number Division of Soil and Water Conservation
O Other;Agency
Type of Visit Compliance Inspection Q Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit A Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: T 1r_ _ Arrival
l1Tiime: Departure Time:
Farm Name: ��,h1 e . E A Y'IY1S
Owner Name: t drl l e. _o h n,5n n. 4 r-.
Mailing Address:
Physical Address:
County:, urry Region: ✓
Owner EmaJ'1:
Phone:
Facility Contact: CA 1 e, o pleA Title: Phon `N'o: 6 — % 227
Onsite Representative: Integrator: 1.4tjF r
YY1Q Sohrnx>n �re-MIOWt S'MI e1 7
Certified Operator: - x z F . +,. _* *Operator Certi t tion Number.
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ® o U-1 I Er Longitude: ®o IN, ® "
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes 4:4o ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

Facility Number: — • Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
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 XNo ❑ 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 t reat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the smctures lack adequate markers as required by the permit? El 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 )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 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN [--IPAN > 10% or ] 0 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
pfJ No
❑ NA
❑ NE
No
❑ NA
❑ NE
f�No
❑ NA
❑ NE
gNo
❑ 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):
18 ressurY. �a e, on qUh ?
Cl U
•
iewer/Inspector NamePhone:iewer/Inspector Signati e 10 Ildlill Date:
LRe
Page 2 of 3 t r 1, ' - 12128104 Continued

Facility Number: p` *e of 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 CA
the appropriate box. ❑ WUp ❑ Checklists
21. D�oeessJecord keeping need
'M W to Application
ainfall MXStocking
ly available? If yes, check
❑ Maps ❑ Other
trrr007pn 5 p<cs
❑ Yes LE Noo ❑ NA ❑ NE
es 01110 ❑ NA ❑ NE
❑ Yes XNo []NA ❑ NE
Ely Freeboard Waste Analysis oil A lysis r WUSLU
Crop Yield ® 120 Minute Inspections Monthly and V Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes VNo
❑ NA
❑ NE
❑ Yes o
[INA
❑ NE
o
ElYesjNo
❑ NA
❑ NE
El Yes
❑ NA
❑ NE
❑ Yes )�
No
❑ NA
❑ NE
❑ Yes Qy,No ❑ NA ❑ NE
❑ Yes IXI No ❑ NA ❑ NE
❑ Yes Lo ❑ (NNA El NE
El Yes ' No ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
❑ Yes *o ❑ NA ❑ NE
❑ Yes 12(No ❑ NA ❑ NE
Additional Comments and/or Drawings:
Q
Page 3 of 3 C4UA,,T t7� ?I --
and 7.
2128104

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 860029 Facility Status: Active Permit: AWS860029 ❑ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Reason for Visit: Routine County: Sum Region: Winston-Salem
Date of Visit: 03/15/2005 Entry Time: 09:10 AM Exit Time: 01 A 5 PM Incident #:
Farm Name: Double E Farms 2 Owner Email:
Owner: Eddie Johnson Phone: [phone]
Mailing Address: 502 White Rd _ __ Elkin NC 28621
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant
Location of Farm:
Integrator. L & H Farms
Latitude: 36"24'08" Longitude: 80"46'14"
White Road. 1124 112 mile south of Zephyr Rd. Approx. 2 1/2 miles west of Dobson
Question Areas:
0 Discharges & Stream Impacts Q Waste Collection & Treatment 0 Waste Application
0 Records and Documents Other Issues
Certified Operator: Thomas E Johnson Operator Certification Number: 21416
Secondary OIC(s):
On -Site Representative(s): Name
On -site representative Eddie Johnson
24 hour contact name Ellen Johnson
Primary Inspector: f4elissa M Rosebrock
Inspector Signature-a[j
Secondary Inspector(s):
Inspection Summary:
18. Need pressure gauge for/on the irrigation gun.
21. Records look good.
21. Soil test results for 2005 look good.
Title Phone
Phone: [phone]
Phone: [phone]
Phone: [phone]
Ext.383
Date: -311
Phone:
Phone:
Page: 1

r /1
Permit: AWS860029 Owner -Facility: Eddie Johnson
Facility Number: 860029
Inspection Date: 03115/2005 Inspection Type: Compliance Inspection Reason for Vlslt: Routine
Regulated Operations
Design Capacity Current Population
Swine
E—ESwine - Wean to Feeder 7,680 6,196
Total Design Capacity: 7,680
Total SSLW: 230,400
Waste Structures
Tvoe Identifier Closed Date Start Date Desianed Freeboard Observed Freeboard
Lagoon LAGOON 22.00
Page: 2

Permit: AWS860029 Owner -Facility: Eddie Johnson Facility Number: 860029
Inspection Date: 03/152005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Disehames R Stream Impacts
1. Is any discharge observed from any part of the operation?
Yes
❑
No NA
moo
NE
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
M ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
0 ❑
❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
M ❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a discharge?
❑
Yam
M ❑
No NA
❑
NE
Waste Collection Storage & Treatment
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (l.eJ 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?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks
❑
❑
❑
and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑
M ❑
❑
improvement?
Yes
No NA
NE
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement?
❑
0 ❑
❑
11. Is there evidence of incorrect application?
❑
s ❑
❑
If yes, check the appropriate box below
Excessive Funding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total P2O5?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
Crop Type 1
Com (Silage)
Crop Type 2
Small Grain (Wheat,
Barley, Oats)
Crop Type 3
Crop Type 4
Crop Type 5
Page: 3

Permit: AWS860029 Owner -Facility: Eddie Johnson
Facility Number:
860029
Inspection Date: 03/152005 Inspection Type: Compliance Inspection
Reason for Visit:
Routine
Waste ApnfirAtinn
Crop Type 6
Yes
No
NA NE
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste Management Plan(CAWMP)? ❑
■
❑ ❑
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?
■
Yes
❑
No
❑ 0
NA NE
Records and Dncuments
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?
❑
■
❑ ❑
If yes, check the appropriate box below. '
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
0
Other?
❑
21. Does record keeping need improvement?
❑
■
❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
0
Weekly Freeboard?
❑
Transfers?
0
Rainfall?
❑
Inspections after> 1 inch rainfall 8 monthly?
❑
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields? -
0
Stocking?
❑
Annual Certification Forth (NPDES only)?
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
■
00
23. If selected, did the facility fail to install and maintain a minbreaker on irrigation equipment (NPDES only)?
❑
■
❑ ❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
0
■
❑ ❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
0
■
00
—26. Did the facility fail to have an actively certified operator in charge?--
0 -0---- -
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
■
❑ ❑
Page: 4

U
Pennit: AWS860029
Inspection Dale: 03/152005
Owner -Facility: Eddie Johnson
Inspection Type: Compliance Inspection
Facility Number: 860029
Reason for Visit: Routine
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
29. Did the facility fail to property 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 concem? If yes, contact a regional Air Quality
representative immediately.
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
32. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
33. Does facility require a follow-up visit by same agency?
yee No NA NF
❑ ■ ❑ ❑
❑ ■ ❑ ❑
❑ ■ ❑ O
❑ 0 ❑ ❑
❑ ■ ❑ ❑
❑ M ❑ ❑
Page: 5

Type of Visit (A Co pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit WRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: �t��-y,- tI� Arrival Time: '' I Departure Time: County: 5u Region: �s P_
Farm Name: E Fa+' M-5 Owner Email: -
Owner Name: O dd l e- So Inn 5o on �Tr• Phone: 3J% • 36 6 • �"o '� / N 1
c e II tr— ^ \ pp
Mailing Address: ' o OL w:l 1 Y_ � QA. F i l4d a L) G oZ O 6 �l ,
Physical Address: Fo � L1_�
1._ v
Facility Contact: Ldrd I,e- h r l- ( (.en Title:
Onsite Representative: EzW i e-ei E--t�l--P� 1 bh nson
Certified Operator.. _1 l6 .S E • Johh5on
Back-up Operator: Ti',P.11t�l?' • _ 10 f ln�—:)OQ
Location of Farm:
Latitude:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Phone No:
Integrator: L+ 0 Fax-rn 5
Operator Certification Number:
Back-up Certification Number:
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)
Longitude:
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 l No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes No
ElYes No
12128104
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Continued

Facility Number- — a • Date of Inspection%010
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ,,.,j,(No El NA El NE
a. If yes, is waste level into the structural freeboard? El Yes [XI No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
ay?:?:
Designed Freeboard (in):
Observed Freeboard (in):
5.
MIv
Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 14No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed ❑ Yes iNo
❑ 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 VNo
❑ NA ❑ NE
8.
Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ANo
❑ 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 'jNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10.
Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes *No
❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No
❑ NA ❑ NE
❑ Excessive 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 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
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
�KNo
No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination., El Yes
' No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
XNo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
kYes
❑ No
❑ NA
❑ NE
Reviewer/Inspector Name I - Phone:
Reviewer/Inspector Signatur Date:
Zma
12128104
Continued

Facility Number: — a *f Inspection •
Required Records &-Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes M
No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes K? No ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21.D:Rai
oep/record keeping need i rovement? If yes, check the appropriate box below. Yes No ❑ NA ❑ NE
rite Application We y Freeboard Waste Analysis LVJ Soil A ysis rite Transfers nu
nfall ❑Stocking Crop Yield 120 Minute Inspections Monthly and 1" Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ) No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ) NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
❑ Yes X No
❑ NA
❑ NE
❑ Yes ONo
❑ NA
❑ NE
❑ Yes XNo
❑ NA
❑ NE
❑ Yes XNo
❑ NA
❑ NE
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Cdditfon0,Commentscand/orDrawings:
a� App�te�t;ot� /\PA-N Ie"v r,onor>us+? /VD._.,
a l Usivid PAN tro m_ C,4 tA3 P ? t�
❑ Yes �k<o
❑ Yes WO
❑ Yes *o
❑ Yes �i(No
❑ Yes /io
El Yes L�iNO
g130/ 0 q =/4 Ls = 2- (5 / W N1/600 �.
R sz , l lbso N//0O6
ip
1,40
acoj j) Prot
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
12128104

f•
91, technical Assistance Site Visit
• UMion of Soil and Water ConservatidW
O Natural Resources Conservation Service
O Soil and Water Conservation District
O Other...
Facility Number 86 - 29 Date: 10/14/04 Time: 11:30 Time On Farm: 60 WSRO
Farm Name Double E Farms
County Surry Phone: [phone]
Mailing Address 502 White Road Elkin NC
Onsite
Representative Eddie 8 Ellen Johnson Integrator Premium Standard Farms
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ Operating below
IN 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
7680
6046
Response to DWQ/DENR referral
Response to DSWC/SWCD referral
Response to complaint/local referral
Requested by producer/integrator
Follow-up
Emergency
Other...
Design Current
Capacity Population
❑ Layer
❑ Non -Layer
❑ Dairy
❑ Non -Dairy
❑ Other
28621
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 withiri\the structural freeboard elevation range for any waste structure? ❑ yes ® no
Structure1 i Structure 2 Structure 3 Structure 4 Structure 5
Identifier Lagoon
Level (Inches) 24
CROP TYPES lCom, Grain eat
SPRAYFIELD
SOIL TYPES Pacolet
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03
❑ Dairy
❑ Non -Dairy
❑ Other
28621
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 withiri\the structural freeboard elevation range for any waste structure? ❑ yes ® no
Structure1 i Structure 2 Structure 3 Structure 4 Structure 5
Identifier Lagoon
Level (Inches) 24
CROP TYPES lCom, Grain eat
SPRAYFIELD
SOIL TYPES Pacolet
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03
❑ Other
28621
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 withiri\the structural freeboard elevation range for any waste structure? ❑ yes ® no
Structure1 i Structure 2 Structure 3 Structure 4 Structure 5
Identifier Lagoon
Level (Inches) 24
CROP TYPES lCom, Grain eat
SPRAYFIELD
SOIL TYPES Pacolet
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

Facility Number 86 - 29 Date:
10/14/04
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)
❑
El
❑ 13.
Waste structure needs maintenance
❑
❑
29. Missing Components (list in comments)
❑ 14.
Over application >= 10% & 10 lbs.
El
El❑
15.
Over application < 10% or < 10 lbs.
30. 2Hre .0200 certification
[116.
Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
32. Irrigation record keeping assistance
❑
❑
❑ 17. Deficient irrigation records
® 18.
Late/missing waste analysis
33. 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:
El Other...
43. Irrigation system design/installation
❑
El
Date:
44. Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45.Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
46. Wettable Acre Determination
❑
❑
1
47. Evaluate WAD certification/rechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
2.
49. Drainage worklevaluation
❑
❑
50. Land shaping, subsoiling, aeration, etc.
51. Runoff control, storrnwater diversion, etc.
❑
❑
❑
❑
3
52. Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4.
64. Mortality BMPs
❑
❑
55. Waste operator education (NPDES)
❑
❑
5.
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6
58. Crop/forage management education
❑
❑
-�---
-- - - -- ---- --- "- "--
- --
59. Soil an`d/or wa§te sam lin education --
2 03/10/03

Facility Number 86 - 29 Date: 10/14/04
Waste analysis: 9/30104 AL
Soil samples dated 3/08/04
Mr. Johnson has received his new C.O.C. and general permit.
" Remember to begin using the new forms for the Permit requirements.
# 18. The waste sample for the July applications was slightly over the 60 day window.
The facility and records look good overall.
TECHNICAL SPECIALIST lRocky Durham rony Davis
SIGNATURE
Date Entered: 10/18/04
Entered By: lRocky Durham
03/10/03

Facility Number 86 29 - Date of Visit: 4/21/2004 Time: 1100
Not Operational O Below Threshold
M Permitted ® Certified E3 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: .........................
FarmName: Amble.E.Fafms............................................................................................ County: S.ury.................................................. MR0 ........
Owner Name: Eddie ....................................... Jolllus011Jr............................................... Phone No: 33fi-3.66.4827............................................................
Mailing Address: 5Q2.\'!Jdft..li.Rad................................................................................... ElJkW..NC................................................................. 286M ..............
Facility Contact: Eddle..ar..Elletl..dstbw.Qtx............................ Title:................................................................ Phone No:...................................................
Onsite Representative: lidslie.aad.E.11zu.'luhlnson...................................................... Integrator: i.A.H.FumS..........................................................
Certified Operator:;Q,hamns-E............................. dIIhn5.Qu..dr..................................... Operator Certification Number.2Q934..
...........................
Location of Farm:
Nhite Road. 1124 1/2 mile south of Zephyr Rd. Approx. 2 1/2 miles west of Dobson.
M Swine ❑ Poultry [I Cattle [I Horse Latitude 36 • 24 08 Longitude 80 • 46 14
Design Current
Swine Canac tv Ponulation-- Poultry
M Wean to Feeder
7680
7396
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons u
I 0 I
Current Design Current
po�Cattle _ Capacity Population
❑ Dairy
❑ 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?
7
❑ Yes M No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes M No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes M No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? M Spillway ❑ Yes M No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ..........lagoon.................................................................................................................................................
Freeboard (inches): 21
12112103 9G�i / Continued

Facility Number. 86-29 • Date of Inspection 4/21/2004
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 ❑ Yes N 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? N Yes []No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes N No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
N No
elevation markings?
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
N No
11.
Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
N No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12.
Crop type Corn (Silage & Grain) Small Grain (Wheat, Barley,
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA WMP)?
❑ 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
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor 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 N No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes N No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concem? If yes, contact a regional ❑ Yes N No
Air Quality representative immediately.
Field Conv N Final Notes
Starting to get a couple of burrow holes near top of embankment.
Make sure to use the PAN values from the CAWMP in completing records.
•24. Operator has plant sample dated 4/7/04 which recommends 60-80 more lbs. of N be applied to pulls 3 and 4. Operator's
licate that only I I and 13 lbs., respectively, remain. Operator is working with regional agronomist to add additional nitrogen.
11/04 waste analysis = ALS 2.4 lbs. N11000 gal.
Reviewer/inspector Name 'Meh Roseblock
Reviewer/Inspector Signature. / I ZIA603 Date: oZ Q
12112103 Continued

Facility Number: 86-29 I*f Inspection 4/21/2004 •
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 A WMP?
❑ 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 Forrn ❑ Crop Yield Form []Rainfall []Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

(Type of Visit 0� Compliance Inspection O Operation Review O Lagoon Evaluation
for Visit ?g Routine O Complaint O Follow up O Emergency Notification O Other
Facility Number I Date of Visit:
0 Permitted E3 Certified1 13 Conditionally Certified 0 Registered
Farm Name: ...... F_%........ a�.:..... -.... -........ - ............ .......
Owner Name:
Mailing Address:
❑ Denied Access
Below
Date Last Operated or Above Threshold:..__...__._.__..
County: ......S.Lx:r... ._......._.....»._._ __»..__......._.
Phone No: ,23.6-..—at.?:Cvv�3._.............
i-\�i. 2(Z62-1
Facility Contact: ....... Q.r..tl..'hy-) ... Phone No:
o t I,,',,
Onsite Representative: ,. -_ «_ _. 1 _�lo�1i)��Yi _..____.. Integrator: ........ 1 �
Certified Operaton. 1Ury1C �_,_, _ Operator Certification Number: ,_,,,,_2O0 ,3 T
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ®- l d Y l` =11 Longitude ®• ®, I l 7 l«
to Feeder
-to Finish
to Wean
+to Feede
to Finis]
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in 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
Stature Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ..... ..........�....._�.... ........................ .... ... ........ ............ _....... .._........................
Freeboard (inches): .,
❑ Yes �No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes No
Structure 6
12112103 Continued

Facility Number: — aCq ate of Inspection eZT
5. Are there any immediate threats to the in gnty of any of the structures observed? (ie/ treevere 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) �ff
7. Do any of the structures need maintenance/improvement? *es ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?((❑ Yes No
9. Do any smctures 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 ❑ Hydr ulic Overload ❑ Frozep Ground [I Copper and/or Ziinc
12. Crop type am j
13. Do the receiving crops d' esignated in the Certified Animal Waste Manage nt Plan (CAWMP)? [I 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 o
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below .
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes �o
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes o
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes NO
Air Quality representative immediately.
Comments (refer to gpestton #) Exptam any YES answers and/or any r�ommendattoas o�r�°yother comments
Use drawings of fac7tty to better explain srtnahons (ax dthonat p� aswry) « 6C1 Field Copy ❑ Final Notes
3) cQ4�'6n windou-z tot,--
Reviewer/Inspector Name
-
Reviewer/Inspector Signature: Date:
12112103
•t • r
Continued

Facility Number: — Dof Inspection •
Required Records & Document~
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 appprop?ate box below.
❑ i3�aste Application ❑]Freeboard ❑�e Analysis Voil 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 twin 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 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes ®No
❑ Yes
❑ Yes6N:
❑ Yes �iNo
❑ Yes �No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes XNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
J p No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Aus ao�
lb ll 1 �03 � LS a• (e
1�-So�l�oo
Make �du�e �a� uaP _�h_ PJ+r� „� e,,
13 PAO IJ
l PAN ve''+
12112103

r
Tec al Assistance Site Visit Report
Division of Soil and Water Conservation
O Natural Resources Conservation Service
O Soil and Water Conservation District
O Other...
Facility Number $6 29
Date: 9/10/03
Time: 9:50
Time On Farts: F —1oo--1 WSRO
Farm Name Double E Farms
County Surry
Phone: [phone]
! Mailing Address 502 White Road
Onsite
Representative Eddie and Ellen Johnson
Type Of Visit.
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ Operating below threshold
® Swine ❑ Poultry ❑ Cattle ❑ Horse
Design Current
Capacity Population
® Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
7660
7461
Elkin NC
Integrator L & H Farms
Purpose Of Visit
Response to DWQ/DENR referral
Response to DSWC/SWCD referral
Response to complaint/local referral
Requested by producer/integrator
Follow-up
Emergency
Other...
Design Current
Capacity Population
❑ Layer
❑ Non -Layer
❑ Dairy
❑ Non -Dairy
❑ Other
28621
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
Structure? Structure 2 Structure 3 Structure 4 Structure 5
Identifier Lagoon
Level (Inches) 22
CROP TYPES ICom, Grain ISmall grain
SPRAYFIELD
SOIL TYPES Pacolet
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03
❑ Dairy
❑ Non -Dairy
❑ Other
28621
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
Structure? Structure 2 Structure 3 Structure 4 Structure 5
Identifier Lagoon
Level (Inches) 22
CROP TYPES ICom, Grain ISmall grain
SPRAYFIELD
SOIL TYPES Pacolet
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03
❑ Other
28621
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
Structure? Structure 2 Structure 3 Structure 4 Structure 5
Identifier Lagoon
Level (Inches) 22
CROP TYPES ICom, Grain ISmall grain
SPRAYFIELD
SOIL TYPES Pacolet
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

•
Facility Number 86 - 29 Date:
9/10/03
PARAMETER
pp 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
Conditional Amendment
❑
❑
❑ 11.
Level in storm storage
26. Waste Plan
27. Review or Evaluate Waste Plan w/producer
❑
❑
❑ 12.
Waste structure integrity compromised
48. Forms Need (list in comment section)
❑
❑
❑ 13.
Waste structure needs maintenance
29. Missing Components (list in comments)
❑
❑
[114.
Over application >= 10% & 10 lbs.
El
El❑
15.
Over application < 10% or < 10 lbs
30.2Hre.0200 certification
❑ 16.
Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
32. Irrigation record keeping assistance
❑
❑
❑ 17. Deficient irrigation records
[118.
Late/missing waste analysis
33. Organize/computerization of records
❑
❑
❑ 19.
Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
❑ 20. Late/missing soils analysis
❑ 21.
Crop needs improvement
35. Sludge or Closure Plan
❑
❑
❑ 22.
Crop inconsistent with waste plan
36. Sludge removal/closure procedures
❑
❑
37. Waste Structure Evaluation
❑
❑
❑ 23. Irrigation maintenance deficiency
[124.
Deficient sprayfield conditions
38. Structure Needs Improvement
❑
❑
39. Operation & Maintenance Improvements
❑
❑
40. Marker check/calibration
❑
❑
Reaulatory Referrals
41. Site evaluation
❑
❑
❑ Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
❑
El
El
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, storrnwater diversion, etc.
❑
❑
❑
❑
3
52. Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4.
54. Mortality BMPs
❑
❑
55. Waste operator education (NPDES)
❑
❑
5.
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6
58. Crop/forage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

E
0
Facility Number 86 - 29 Date: 9I10/03
COMMENTS:
analysis: 8-15-03 ALS 5.3 Ibs.N/1000 gals.
4-03-03 ALS 1.8 Ibs.N/1000 gals. B
* Facility and records look good.
Suggest sending the waste samples to the NCDA lab for testing. There seems to be a large discrepancy
)etween the NCDA lab and the A & L waste analysis.
k
TECHNICAL SPECIALIST lRocky Durham rony Davis ICameron Pardue
SIGNATURE
Date Entered: 9/17/03 Entered By: lRocky Durham
3 03/10/03

10 DiM of Water Quality
O Divi n of Soil and Water Conservation
O Other Agency
(Type of Visit 0• Compliance Inspection O Operation Review O Lagoon Evaluation I
Reason for Visit O• Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 86 29 Date of Visit: Ol/28/2003 Time: 0930
O Not Operational O Below Threshold
® Permitted ® Certified 0 Conditionally Certified E3 Registered Date Last Operated or Above Threshold: .......... ..............
FarmName: ENable.E..Fairms........................................................................................... County: S.uxx.X.................................................. W..SRQ........
Owner Nantes Eddie ....................................... JohuSu u._J[............................................. Phone No: 33.6. 3.66. 4.8Z7............................................................
MailingAddress: 5Q2..\ihlite..Iiasd...................................................................................EI.IciO..n.'C................................................................. 28.62..1..............
Facility Contact: G' ddie_0[..Fl1e.a ohitsOO.............................Title:................................................................ Phone No:...................................................
Onsite Representative: Eddie.and.Ellen 3AhuSOA...................................................... Integrator:L.&..Ii.Facros..........................................................
Certified Operator:.Th.9.bias..E............................. J.9.11IMiQuIr ..................................... Operator Certification Number:2.QQ3.4.............................
Location of Farm:
White Road. 1124 1/2 mile south of Zephyr Rd. Approx. 2 1/2 miles west of Dobson.
® Swine ❑ Poultry [I Cattle [I Horse Latitude 36 • 24 O8 Longitude 80 • 461, 14
Design Current
Swine Canacity Ponulation
® Wean to Feeder
7680
5575
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons I 1
Holding Ponds / Solid Traps C
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I 1 10 Dairy
❑ Non -Layer I Non -Dairy
❑ Other
Total Design Capacity 7,680
Total SSLW 230,400
Subsurface Drains Present
No
Area 1❑ Spray Field Area
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ®No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ®No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ..........Lagoon.........................................................................................................................................................................................
Freeboard (inches): 22
05103101 v114L Continued

Facility Number: 86-29 • Date of Inspection O1/28/200
f
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
M No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
N No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
N No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
N 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?
❑ Yes
N No
11.
Is there evidence of over application? ❑ Excessive Pending N PAN ❑ Hydraulic Overload
N Ycs
❑ No
12.
Crop type
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
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
N No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
N No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
N No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
N No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
N No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
N No
23.
Did Reviewer/Inspector fail to'discuss review/inspection with on -site representative?
❑ Yes
N No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
N No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
N Yes
❑ No
0 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 explain situations. (use additional pages as necessary): ❑ Field Copy N Final Notes
11. and 25. Over -application of animal waste was noted on three fields/pulls that were each used to grow two crops of corn in 2002.
Since yield on second crop was only half of the first crop, the PAN allowed for the second crop should also have been cut in half per Sue
Homewood-DWQ Permitting. Operator was instructed to contact DWQ prior to deviating from the CAWMP and permit.
19. and 25. CAWMP/Pemrit lists application months as Feb -Nov. Operator made some applications in Dec. 2002 due to excessive
rainfall. Again, operator needs to contact DWQ if varying from the CAWMP/Permit.
Reviewer/Inspector Name Meli s Rosebrock
Reviewer/Inspector Signature. Date:
05103101 1 1 Continued

Facility Nurpber: 86-29 Date 0spection O1/28/2003
0
I
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
Not applicable at this time.
05103101

>
9 :NCO
Type of Visit J& Compliance Inspection 0 Operation Review U Lagoon Evaluation
Reason for Visit �$ Routine U Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of visit: L'40 Time:
10 r
Not Operational 0 Below Threshold
Permitted CertifiedO Conditionaally Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name: ho o b le_ E Far S County- S U r
E Owner Name: At e. _ 5 1 n s on } _rrr . Phone No: 33 6 • 36 . 4-9 ;?- %
Mailing Address: So 2-LA_)h 14-e_ EJ • G i �L 26 d2�_
Facility Contact: Edd 1 P 6 f (i &, tT no Phone No:
Onsite Representative- Edd 1 Q + 12 e /-iT�T�.5 o r) integrator: - � tf'1 Fa rm
—�y
Certified Operator: 1 ho M CV o-5 . C.. • o h n nor) Operator Certification Number:
Swine ❑ Poultry
❑ Cattle ❑Horse Latitude ®•
EU1• UM- Longitude
I-W1• • E791`
-. Swine,
-Design" _ --Current-_- -_. - ' - -_
sCpacity Ponolation = ;Pouttn'
Design- Current-...-.':.Design
C�naeity >Pnm.latinn - Cattle`-.`o..c..aan....
--Gurreot . -
%• LJ feeder to Finish IL,J Non -Laver I I I'=: I❑ Non -Dairy � I � __
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity a $ a
❑ Gilts
❑ Boats Total ssw-- O 0
'.Number of Lagoons u - ❑ Subsurface Drains Present ❑ Laecton Area 10 S rav Field Area
Holding Pom1s:/:Soled Trips' `_-, ❑ No Liquid Waste Management System
i
®; Y.
Discharoes & 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 ves, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes L)p No
Waste Collection & Treatment ���,,,ttt
4. Is storage capacity (freeboard plus storm storage) less than adequate? t,pl Spillway El Yes XNo
Structure I Structure 2 Structure 3 , Structure 4 Structure 5 Structure 6
Identifier: L�41.00
Freeboard (inches):
05103101
Continued

r
Facility Number: CR
Date of Inspection
\J
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any pan 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 Aoolication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? El Excessive Ponding IPAN ❑ Hydraulic Overload
12. Crop type (', _'4'4'14/,
13. Do the receiving crops differ with those designated inAe Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Reguired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) V/ �� V/
19. Does record keeping need improvement? (ie/ irrigation, free oard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes )�No
❑ Yes XNo
❑ Yes XNo
❑ Yes P No
❑ Yes �Io
) ] Yes No
❑ Yes KNO
❑ Yes fXNo
❑ Yes N No
❑ Yes gNo
❑ Yes A No
❑ Yes )RNo
❑ Yes No
[:]Yes �No
❑ Yes XNo
❑ Yes 14'NIo
[:]Yes >q'No
❑ Yes �VNo
❑ Yes �No
DO Yes 0610
�0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Commeots (reter to,;gueshon t7£zplaina_ _n.. yr YES answers and/or -any reeom- mendaLon$ or any 'her'com—ierits.-
_
Use drawings of facility to better explain situations. use addttron'slpages_
��,.5 _v
Field Conv ❑ Final Notes
Reviewer/Inspector Name
Reviewer/Inspector Signature. Date
05103101 Continued
A-p jw� lay cC414J AA�Vl &4m - J#i &a,�4 47-
e4l tom t zax x�iocts �� �,

Facility wrnber: $(o — Date of inspection I 1 /� 5{ / OI -1 •' 4 v
Odor- Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes „o
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes lly�l`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? �Y�o
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.)_lOwo
31. Do the animals feed storage bins fail to have appropriate cover? ��❑ Yes �❑N'o
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?

ITVpgof Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
n for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 86 29 Date of Visit: 6262002 Time: 11:30
0 Not Operational 0 Below Threshold
0 Certified 0 Conditionally Certified 0 Registered
Name: D.eruble.E.Fair=...........................................................................................
Date Last Operated or Above Threshold:
County: SAUC.17f.................................................. WSRQ........
OwnerName: F.,tlike....................................... dohmoxt..jr.............................................. Phone No: 33.b.M-4827............................................................
MailingAddress: 502_lXlllte.lio;#.d................................................................................... EVARM ................................................................. 20.621..............
Facility Contact:
Title:
Phone No:
Onsite Representative: Eddie.muJI.Ellatdohimtt..................................................... Integrator. L.tFt.H FatMM.........................................................
Certified Operator:;l'jtonpas..E............................. J.0 tt siurillr..................................... Operator Certification Number. 2QU34.............................
Location of Farm:
White Road 11241/2 mile south of Zephyr Rd. Approx. 2 1/2 miles west of Dobson.
®Swine []Poultry []Cattle ❑ Horse Latitude 36 • DKI 08 - Longitude 80 • EK1 14 u
Design Current
Swine Capacity Population
® Wean to Feeder
7680
6876
❑ Feeder to Finish
Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer Dairy
❑ Non -Layer Non -Dairy
Other
Total Design Capacity 7,680
Total SSLW 230,400
I Number of Lagoons 1�0 Subsurface Drains Present 110 Lagoon Area 10 Spray Feld Area
Holding Ponds / Solid Traps JEI No Liquid Waste Management System
Disehargee. & 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: ............................................................................................................................................. ......................................................................
Freeboard (inches): 36
05103101 Continued

Facility Number: 86-29 Date of Inspection fi/26/2002
`®
5.
Are there any immediate threats to th ntegrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
N No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
N No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
N 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?
❑ Yes
N No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
N No
12.
Crop type Small Grain (Wheat, Barley, Corn (Silage & Grain)
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
N No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
N No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
N No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
N No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
N No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
N No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
N No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
N No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
N No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
N No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
N No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
N No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? N Yes ❑ No
0--No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Field Copy N Final Notes
25. Need to update the pulls on T25392 (G2) and T25390 (172) for wettable acres. Mr. Johnson feels he can irrigate more acres than
re being counted.
acility and records look good overall.
Reviewer/Inspector Name [Rt
Durham
Reviewer/Inspector Signature:
Date:
05103101 Continued

Facility Number: 86-29 Date 0pection 6/26/2002
•
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation? ,
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
Additional omments and/orDrawings:
Waste analysis: 11-20-01 ALB (swine) 2.4 1bs.N./1000 gals. I
5-28-02 ALS (1) 2.5
05103101

Facility Number 86 29 Date of Visit: U10/2002 Time: 1250
Q Not Operational Q Below Threshold
■ Permitted E Certified E3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: Mable.E..Farm ........................................................................................... County: 5.urry ................................................. W. SRQ........
Owner Name: Eddie ....................................... JQ)jWOxt..dr.............................................. Phone No: 33.6-3.66 4827............................................................
Mailing Address: SQl.l►Mite.RQad................................................................................... EI.ICia.NC................................................................. 1.&621..............
Facility Contact: Eddie.or.Elleadxt wso.a............................Title:................................................................ Phone No:...................................................
Onsite Representative: Eddie.altld.Elle111.d0ltASOA..................................................... Integrator: E.&.k1.Fa L.&HImm .........................................................
Certified Operator:.ThomaS.E............................. I.QI 1SU1t.LC.................................... Operator Certification Number: 2QU34.............................
Location of Farm:
White Road. 1124 1/2 mile south of Zephyr Rd. Approx. 21/2 miles west of Dobson.
®Swine []Poultry []Cattle []Horse Latitude 36 • ®' 08 Longitude 80 • ® 14
Wean to Feeder 7680 7376 10 Layer I I ❑ Dairy
Feeder to Finish ❑ Non -Layer 1 11 JE1 Non -Dairy
Farrow to Wean -
Farrow to Feeder ❑Other
Farrow to Finish Total Design Gapaeity 7,680
Gilts
Boars T;ota1SSI,W 0
I Number of Lagoons 1 �surface Drains Present 110 Lagoon Area J❑ Spray Field Area I
Holding Ponds /Solid Traps �0 ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? to Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ..........Lagoan.......... ................................... .................................... ................
.........................................................................................
Freeboard (inches): 29
05103101 Continued
. - 3eG 7 ..b7 ;

Facility Number: 86-29 • Date of Inspection LI0/2002
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ t es, 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?
❑ Yes
N No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
N 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?
❑ Yes
N No
11.
Is there evidence of over application? ❑ Excessive Pending ❑ PAN ❑ Hydraulic Overload
❑ Yes
N No
12.
Crop type Corn (Silage & Grain) Small Grain (Wheat, Barley,
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
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
N No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
N No
19.
Does record -keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
N No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
N No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
N No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
N No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
N No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
N No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
N No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments meter to question Exphtin any ES answers and/or any recommen [ions or any other comments.
drawings of facili to better explain situations. use additional pages as necessary ❑ Field Copy N Final Notes
7. Continue efforts to control burrow holes in dam. Vegetation is low now, but need to keep low to deter groundhogs.
19. Suggest keeping records in pen.
26. Not applicable.
Reviewer/Inspector Name melissa Rosebr ock
Reviewer/Inspector Signature: V 14 47 Date: b Q a-
05103101 -Continued

Facility Number: 56-29 Dat0nspection F 1/10/2002
E
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 permanenthemporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
05103101

of Visit Q Compliance Inspection O Operation Review O Lagoon Evaluation
(Reason for Visit X Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access I
Facility Number Date of Visit: O 0,- Time:
Q Not Operational Q Below Threshold
Permitted ® Certified O Conditionally Certified 13Registered Date Last Operated or Above Threshold
Farm Name: .... X 1p Q. 511Q c 6Liri'i•,,,t........................................... County: ..... 150I. .Y.............. .......... .__ ....
Owner Name:..... LI,Q .. e.... Q.� n 6n/.�J•.. J...............t...
..............
. Phone
No:.... (.SC!_/t...43.1P.. 6..:.Z o..a 7
FacLhtyContaM:....Qf1....G1).h.1.........1�.�f.T.../.....Ci.I...K.I..r)..[.!...-..-..agPttodeNo:.................................._...........
ailingAddress:...... U GL i J...Q r.c�.'Pn....1. l...i�1i.nsacO.................................................................................................................._
Onsite RepresentaNve:..�� ./.GC .. e E.. / �� Inte .k....H.....................w..5._......_.__._ _
-� .LF........q..............r...L.mO...........!���%1 grator:............�1 FFFGi Y
Certified Operator:..... 1 �.Q}.!{h r......C..i.. .Q�...................... Operator Certification Number: .... Z���'
........................
Location of Farm:
Swine ❑ PouHry ❑ Cattle ❑ Horse Latitude E�E• E=` E.. Longitude ®• F7V` EM .
Design :Current - Design; Current _ Design Current .
Swine Ca aci Po ulatson Poultry Caci , Po ulatioo Cattle CapacityPb elation
Wean to Feeder ❑ Layer ❑Dairy
Feeder to Finish ❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other- =
❑ Farrow to Finish Total DCSIgR CffptlClty -_
"❑ Gilts
❑Boars Total SSLW. 10
Number of Lagoons J �❑ Subsurface Drains Present [] Lagoon Area J❑ Spray Field Area
Holding Ponds / Solid Traps. ® _ ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? []Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes []No
c. If discharge is observed, what is the estimated flow in gaUmin?
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 o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? �jl Spillway ❑ YesN0
Structure 1 Structure 2 Structure 3 t Structure 4 Structure 5 Structure 6
Identifier: Wn........... .................................... ................................... .................................... .................................... ....................................
Freeboard (inches):
5/00 Continued on back

Facility Number: — 2, _ Date of Inspection ( 0
5.
Are there any immediate threats to the integnn y of any of the structures observed? (ie/ trees, severe erosion,
[] Yes
)�No
seepage, etc.)
7�
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
[I Yes
KNo
(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 maintenancelimprovement?
❑ Yes
C,�!(`T0
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? PAN ❑ Hydraulic Overload
Excessive PonndinAg�
❑ Yes
No
12.
,❑
, , \ .❑
Crop type d // IAfA�7✓ V{ (�/b 6dgL V
13.
Do the receiving crops differ vith those designated in the Certifie 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
o
15.
Does the receiving crop need improvement?
❑ Yes
No
16.
Is there a lack of adequate waste application equipment?
❑ Yes ARO
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
XNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ✓ i /
✓analysis
❑ Yes
No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste & 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
XNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
�[
(ie/ discharge, freeboard problems, over application)
❑ Yes
IR No
!g�
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
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
fVQ •YiQl�ii¢ns:or ilefjciencies were n e(1 ilStrii. 9 this;visjt: • .. 0 jvSti•i•ec$iye 40 fp6j 0r , ::;
6firisporideii& about this visit::::: ` ::::::::::::::::::: ' :::::::::: :
• c
i I
Reviewer/Inspector Name Mal 1 ME

Facility Number: — Z D* Inspection t)2. •
Odor Issues -
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
Ej4rr�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
b Io
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
Q[J �[No
otra ` outman an or< raww_'—'
..3z�..a,a.:`u`�^--r-`.�__'�
,,gg

Facility Number 86 29 Date of Visit: 9/18/2001 Time: 10:15
Q Not Operational Q Below Threshold
Permitted M Certified l4 Conditionally Certified 0 Registered Date Last Operated or Above Threshold .....................
FarmName: Muble.E,.EUM........................................................................................... County:&artx.................................................. \'i',SBQ........
OwnerName: Eddie ....................................... du4mjm.dr.............................................. Phone No: d3.6,3. 6.4827............................................................
MailingAddress: 5.Q2..Whjft!..R9ad................................................................................... C' IlaU1NC................................................................. U.621 ..............
Facility Contact:
Title:
Phone No:
Onsite Representative: FAd c.and.F.11.¢.n.doltnwjjt..................................................... Integrator: L_8c..i1.F.aIMM........................................... ..............
Certified Operator:Tb.RUT85................................. dohtlsou............................................ Operator Certification Number: 2QU34............... ..............
Location of Farm:
White Road. 11241/2 mile south of Zephyr Rd. Approx. 21/2 miles west of Dobson. +
® Swine ❑ Poultry [3 Cattle ❑ Horse Latitude ®• ®, ®,, Longitude 80 • 71 14 °�
Discharnes 8� Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
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 1 Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes IN No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes IN No
❑ Yes ® No
❑ Yes ® No
Structure 6
Identifier: .........................................................................................................................................
Freeboard (inches): 22
05103101
Continued

Facility Number: 86-29 Date of Inspection 9/18/2001
.. ti
5.
Are there any immediate threats to thel}Ifegrity 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?
❑ Yes
N No
8.
Does any part of the waste management system other than waste structures require maintenancelimprovement?
❑ Yes
N 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?
❑ Yes
N No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
F9 No
12.
Crop type Com (Silage & Grain) Small Grain (Wheat, Barley,
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
N No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
N No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
N No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
N No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
N No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
N No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
N No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
N No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
N No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
N No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
N No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
N No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
N No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
ommen e o air ao ern en .
f ac to r e 1 ' r ❑ Field Copy N Final Notes
19. Need to refigure the application records with the correct waste sample ( within 60 days of the application event ).
o evidence of over application.
Overall records and facility look good.
Reviewer/Inspector Name lRocky Durham
Reviewer/Inspector Signature: Date:
05103101 Continued

ft
Facility Number: 86-29 D. Inspection 9/18/2001
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
analysis: 8-14-01 ALS 3.0lbs.N/1000 gals. B
2-27-01 ALS 4.3 " " I
05103101

Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number j
Date of Visit: 3/13/2001 Time: 1100
0 Not -Operational Q Below Threshold
E Permitted ® Certified E3 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: ............
FarmName: double.E.F,atfnts............................................................................................ County: Stxcr3:.................................................. .W.SRO.......
Owner Name: Ed.lie...................................... do.ImsA.tt..dr............................... ............... Phone No: 336:MA82.7...........................................................
MailingAddress: 5.02.Wbitt.Etlad...................... :............................................................ EIW.NC ................................................................. Z81621 ..............
Facility Contact: Ell..m.and.Eddie.19hil un..........................Title:............................................................... Phone No:....................................................
Onsite Representative: Elleo.and.Eddie.Jtdnl.S.utt..................................................... Integrator: I.:.t%.ILF
Arm ..........................................................
Certified Operator: jbuntaS................................. .IRIOlMB............................................ Operator Certification Number: 2UQ3i4.......................
......
Location of Farm:
White Road. 11241/2 mile south of Zephyr Rd. Approx. 21/2 miles west of Dobson.
® Swine [IPoultry ❑ Cattle ❑ Horse Latitude ®• 24 08 Longitude 80 • ® 14
Swice
Design
CaPa ci
Current
Po ulation
Design Current
Poultry Ca aci P,o ulation
Desi'g
Cattle Ca aci P,o ulatione=
® Wean to Feeder
7680
6081
❑ Layer
❑Dairy
❑ Feeder to Finish
❑ Non -Layer ❑Non -Dairy
❑ Other
Total Design Capacity 7,"0
Total SSLW 230,400
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
I
Number of Lagoons 0 ❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Holdmg 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, notifyDWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated Flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
/other than from a discharge? ❑ Yes ® No
01/01/01 T / Continued
1'r-�

Facility Number: 86-29 • Date of Inspection 3/13/2001 1•
Waste Collection & Treatment
4. Is storage capacity (freeboard plus stone storage) less than adequate? ® Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: L.agQQxl................................................................................ ............................
Freeboard(inches): ...............2b........................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental ffireat, notify, is yr Q)
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 ADDlication
❑ Yes ® No
Structure 6
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
® No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12.
Crop type Corn (Silage & Grain) Fescue (Graze) Small Grain (Wheat, Barley,
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
- ❑ Yes
® No
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
17. Are rock outcrops present?
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
18. Is there a water supply well within 250 feet of the sprayfield boundary? ❑ Unknown ❑ Yes ❑ No
❑ On -site ❑ Off -site
Required Records & Documents
19. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ® No
20. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes ® No
21.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
®No
22.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
KNo
23.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
24.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
25.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
26.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
27. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ® No
Odor Issues
28-D6iFs—the discharge pipe from theconfinementbuilding to the'storage pond -or lagoon fail to'discharge at/or below"_O"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 ® No
01/01/01 Continued

Facility Number: 86-29 Day - )f Inspection 3/13/2001 •
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: 3/15/2001
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
h-0,H&HUME-Heime'o xplain any we • an or an mmen do o an othe rnmmen
be lain io ' 'onal n ❑ Field Copy ®Final Notes
7. Continue efforts to control groundhogs and woody vegetation on dam.
21. For fescue, keep PAN balance on a yearly basis (ex. 2001).
Reviewer/Inspector Name Melissa Rosebrock
Reviewer/Inspector SignatureZM . la Date:
01/01/01

Type of Visit ID Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: !".F-►'�N-�-' Time:
�[ Not Operational Q Below Threshold
w Permitted 0 Certified E3Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: .... D.Li .11 .......G..... anyn,5............................................... County:........SAj. rl..................).p....................
.............
,
Owner Name:... tt.I.g._°.:.._ �...��.ji.....^�O.Xi;.......................... Phone No:.....!t�3 /01.rz......................
Facility Contact: ..G.l1.t1��QX�. ...�rflfll.Ie,...ti.Ili.�1.%1��yjii)e:.............................L...................................Phone No:..................../..............................
MailingAddress:.....l..l........ _.1.tt......._.............................................. L..E!..�'.�.n..�.L"..F.s............u..........a.tO..sr�................
Onsite Representative:...G,f14...d.:..... v................................................................ Integrator:............._.`.:..L..1.....................................................
Certified Operator: ...'..�.-.h � . a., ................. �r- 'j''
1 1 KlC\!) S �'..-J..0.1�%i.4�...�.._�L..r....... Operator Certification Number ...........................................
Location of Farm:
Swine [I Poultry ❑Cattle ❑Horse Latitude FW • a - ®�� Longitude Ml• I Yt, l` L_L�L._I-
Swine-
Current
emulation Poultry
- Cattle _
❑ Other
Total Design Capacity
Total SSLW- J
.Number of Lagoons __ - ❑ Subsurface Drains Present HO Lagoon Area ❑ Spray FieldArmR
Holding Ponds /Solid Traps ® ❑ 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 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? kSpillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes XNo
Structure 6
Identifier:
Freeboard (inches):
5100
i
Continued on back

Facility Number. — Date
of Inspection Printed on: 1/9/2001 `/
5. Are there any immediate threats to the4grity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ®No
seepage, etc.) ( 1
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 maintenancelimprovement?
❑ Yes
,❑[
W 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
11.
Is there evidence of over application? ❑ Excessive Ponding/ [I PAN [IHydraulicOverload
El Yes
�No
12.
Crop type Ab 41 l one rl 1 V a ,, i U Q. / a Y-Q 2� l liit-r Lo, .
13.
Do the receiving crops differ with those designated in the Certit'toAnimal WasKe Management Plan (CAWMP)?
Yes
No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
NNo
b) Does the facility need a wettable acre determination?
❑ Yes
PdNo
c) This facility is pended for a wettable acre determination?
❑Yes
No
15.
Does the receiving crop need improvement?
❑ Yes
XNo
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.)
[I Yes
0 No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
A No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
'WNo
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
O(No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
JKNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
IXN0
•Yi01ati¢4 ' .01- 000c;tettcies -ware pQCed• 00 .►tig this;vW d fus... • ; • ; - .
6rais mideitce:abotitithisvisit:::::::::::::::::::::::•:•:::•:•:•:•:-:•:•:-:-:•:
V)25-ie S&MpkS: a ago o l /7 op
14 _'AwlkelpYoAN mot. i � '-A �
Reviewer/Inspector Name Y- '--r
Reviewer/Inspector Signatu AAa a I L4 Date: s . S/VO

Facility Number: — �of Inspection I "'y/I i/OI I • Printed on: 1/9/2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge actor 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?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes 0 No
❑ Yes 6j No
❑ Yes �KNo
❑ Yes No
❑ Yes No
❑ Yes WNo
Additional Comments an or Drawings,
Nof�sp (, Si6 Qt�rz� ySIS 7 &-te- now? AU
(,c)2f�ed QC;re� from � rr� ioK) h For
Ialmv-e . SP �►-a�e f rn� � r
7
Carh�► FQ��e
5100

ion of Water Quality �`
ion of Soil and Water Conservation
Q Other Agency �
71
(Type of Visit O Compliance Inspection p Operation Review O Lagoon Evaluation I
Reason for Visit *Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 86 29 Date of Visit: 9/27/2000 Time: Io:15 Printed on: 2/22/2001
0 Not Operational O Below Threshold
Permitted 0 Certified Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ......................
FarmName: Wable.C.Eaiom ........................................................................................... County: S.urjry .................................................. WSRQ........
OwnerName: Eddie ....................................... lohwoxt...lr............................................... Phone No: 3br.3G6 4& 7............................................................
Facility Contact:
Title:
Phone No:
MailingAddress: 124..!'.F'Itlte.l;.Qad................................................................................... Elkia.NC........................ ......... ................................ 28bZA..............
Onsite Representative: Eddie.&.E.11e0.debxMjM......................................................... Integrator: L.A.1j.Farxtxs.................................................. .......
Certified Operator::AAtA. U05.E............................ d911uSA.n. 1x:..................................... Operator Certification Number: ZA.'1A6.............................
Location of Farm:
® Swine ❑ Poultry ❑ Cattle ❑ Morse Latitude ®• ®' ®" Longitude 80 • ®° 14
Design Current
Swine Canarity Pnnulatinn
® Wean to Feeder
7680
6471
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons I 1
Holding Ponds / Solid Traps C
Design Current Design Current
Poultry Ca acit Population Cattle Ca aci Po citation
❑ layer I I Dairy
❑ Non -Layer I I❑Non-Dairy
❑ Other
Total Design Capacity 7,680
Total SSLW 230,400
Subsurface Drains Present ❑ Lagoon Area I0 Spray Field Area
No Liquid Waste Management System
Discharrnes & 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 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
Identifier: ............................................................................................................................................................................
Freeboard (inches): 28
5100
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes a No
❑ Yes ® No
Structure 6
Continued on back

Facility Number: 86-29 Date of Inspection 9/27/2000 • printed on: 2/22/2001
5. Are there any immediate threats to theogrity of any of the structures observed? (ie/ trees, severe erosion, ❑Yes ®No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stucmres lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste ADolieatlOn
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
® No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
IN No
12.
Crop type Com (Silage & Grain) Small Grain (Wheat, Barley, Fescue (Hay)
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a,wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
:]' Nti vigl;atititis;oi7 deficiencieswo(eddiing (hsvst.Yu;ilecvefdti.rthtiiwl ef
coriesnotideitce: about this .visit. ::............ .
19. Missing a waste analysis for July and August applications.
a by wetted acres from irrigation design for figuring Nitrogen balance. Also, separate form for com and fescue.
verall records and facility look good.
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Reviewer/Inspector Name Rocky Durham V
Reviewer/Inspector Signature: Date: 5100

Facility Number: 86--29 D* Inspection 9/27/2000 • Printed on: 2/22/2001
Odor Issue
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
5/00

Facility Number 86 29 Date of Visit 4/4/2000 Printed on: 4/5/2000
0 Not Operational O Below Threshold
■ Permitted ® Certified 0 Conditionally Certified E3 Registered Date Last Operated or Above Threshold: .....................
Farm Name: O.Q01e.E.1_arttxc........................................................................................... County: Sut's3'.................................................. WSRQ........
Owner Name: Eddie ....................................... jQhWQt1.dlC............................................... Phone No: 33br.3.66 4827............................................................
Facility Contact:)Alll:la.d.QIamon................................................Title:................................................................ Phone No: fax. 3b.. b.G.J1# ................
Mailing Address: 5tt2.'.bllt¢.Ii.Qad................................................................................... ElJkkNC ................................................................. 206zl..............
Onsite Representative: Elteatalad.Eddis.dQbMQu...................................................... integrator: L..&.H.F.OAM................................................. ........
Certified Operator:.ThjQ. 05..E............................. J.Q.bJjj5.Q.RJr ..................................... Operator Certification Number:2),416.itud.2AQ ......
Location of Farm:
N Swine ❑ Poultry ❑ Cattle ❑ Hor:Latitude ®• 24 08 .< Longitude 80 • ® 14 ..
D stg v"
Current ;...
y - Design Current
Dyacr
r"{jb* "Design o °' Cu- rrrrent ,'`,,
Swine
Ca aci
P�,O dlahon
Poul try _�l'o ulation
Cattle „ Ca acit P,o ulationl
N Wean to Feeder
7680
5786
❑ Layer
❑Dairy
❑ Feeder to Finish
10 Non -Layer
❑Non -Dairy
❑ Farrow to Wean
❑ Other I I-'
❑ Farrow to Feeder
❑ Farrow to Finish
Total Design Capacity 7,650
'" ' z tR > T otal SSI W 230,400
❑ Gilts
❑ Boars
Number of lagoons 0
❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps
❑ No o Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes N 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 N No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes N No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? N Spillway ❑ Yes N No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......................................................................................................................................................................................................................
Freeboard (inches): 30
# 7a 0 Continued on back

Facility Number: 86-29 Date of Inspection 4/4/2000 Printed on: 4/5/2000
5.
Are there any immediate threats to the int hty 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? 1
❑ 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 (Hay) Small Grain (Wheat, Barley, 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?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
®`Ntj yiolations:or deficiencies were _noted :dut h19 this. visit: 'Y' am'wilt receive ttti firthei
correspondence. about this .visit .. . ............ .......... .
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Need to change waste plan to add February to spray months for waste application. Spoke with Tony Davis of Surry Co. SWCD
months need to be February -November to reflect realistically the needs of this farm.
samples completed for 1999 and 2000.
to samples were taken 7/20/99 and 2/3/00.
Post -it' Fax Note 7671
Date
S L)b
pages ,3
To /
0
From
e r
CoMept.
Co.
Phone #
Phone #
Fax #
Fax #
Reviewer/Inspector Name `,/
Reviewer/Inspector Signature: IDate:

Facility Number: 8(r29 [of Inspection 4/4/2000 • Printed on: 4/5/2000
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
® No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
® No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
® No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
® No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
® No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
❑ No

tioutine p Complaint p Follow-up of DWQ inspection Q Follow-up of DSWC review O Other
Facility Number Date of Inspection O Q
Time of Inspection 24 hr.
Permitted Certified Q Conditionally Certified Q Registered 0 Not O erational Date Last Operated:
%
FarmName: ..... Uouble-....... L......... F4L--,5............................................. County:...... Ui"I_......./..(..p........................................
Owner Name
:.........E-dd 1 :.... Q.h.f1ti ................. ................................... Phone No:. ��// // T p e2
rr.... .-.QQ Kt ... ...............................................
Facility Contact: E.0en....,To1\oan....................... Title: ................................................................^.ti � ......
Mailing Address:..... S0 ........... Vv..K I -6,... !�-!c!.:.............. �_��:�n.. j.. N.G............`Z96. -/
L...... ............................................... ..........................
Onsite Representative: ...,...l.�.e;�.,,oQ......................................... Integrator: N .. ....................................................................
Certified Operator: it
TnhA.$L�.iZ..f.._TI•t. ............................... Operator Certification Number:,,...-3�y q('j�(6 ,/3�..•.
Location of Farm:
p� 1 l .1N.............
Latitude ®_ ©., Longitude $O • ®, EIP"
Swine _
,-CI-1 Current Destg,Current
PltPopulation .CattlrPo ulationn ty e. Caacit -
Wean to Feeder
❑Layer '- ❑Dairy
' _
Feeder to Finish
ILI Non -Layer' ❑ Non -Dairy
❑ Farrow to Wean
-_
:. ❑ Other
❑ Farrow to Feeder
-'
Total Desig n Capacity
Total SSLW ;::
❑Farrow to Finish
❑ Gilts
❑ Boars
. Number of Lagoons :, ❑ Subsurface Drains Present ❑ Lagoon Area.
I0 Spray Field TrZT14
- "Holding Ponds /Solid Traps [� ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes � No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
❑ Yes ❑ No
c. if discharge is observed, what is the estimated Flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? -
❑ Yes jVo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
[I Yes I,(No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? kpiliway
❑ Yes � No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
1 .II
Freeboard (inches): ............ �.i�................................................. ...................................
.................................... ....................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
...............................`.j..�/..
❑ Yes I/�N0
seepage, etc.)
3/23/99
Continued on back

1~acility Number: 86 - a of Inspection 1Oq1o7J•
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? OM I Tr
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.
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
))YNo
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
*0
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
xNo
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ism 7- a0001
-BAIL_
S01I 50JVP)e5 dome -PO K 1999 w- C?006.
to&' 6 e- SO- PA25 -&Xey) a/3/oo and 7/0-o/99
Earle, 1&)O-h11 Cor!)

' Facility Number: g - _R of Inspection
D l pnl
6.
Are there structures on -site which are n 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
Dp No
i17'7')J
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
WNo
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
11.
Is there evidence of over application? ❑ Excessive Ponding [I PAN
❑ Yes
���.XNo
IYI No
12.
Crop type No -lit) &01-n t Fe$ c.ue,
l
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes Jk&o
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
O No
b) Does the facility need a wettable acre determination?
❑ Yes
N No
c) This facility is pended for a wettable acre determination?
❑ Yes
X No
15.
Does the receiving crop need improvement? _
❑ Yes
No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
X 1 No
Required Records & Documents
17. Fail have Certificate Coverage & General Permit
to of readily available?
❑ Yes
�dNo
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
$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
j No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
fie/ 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
Rio •Yiglatit... deficiencies . gre it6fed. dirritig 4his:visit: -".*.'-I I.l-f 4e iye tio: fui thgr ; • ; • /
coriesporideike: abotit this visit_
Use drawingI'of facility to better,explain situahons (uie-addtbohal pages asinecessary)g•. K
sheep 3� - /UtavFKKlS of a pph' eat m ?
Wbrch-M jb' ecrv) Pa�ez o-f pre✓loa5 ts+e 7
N6V, Fcr rescue
NeLO u-\d5fe ,pi Qn n eels 46 be- added
ChQn,V was+e lall +a aM Febroary fO '5 F mo
-Vor • Oas+e= TJe � -f-a be Feb,—N6V* Fo re{'Ie needs �'
Reviewer/Inspector Name
0
Reviewer/Inspector Signaturl` fTYI.AVI/.i IV-11 111M0-fYfAtrle Date:

r
051- 25 August 30, 1998
Double E farms
Elkin, N. C. 28621
1. GENERAL
Farm visited August 25, 1998 by Richard Phillips and Jeffrey Healey
2. HIGH RISK AREAS-- none
3. GENERAL SITE INFORMATION
The facilities present an extremely pleasing appearance, well grassed and mowed, all very neat.
No evidence of trash or spilled iced outside. Buildings are widely spaced on top of a hill, which
provides good air drainage. Diversions and pipes have been used to provide added erosion control.
Leland cypress has been planted for a screen completely around the houses. A security fence has
been installed on all sides. The lagoon is not visible from the road, as a matter of fact, most
visitors assume it is a farm pond. Biosecurity is excellent, with shower in -shower out facilities.
Office is very clean and organized.
Neighbors are extremely close- - 500feet, 800 feet, and 1100 feet. None of these have
' complained about odor. One neighbor at 3000 feet has complained three times. In this situation,
this neighbor is in a valley which probably drains air currents from the swine houses on warm
humid evenings. Options to buy have been executed on two of (he neighLu.' ..,y properties.
A "pig-pickin" ( barbecue) is held every fall for the neighbors and others in the vicinity. Last
fall producer reported over 300 attended.
4. BUILDINGS
There are 4 production houses, divided into 8 rooms. Rooms 5 and 7 were evaluated in two
separate houses. Houses are tunnel -ventilated with full season mechanical ventilation, using two
36" and two 48" fans in each room. Air velocity in the hall at the upstream end ( where the air
had to pass through some restricting louvers) was about 6 miles per hour. It is estimated at 4 to
5 miles per hour in the rooms itself. Almost no odor of any kind was detected in the pig area, and
certainly no objectionable odor. Pigs were dry and free of manure. Alleyways were absolutely
clean. Producer cleans these daily, but with this regimen pigs seem to be trained to not backup
and use the alleyway, since alley is always kept clean. A plastic shield is placed in the gilt area to
prevent urinating into the alley.
Floors are completely slatted with plastic slats. Producer believes this keeps the pigs cleaner
than concrete slats. Almost no manure was noticed on the slats. Manure drops through the slots
into a shallow pit. Pits are emptied weekly by removing the pull plug. They are then recharged
with lagoon water. Waste level was 12" below the slats in both rooms. Pits are not ventilated but
this does seem to be necessary since there is no noticeable odor in thr; rooms. Buildings are
thoroughly cleaned and disinfected during the week after emptying.
Louvers and shrouds on the fans were 80% dust covered --probably a normal amount. Producer
reports that if an air compressor were to be used to clean the fans while pigs are in the house, that

mom
4
/ pigs would "spook" and pile up. In the past this has caused a number of pigs to rupture, and they
then had to be destroyed. Producer is well aware that dust is a source of odor and that feed is a
primary source of dust. Pelletized feed is provided the first 3 or 4 weeks. After that pelletizing
is not feasible for the feed mill, thus there is feed dust, which appears to be most of the dust seen.
Producer states that adding oil to the feed to reduce dust would make the hogs too fat, thus this is
not a good alternative.
5. LAGOON SYSTEM
Lagoon size of one acre as reported checks out o.k. No odor was detected when walking around the
lagoon. No pinkish color was seen, probably has not had time to develop. A steel marking post is
installed to indicate maximum allowable lagoon level. Embankment appears stable, although there
are a few areas where vegetation is lacking. Nitrogen concentration is rather high, 875 mg/1
when last tested by NCDA.
6. LAND APPLICATION
Lagoon effluent is applied to fescue primarily, which is either grazed or cut for hay. Some was
applied this summer to corn. Producer uses rain gages to calibrate the depth of water applied
versus the traveler speed. Nitrogen requirements are obtained annually from a private testing
lab. Irrigation equipment was not seen as it was 10 miles away and in use ( due to dry weather).
/ Pump has a cutoff ( Murphy) switch to shut down in case of a line break.. Producer irrigates in
the mornings. Producer had readily available the required waste management plan (developed by
NRCS), the test results, the application plan, and the operator's wastewater application license
7. MORTALITY MANAGEMENT
Producer reports that they have very few "dead". Dead animals are picked up daily and buried at
the present time. However, they have purchased a cooler so they can refrigerate the dead and have
them picked up by a rendering company. They tried composting but were not satisfied.. However,
they do compost the dead chickens from their broiler houses which are nearby. Present burial
area is not visible from the public road.
& STRENGTHS
o Very pleasing appearance, new, neat, well maintained
o Excellent air flow in the house, no detectable odor, buildings dry
o Animals very clean and dry
o Permits, records readily available and understood
o Good public relations, such as the fall barbecue
o Cypress screen,is excellent
o Hogs "well trained" to dung inside their pens
o Options to buy out closest neighbors is commendable
o Overall rating of 5, the very highest
I 9. CHALLENGES
o No challenges really, except to keep odors to the very minimum possible with the close
neighbors
o Post emergency numbers In case owners are not available

! Odor/Environmental Assessment Report O 5 1 -25
Double E Farms
Elkin, N. C. 28323
Farm visited August 25th by Jeffrey Healey and Richard Phillips
Report Date
4"9 30 /y9,
5u ted By: ,
Richard L. Phillips
n
to
Concurred By: ,
Je f e ley

nLE NAME 502001\04AIN2 (12-27-94)
HYDRO ANALYTICAL
CHAIN OF CUSTODY RECORD
6300 RAMADA DRIVE
REGULATORY CLASSIFICATION
CLEMMONS, NC 27012
TELEPHONE [phone] • FAX [phone]
❑ PRETREATMENT ® NPDES ❑ DRINKING WATER ❑ OTHER
OACT NOJ
CLIENT NAME
REQUESTED PARAMETERS
REMARKS
DiviGion of Lun)er Gua1i V-t.�
PRESERVATION
0
SAMPLERS: (SIGNATURE)
I (PRINT)
�Ql1Uri.
• �0.•Lde�k
'senm1 e1
LAB
9AMPLB
OAIE
111E
LOCA110N
(�}S
�'1 r�
HNO, H2SO. NaOH None
HC7 Na,S203 Other
HNO3 H2SO' NaOH None
HC1 Na2S203 Other
HNO, H2SO4 NaOH None
HC1 Na2S203 Other
HNO3 H2SO4 NaOH None
HC1 Na2S20, Other
HNO3 H2SO. NaOH None
•
HC7 Na2S203 Other
-
HNO3 H2SO. NaOH None
HC1 Na2S203 Other
HNO, H2SO. NaOH None
HC1 Na2S203 Other
HNO3 H2S0, NaOH None
HC1 Na2S203 Other
HNO3 H2SO4 NaOH None
-
HC1 Na2S203 Other
HNO3 H2SO. NaOH None
HC1 Na2S203 Other
RELINQUISHED BY: (SIGNATURE)
DATE
TIME
RECEIVED BY:
DATE
TIME
LAB USE ONLY
1• efvvvt.L. -V1 K • (2cv,Je- n�.
9-ZI-9p,
(2; 3s
'��/
/pZ .35�
SAMPLES 5 4-C:
SAMPLES PRESERVED:
HOLDING TIME:
CHLORINE: •
2.
3.
LAB REMARKS:
�
CHECKED BY:
CUSTODY SEAL:

wompol"-
33G - 3GG- 45 51
1 y6 Salem For 1,-"Rd _
EIkin3 NC

c:
_ •v DIVISION 01: WATER QUALITY
LU Lr { G 0Chemistry l.nboramry I4epurt/Waler Qualily
% � L
h I
COUNTI
JOHNS R
SURRY
CD
T- _
PRIORITY
RIVER BASIN:
-:=_
CD
0 8
AMBIENT
QA
�W
REPORTTO
"SRO
Regional ORvu
COMPLIANCE
CHAINOFCUSI'ODY
�r
Ocher
Im
ij
jL7�
EMERGENCY
COLLECfORISI:
RANKIN
Vl
Estimated BOO Ran e•
L
5 I 1
ElSAMPLETYPF.
l STREAM
O EFFLUENT*
❑ LAKE
❑ INFLUENT
❑ ESTUARY
171
Lab Number
8W2357
Data Received
4NNS
Time Reeebed:
8:55 AM
Received Dy -.
IIh1W
Data Released : AR
Dole Re,ried : 400198
R tat on .oe,t a: FA M
Seed: Chlorinated: Ranarla:
Sr� Dale Begin (yylmnt/dd) Data End D Irun/dd) Tlme DeRin Time End Depth - DM, DO, DBA/ Value]ype - A, II,L Congrmile-T,S, Sannple Type
980408 1000
BOD 31 u nWL
COD lligb 340 mg/L
COD Law 335 mg/L
S
Calif.,. MI: FeeaU1616 440 f100 l
Coliform. MFTota1J1504 fl00ml
Coliform tube i'ma101615 1100.1
Califon. Fecal Sue, 31673 limnal
Residue Total SM mgfl.
Volatile 505 mg/L
Fiacd 510 mg/L
Residue Smpended 510 mgll.
Volatile 535 mg/1.
I'i.ed 540 url.
pll4l0 snits
Ae,dnv in pH 4 5 436 mg/L
'diry to pli 8 3 435 rng/L
1111
linhv to pit 8 J 415 mg/L
Ikalinity to pH 4. 5410 mglL
'fOC G80 mg/L
1'unbidla 76 Ni'U
conform Total l obe •/IlK nds
COMMENTS:
Chloride 940 mg/L
Chi a: T6 32217 ug/L
Chi a. Corr 32209 ug1L
Pheophytin a 32213 110,
Color: True 80
-
Coloc(pll) 83 pltto
Color: pH 7.6 82
Cyanide 720 mWL
Fluoride 951 rnI
Fonnaldchyd971880 mgll.
Ore. and Oita 556 mg/I.
I lnrdaaa Total 900 ing/I.
S,,,ilic Cond. 05 outbas4 in2
MBAS 38214 atg/I.
Phenols 32730 ug/L
Sulfate 945 mg/L
Sulfide 745 ioWL
Boron
Tvnninh Lignin ug/L
I lesavnlent Chromium ug/L
X
NH3mN610
1.3
mg/L
8
TKN an N 625
2.6
mg4
X
NO2 plus NO3 es N 630
0.82
m VL
%
P. Taal as P 665
1.8
ntg/L
PO4 as P 70507
mgfL
P. Dissolved m P 666
mgfL
K-Potassium
mglL
Cd-Cadmium 1027
ug/L
Cr-Chromium. Total 1034
ug/L
Co. Cap" 1W2
ugfl.
Ni-Nteke11067
ug/L
Pb- Lead 1051
ng11.
%n-Zirm 1092
ug/1.
V.Mannlit
t1wL
Ag Silver 1077
tWL
AI- Aluminum 1105
nglL
Be. Beryllium 1012
uFIL
Ca-Calcium916
mglL
Co. Cobalt 1037
ng/L
Fe -Iron 1045
ng/L

DIVISION OF ENVIRONMENTAL MANAGEMENT WATER UALITY 1 For Lab Use ONLY
/
COUNTY J f Y t
Q F ELD-LAB FORM (DM1) O
PRIORITY SAMPLE
RIVER BASIN I rr. C` h,- \ R, t' _. \e, r.
AMBIENT
TYPE
��1I
❑
REPORT TO:
ARO PRO MRO RHO WaRO WIRO WSRO'TS
Qp
.1�1STREAM
EFFLUENT
AT BM
®COMPLIANCE ❑
❑
❑
Other
CHAIN
LAKE
INFLUENT
OF CUSTODY
EMERGENCY
❑
Shipped by: Has Courier`, Stall, Other
ESTUARY
COLLECTOR(S): 1 -' (l''1 L t ✓)
Lab Number:
Date Recel a
Tlme:O
55
Rec'd b
From: Bu Iourle
end Del
DATA ENTRY BY:
CKI:
DATE REPORTED:
I
Estimated ROD Range: 0-5/5-25/25-65/40.130 or 100 plus STATION LOCATION:
Seed: Yes Nom Chlorinated: Ye. El No.Q REMARKS:
Station # [late Begin (yy/mm/dd) Time Begin I Date End Time End Depth DM DR DBM Value Type Compo
U t-� O9 10', (.:f) (�� ;�t� C J iC`',C; A H L T S B
RODS 310 mg/1
v aaa mg/I
u MF Fecal 31616 /100m1
I s MP Total 31504 /100m1
Tube Fecal 31615 /loom]
Fecal Strep 31673 /100ml
Total 500 mg/I
Chloride 900 mg/I
NH3 as N 610 mall
NH3 as N 610 mall
C ( G ) GNXX
Mn-Manganese 1055 I ug/1
NaSodlum 929 I mg/1
Arsenic. -Total 1002 USA
Se-Selenlum 1147 us/1
Hg-Mercury 71900 ball
Orgenochlorine Pesticides
Orgdwphosplarue Pesdcl des
Acid Herbicides
l
i I -
Base/ Neutral Extractable Organics
Sampling Point %
Conductance at 25 C
Water Temperature
D.O. mgA
PH
Alkalinity
Acidity
Air Temperature
(C)p
H 8.3 pit 4.5
pH 4.5 pH 8.9
it
2
94
10
300 1
400 1
82244 1 431
82243 182242
20
Salinity %
Preclpitlon Uri/day)
Cloud Cover Is
Wind Direction (Deg)
Stream Flow Saver ty
11351
Turbidity Severity
Wind Velocity M/H een Stream Depth IL
Stream Width ft.
480
45
32
36
11350
35 W
4
DMI/R*Awd 10/86