970018_INSPECTIONS_20171231

E
Water Resources -
Environmental Quality
Robert M. Hayes
Robert Hayes Farm
1701 Mining Ridge Road
Elkin, NC 28621
Dear Mr. Hayes:
ROY COOPER
Governor
MICHAEL S. REOAN
Secretary
S. JAY ZIMMERMAN
Director
July 12, 2017
Re: COMPLIANCE INSPECTION
Robert Hayes Farm/Facility 97-18
General Permit AWC970018
Wilkes County
On May 9, 2017, staff of the North Carolina Division of Water Resources (DWR), Water Quality
Regional Operations Section (WQROS), inspected the Robert Hayes Farm and the permitted
waste disposal system. We wish to thank you for being present and assisting during the
inspection.
The enclosed report should be self-explanatory; however, should you have any questions
concerning this report, please contact me at [phone].
James B. Bealle III, Environmental Specialist
Mooresville Regional Office
Water Quality Regional Operations Section
Division of Water Resources
enclosure: Compliance Inspection Report dated May 9, 2017
jb
State of North Carolina I Environmental Quality I Water Resources I Water Quality Regional operations
Mooresville Regional Office 1 610 East Center Avenue, Suite 3011 Mooresville, North Carolina 28115

Division of Water Resources
❑ Division of Soil and Water Conservation
/ Other Agency "
Facility Number:
970018 Facility Status:
Inppection Type:
Compliance Inspection
Reason for visit:
Routine '
Date of Visit:
05/OW017 Entry Time: 03:30 pm
Farm Name:
Robert Hayes Farm
Owner:
Robert M Hayes
Mailing Address:
1675 Mining Rdg Church Rd
Physical Address:
Active
Permit AWC970018
Inactive Or Closed Date:
County: Wilkes Region:
Exit Time: ' 5:30pm Incident#
Owner Email:
Phone:
Elkin NC 28621
Denied Access
Winston-Salem
336-957-8367
Facility Status. Compliant ❑ Not Compliant Integrator.
Location of Farm: latitude: 36' 19' 16" Longitude: 80° 55' 40"
Hwy. 21 N. of Ellin to Old 21. Left onto old 21 then left onto Mining Ridge Church Rd. farm is located at intersection of Mining
Ridge Ch. Rd. and Shoat' Branch Rd.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat Waste Application.
Records and Documents Other Issues
Certified Operator: Robert M Hayes Operator Certification Number: 21407
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Robert Mickey Hayes Phone: [phone]
On -site representative Robert Mickey Hayes Phone: [phone]
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
11/15/16 > Waste Analysis > N = 5.59 Lbs/1000 Gallons
04/07/16 > Waste Analysis > N = 4.67 Lbs/1000 Gallons
04/14/15 > Soil Analysis
Phone: [phone] Ex.
-_ ___Date:—. -_
14. Facility Operator is cum:ntly in the process of coordinating with Wilkes SWCD/NRCS to revise the CAWMP to include Slurry
Tank application method, and additional fields/crops for waste application.
24. Calibration of waste application equipment to be scheduled prior to next application event.
32. Silage Leachate must be controlled following BMPs to prevent potential discharge. Facility Operator advised to coordinate
with Wilkes SWCD/NRCS to develop and implement a plan to address ASAPI
lb
page: 1

Permit: AWC970018
Owner - Facility :
RobertM Hayes
Facility Number: . 970018
Inspection Date: 05/09/17
Inppection Type:
Compliance Inspection
Reason for Visit: Routine
Regulated Operations
Design Capacity
Current promotions
Cattle
Cattle -Milk Cow 136 72
Total Design Capacity: 136
Total SSLW: 190,400
Waste Structures
Disignated Observed"
Type Identifier Closed Date Start Date Freeboard Freeboard
Waste Pond WSP 48.00
Wet Stack MT.STACK
page: 2

• •
Permit: AWC970018 Owner - Facility : Robert M Hayes Facility Number. 970018
Inspection Date: 05/09/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
ves
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)
❑
❑ 0
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
❑ M
❑
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)
❑
❑ 0
❑
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 Waters of the
❑
M ❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
res
No Na Ne
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 (I.e./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
-6. Are there structures on -site that are not properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
0 ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
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?
Waste Application
Yes
No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑
0 ❑
❑
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)?
❑
PAN? '
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window? _
❑ .
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWC970018 Owner - Facility : RobertM Hayes Facility Number: 970018
Inspection Date: 05/09/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application yes No Na Ne
Crop Type 1 Com (Silage) -
Crop Type 2 Fescue (Hay, Pasture)
Crop Type 3 - Small Grain (Wheat Barley,
Oats)
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lad( of property operating waste application equipment?
Records and Documents
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.
WLIP?
Checklists?
Design?
Maps?
Lease Agreements?
Other?
If Other, please specify
21. Does record keeping need improvement?
If yes, check the appropriate box below.
Waste Application?
Weekly Freeboard?
Waste Analysis?
Soil analysis?
Waste Transfers?
Weather code?
Rainfall?
Stocking?
■ ❑❑ ❑
❑■❑❑
❑■❑❑
❑
■❑
❑
❑■❑❑
Yes
No No No
❑
E ❑
❑
❑
E ❑
❑
El
El
El
El
❑■❑❑
page: 4

Permit: AWC970018 Owner - Facility : RobertM Hayes Facility Number: 970018
Inspection Date: 05/09/17 Inspection Type: Compliance Inspection - Reason for Visit: Routine
Records and Documents
Yes
No No No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22-. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑ M
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
❑ M
❑
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?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑ M
❑
Other Issues
Yes
No No No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
M ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
M ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
M
❑ ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewfinspection with on -site representative?
❑
M ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
❑
❑
page: 5

OUivisionof6SoJ.Cn of Water Resources
Facility Number - 18: 0 Divisireation
OO Other Agency
Type of Visit: aCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: aRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: W 1Lko Region: W5P10
Farm Name: ROP Gr S' ywleS q1'R A Owner Email:
Owner Name: POR&I"i wmc-s Phone: (3 536.45i• )u45
Mailing Address: r%ol Mwii kip6E eouect1 Rai, 6Lkw„ 6
Physical Address: ,/
Facility Contact: Kbewy t*\1e $ Title:
Onsite Representative: /_91l Integrator:
Phone:
Certified Operator: Certification Number: � 14b
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine Capacity Pop.
Wet Poultry
Design
Capacity
Current
Pop.
Design Current
C++ante - Capacity Pop.
Wean to Finish
I Layer
I
Wean [o Feeder
I INon-Layer
IDai
Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D,ry P,oultr.+
Layers
Design
Ca raci.
Current
P,o P.
D Cow
Non-Dai
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Turkeys
Turkey Poults
Other
lBeef Brood Cow
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure. ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
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 r�71 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
[:]Yes
jj] No
❑ NA
❑ NE
Page I of 21412015 Continued

Facility Number: 1& 6 jDate of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Er 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: UAV� f6vA sTRc�
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): D
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes M 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 UR'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? B Yes ❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 2'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 [Ef 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 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): Cop-Ij SILK&e
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
®'No
❑ NA
ONE
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
[WNo
❑ NA
NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
Co No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
b'No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
KNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
rNo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑Maps ❑LeaseAgreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
FNo
❑ NA
❑ NE
pplicWlat4 E444eki�: E 'A'a� n 46
❑ Waste Transfers
E Itain 11 ❑ 120 Minute Inspections JEaor r1 i - icaimaii-ham.
Wns ef 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
5-NA
❑ NE
Page 2 of 3
21412015 Continued

Facili Number: L17 l Date of inspection: Bt
24. Did the facility fail to calibrate waste appG on equipment as required by the permit.
❑ Yes
[KNo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
gNo
❑ 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 fast survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
ZNo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[ff 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 a No ❑ NA ❑ NE
❑ Yes ErNo ❑ NA ❑ NE
❑ Yes ff No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
❑ Yes LErNo
❑ Yes [�'No
❑ Yes CB -No
❑ NA ❑ NE
❑ NA ❑ NE
❑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).
—OPUP,TOIZ Vf% ? 6 OUC- w 'J.vtp
— Sott_ -r"OVE aa1C. (�xt6 Pit hGf�W d�18
CRUBRATtow Oki ,.v16.
— CREG14T 13Uff6as
"- .t"o.a EaS.c PIJ �f� PowA
�-I, I %
j,Sn ` LycV7 kbftode C#'J'
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
So Yov c+w Sew 7t,F pee&&4 t0 Ap*.AK-44
w_o.0_
Q
Phone: 33� koC-�9'tg
Date: &Lg-i is
21412015

Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 De
Date of Visit: h
ZaIS. I Arrival Time: t 30a •� Departure Time: /,' 3 ri County: i E
Farm Name:omAa l e,J#ay,S �u !/✓/ Owner Email:
/ Ile.
Owner Name: / DC a b o {' 1�w 1S Phone: id '151-8317 eQ 3
Mailing Address:
Physical Address:
Facility Contact:
WIL
nA li..r(
Title:
Representative:
Onsite 10 o/d CYp/
Q /// i�A a
Certified Operator: a&'114
A�?S
Back-up Operator: �c,4/
,t d S
Location of Farm:
Integrator:
i Access
Region: G
957-7 1115
Phone: r 3V - '/$-%- Z// fb
Certification Number:
Certification Number:
Latitude: Longitude:
a1 `la 7
U.S. fFwrRf , L Ol N�✓Y2I�
,>'/,;,,�9 .• � c�. R
.
Swine
Wean to sh
Design Current
Capacity Pop.
Wet Poultry
La er
Design
SO
Capacity
Current
Pop.
Cattle
DairyCow
Design
Capacity
3
Current
Po p.
g0
Wean to Feeder
Non -La er
DairyCalf
0.
Feeder to Finish
Dairy Heifer
Farrow to can
Farrow to Feeder
Farrow to Finish
D , P,oultr
Layers
Design
Ca aci
Current
P,o
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullers
Beef Brood Cow
Other
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 jg-No ❑ NA ❑ NE
[:]Yes
[-]No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
jELNo
❑ NA
❑ NE
Page 1 of 3
21412014 Continued

[Facility Number: • jDate of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes 15a'No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes [—]No
❑ NA
❑ NE
Structure 3 Structure 4
Structure 5 Structure 6
77S��tr'_u/Ic'.ture �Sttr[ucttu/re //2
Identifier: W*5 ci WekA04k
Spillway?: Y 5
Designed Freeboard (in):
Observed Freeboard (in): 3�
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 JK 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 fallo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes EZNo
❑ 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 _Q 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
J �❑
12. Crop Type(s): ��n SAI-*L_ / %J a yi
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�c No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Q No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
5No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
5kNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
Reuuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
EZ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
1No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21.DDoes record keeping need improvement? "������^�����•�•.
,
❑ Yes
® No
❑ NA
❑ NE
� Waste Applicati Q' ekly Freeboard Q caste Analysis Soil Analysis
Rainfall
c���4�5
[�'V6eather Code
❑ Stocking Crop Yield 120 Minute Inspections ✓ l% nthly and 1" Rainfall
Inspections
-
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: y- /
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes DD No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No C3 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?
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:
❑ Yes
® No
❑ NA
❑ NE
[:]Yes
gLNo
❑ NA
❑ NE
❑ Yes
RNo
❑ NA
❑ NE
[:]Yes 5jNo ❑ NA ❑ NE
❑ Yes allo ❑ NA ❑ NE
❑ Yes � No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes K No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes .JAL No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ES -No ❑ NA ❑ NE
Comments (refer to question ff): 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).
'Atj 0)0Lra4r- I%iL 1%2et(G /fir$ 4 /Z/3//26/.S/ jfi 3!90 " Zv(S
�l/flfw//ten Gu/�s-x.�nrn o�NL ZO/[6
ylnb�.yl4iAewf" ,vjowr�?: LLS/ 6�''N'ei- Go.1'l-✓'eI
l,/sr•�J /I%tJ I.V•s S% P�rrtl3/t//�l/(Iy, � L/
15/4� y Xt/= 41-Y3 Ploy - 4 V
Reviewer/Inspector Name: / //i
Reviewer/Inspector Signature:
Page 3 of 3
0� 012Js o n Lq %/k
yy,l
Phone: 3.36- 77^
Date: I '-141 - Z m lJr
21412014

Type of Visit: ((1 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit: QO Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: ,%0 Arrival Time: Departure Time: o® County:
Farm Name: Ac)berl- qa_tAQ„S Farm Owner Email:
Owner Name: P-p Phone:
Mailing
Mailing Address: 1, U 1 AAI h I aJ04&
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
f
o
Latitude:
Integrator:
Region: U3S/Z0
1� 1
Phone:
Certification Number: t� �
Certification Number:
Longitude:
U5 Hty3y c2-I L 01a Htoya_lf
L
IrtIt'1°
G Q d
Design C•gre
Swine Capacity Pop.
Wean to Finish
MQsi
Wet Poultry
Layer
gn Current
Capacity Pop.
Cattle
Dai Cow
Design Current
Capacity Pop.
Wean to Feeder
Non -Layer
Dai Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dt. P,oW .+
I Layers
Design Current
Ca aci Pao ,
I
Dry Cow
Non -Dairy
Beef Stocker
a
Gilts
Non -Layers
I
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
01 Other
Turkeys
Turkey Points
Oth,r
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
XNo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes [-]No
❑ YesNo
❑ Yes I
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3
21412014 Continued

Facility Number: Date of Inspection:
0�0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[:]Yes
ONo
❑ 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: w5Q we- +-a-c
Spillway?:
Designed Freeboard (in): e
Observed Freeboard (in): J
5. Are there any immediate threats to the integrity of Ly 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
�dNo
❑ 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)
ZN
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 q 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
rVNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
gNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
P No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
4 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
WNo
❑ NA
❑ NE
Required Records & Documents
_
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
V No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
WNo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑Other:
21.oes record keeping nee improvement rf �� ti�a 0Yes []No NQ� ❑ NE
[,waste Applica 'on eekly Freeboar Waste Anal is oil Analysis 041�C94eather Code
ainfall Stocking Crop Yield 120 Minute Inspections onthly and V Rainfall Inspections ❑Stadge-Snwey-
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 8fNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes ❑ No j� NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: q I- / Date of Inspection, b
24. Did the facility fail to calibrate waste ap rcation 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 ❑ l No u NA ❑ NE
the appropriate box(es) below. T'
❑ 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 I XI No ❑ NA ❑ NE
Other Issues 7'
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes eNo ❑ 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:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes I No ❑ NA ❑ NE
[—]Yes eNo ❑ NA ❑ NE
❑ Yes ENNo ❑ NA ❑ NE
❑ Yes VNo ❑ NA ❑ NE
❑ Yes [XNo ❑ NA ❑ NE
❑ Yes EyNo ❑ NA ❑ NE
(Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawings of facility to better explain situations (use additional Daues as necessarv).
'a 5oui
aq. Irr'ar°il�O SySt Ltalibr4^1�d ?�D b2� Se�� -}� T�I�J�
'A4-
d'h_ e jla Vl a_°, q .
6 �.4
OkV
Reviewer/Inspector Name:
55.49 (6 - N 1 L D00
Reviewer/Inspector Signaturt
Page 3 of 3
,me l i ssa
(_0115/14 . 6.a9 I�5-N/i
Phone: 1 1 1- 5 zSq
D'7_
Date: 9 � �
(-05e,brW&@ ACjeA rBjb , V " 2/4/2"

Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: *Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1 1Arrival Time: Q 0 n Departure Time: County: y 1 i 1 Kq5 Region: j,_)$ P_0
Farm Name: Ober ( FMi t APS F& h m Owner Email:
Owner Name: Phone:
Mailing Address: L1 Q M1 h1k 6 \C �� I G h U f c h Ic d I �� n� t✓ fp o2%
i
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone: F 9 S 1— ti ($ rp
Integrator:
Certification Number:
Certification Number:
Location of Farm: Latitude 3 (p0 19 f ( (0' 1 Longitude: g Oo .5 S f q o `i
U6 Q4,vJ" 1-1 /";) UVICI Ftw� aJ IQ MintI / Ptc SP t^ e
�•
Design Current
Swine Capacity Pop.
Design Current
Wet Poultry Capacity Pop.
Design Current
Cattle Capacity Pop.
Wean to Finish
La er
a Cow
1361
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Farrow to Wean
Design Curreut
Dr. + P,oult Ca aci P,o
Layers
Dai Heifer
Cow
Farrow to Feeder
Farrow to Finish
Non -Da'
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
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 DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
[)] No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
] No
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
Page 1 of 21412011 Continued

Facility Number: • Date of -Inspection.
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [g 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: \ti(1tSi',pga6 5}aCAk--
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):b
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ZNo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
gNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
gNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Ca"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
A'No
�`���"`"'"''tttt
❑ 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 JN(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
(r
12. Crop Type(s): A. ) 6aA,-,.P A�Uh�_ 0
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 'WNo
❑ Yes CNo
❑ Yes ArNo
❑ Yes No
❑ Yes No
❑ Yes tq No
❑ Yes '[�Ko
❑ Other:
21. Does record keeping need improvement? ❑ Yes ;Sr&o
Waste Application ® Weekly Freeboard Nrwaste Analysis Soil Analysis
Rainfall [Wtocking [gCrop Yield �0 Minute Inspections Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes jRrNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [:]No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Weather Code
❑ NA ❑ NE
<NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: • Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? WYes [:]No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [—]Yes ❑ No XNA ❑ 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 CKrNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Pj 2Mo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes KNo ❑ NA ❑ NE
and report mortality rates that were higher than normal?yy7/ll��
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes �.l No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately. YY��
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
ONo
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
A 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
eNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
&No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
CB�No
❑ NA
❑ NE
(Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawings of facility to better explain situations (use additional pages as necessary).
aol� So< < test? �e56 Use_ "cuv\ aol �..
12?01�P_ Mo (y01) 4,1 r ne-.
aan.plv�� nez�� -CIMC --the, Iirrllabon i S used ,
�w�-�-�a�,l�-� o�✓ f�-Pt� 7 t� �� K
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
r�
Phone:
Date:
2/4,1011

Type of Visit:
�Cympliance Inspection
Operation Review Q Structure Evaluation
Q Technical Assistance
Reason for Visi :
`K Routine O Complaint
O Follow-up O Referral 0 Emergency
O Other O Denied Access
Date of Visit: I 14"val Time: Departure Time: I J County: W I I lL>°S Region: (,y$ (L Q
Farm Name: R'pTf'bt d— ti 9::!:j e,5 Far M Owner Email: (��f Q c7 — 7 4 4.5
Owner Name: bgr 4-4A.: j e's (_Phone: H 44 S 7 — 836
Mailing Address:
Physical Address: W
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone: f:- 4 5 /^ y 1 O 6
Integrator:
Certification Number: & `'
Certification Number:
Location of Farm: Latitude3 1p ) Q /6 Longitude: 8 0 SS q Q
US f}wy �I
N •i
L 6) Lj 4w1
0-1 L
M1nivij ge_ c h. ,
Design
Capaapacity
Current
La er
Design
Current
Design Current
Pop.Weish
Dai CowWeder
Non -La er
Dai Calf
Dai Heifer
Feenish
Farean
Fareder
Irl
I)r P,om +
Design
Ca aci
Current
Pao
Cow
Non-Da'Farinish
Beef Stocker
Gil
Beef Feeder
Bo
ENon-Layers
Beef Brood Cow
Ot
NJ Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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 �6 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
[-]Yes [—]No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
Yes "``III] No ❑ NA ❑ NE
Pagel of 21412011 Continued

Facility Number: -
I. jDate of inspection: ,S 01
Waste Collection & Treatment
�[
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
IXI No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
[-]Yes
0 No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
,,...���(((
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
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 [A 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 M/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 nn ❑ Evidence
��ofyyWind Drift ❑ Application Outside of Approved Area
12. Crop Type(s) . 0,I&A' l.0 (Y�J1 .iV1 kAA al*M tk&u.,-
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 t] No [_]NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes
rV No
❑ NA
❑ NE
❑ Yes
[ 'kgo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes K]No ❑ NA ❑ NE
❑ Yes F ❑ NA ❑ NE
❑Other:
21. Does record keeping need improvement? ❑Yes CANo
Waste Application eekly Freeboa Waste Analysis Soil Analysis ❑�te�raesfecc
Rainfall �tocking [Crop Yield �120 Minute Inspections Monthly and V Rainfall Inspections
CALK
22.1!!d:e facility fail to install and maintain a rain gauge? ❑ Yes K No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [—]No
❑ ❑ NE
Weather Code
I"ISludge survey
❑ NA ❑ NE
j'PA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - 1 • Date of Inspection: 5- 0
24. Did the facility fail to calibrate waste application equipment as required by the permit? WF ❑ Yes No❑[ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑Yes No 11CI NA ❑ NE
the appropriate box(es) below. 7'
❑ 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
o ❑ 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?
777777y'''"������(
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.
7�
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 No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
T'
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 181
No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes EA No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary). - "'
gTre49S
On d ary ? P.Qe o-4e a A%d i.A� 1_1&
b r " on ._ � u e. ao i a. !v@* LAzk (1L&,xp&jXj
6 P-�� eel. e,� bU-)P v1-P�,�, W"t-(" PeAJO (A Orl� a d
a P l ease.. C_ ocns(d -tr MW l n. PtAc� b 0-C V- fro nk. Cxee-V_ a� L ats5 -
AVID �k, oiR e ouc,I \ side_ a �5+reann • 7e i ncrenseA b ��
rA i t l hop k-► lk4_4. Se CL,(7" u * Wk0aw re_ -Vv'o av&_ s aP ed Ic�l
(1�0�6j�0�a SI(�S.(��I0001g3X LollOjla- = 7.tngIke. Nllnnoq,0.
Reviewer/Inspector Name:
Phone:
Reviewer/Inspector Signature:
Page 3 of 3
Date: 1;- 5-/goI o�-r�_
21412011

of
for Visit: (I Routine
O Referral O Emergency O Other O Denied Access
Date of Visit: Urrival Time: ® Departure Time: County: Region: LL)$ Q�
Farm Name: —P0 blr' "C4— to's Owner Email:
Owner Name: �Q ell / e,s /Phone: (� � C1 S -7 ` 'U4 7
Mailing Address: (, 0 j I h 1 {� 9� �1 I-j n I. NC-- a 8 6a1
Physical Address:
Facility Contact: ��.(� M t tle:
Onsite Representative:
Certified Oneratnr
Back-up Operator:
Location of Farm:
Jqs-7 -y(g4.
Integrator:
Certification Number:
Certification Number:
Latitude: 3 to 1 9 Ito Longitude: q0 S 5 46
N
Q
01
4wq 3-I 1 0
n�
PI'dVe-
Design
Fugen
I
Design Current
Design
Current
Swine
Capacity
Pop.
Wet Poultry
Capacity Pop.
Cattle
Capacity
Pop.
Wean to Finish
Layer
Da' Cow
3
(p
Wean to Feeder
Non -Layer
Da Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design Current Cow
a'- }
Farrow to Feeder
D . P,ou1tG
Ca aci. P,o
Non -Dairy"
Farrow to Finish
La ers
I
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[—]Yes [$No
❑ Yes [—]No
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
IN Yes
❑ No
❑ NA
❑ NE
r
Pagel of 21412011 Continued

Facifi Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Cg'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
Identifier: rA,s P Y $
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
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 r'ql&o ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? WYes ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes XNo ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �No ❑ NA ❑ NE
maintenance or improvement?
Waste Application y, �
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes I X1 No ❑ NA ❑ NE
maintenance or improvement? �� CC
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �dNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes �SrNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
[—]Yes No
❑ NA ❑ NE
❑ Yes KNo
[—]Yes Pg'No
❑ Yes No
❑ Yes No
❑ Other:
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
21. es record keeping need improvement? Ifyes ctrecic#1eEepyFapria Yes ❑ No Intl ❑ NE
Wjste Applicaf 'n ,L�.7�/Weekly Freeboard ,L�J{Waste Analysis Soil Anal s' �`E Weather Code
Rainfall Stocking Crop Yield 120 Minute Inspections Monthly and l" Rainfall Inspections ❑ 3indge smvej
22. Did the facility fail to install and maintain a rain gauge? ❑Yes I NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No I w NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: Date of Inspection:
l ;2011
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
No
OeNA
❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27. Did,the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
[ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
'ZNo
❑ 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
gNo
❑ 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
XNo
❑ 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
ONo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
d �/
I No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
I7
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
rN"_� �No
o
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any -other comments , m
Use dr ings of facility to better explain situations (use additional pages as necessary). Ni
CaII brc3 fi0r\ dve Q �n bti P.YId o� ao� a
FJ.�- Pip
C Dz� ®C� . o!a waste 5o" (es
� o
Il/i(o(ll_�6.511es N�I000q�Q. 611a3/1<> Ls�=
(01 ScL3= la•�t lksN��i
Reviewer/Inspector Name: o5e° b r0L1Phone: '72 I — S d 89
Reviewer/Inspector Signature: Date: G210� 21�0
Page 3 of 3 21412011

}� Dtvtsion of Water Quality - $
{ FaCillty.NUmbei. (y.DlvlSl00 otSotl and Water Conservation
0 Other Agency
Type of Visit VCompliance
Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
XRoutine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Re too• WS 90
Date of Visit: 6 L pp/d Arrival Time: •�3 ���M Departure Time: � County: g'
Farm Name: K66ww t "tL'[(fr_ fztf AN t 0 Owner Email:
Owner Name: f,.5DU {-tal:,e/ Phone:
Mailing Address: 1701 /pp- ,' ,f� A4 ' � Z C Jl• /��• C 2 04 �
Physical Address: 15AA� r1 ' `
Facility Contact: �P _-lLef Title: Phone No: �S / —7l'?
Onsite Representative: Ka r�ee� Integrator: �—
s Certified Operator: ��`"'/f Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: N1 OUT] • U.. Longitude: ®n®, ®..
,•Design
Current =Design 'Current :. -, Design
S,wme ,.. ,.
...'ILI
,�C-urrent.•
Capacity Population >> Wet Poultry Capacity ,Population -Cattle C^^apacttyPopulaho`d
_- _- .: .. ,.. .. . _
Wean to Finish
A ❑ La er
ai
Dai Cow
❑WeantoF
Feeder
c ❑ Non -Layer
1
11
❑ Dairy Calf
•` ❑ Feeder to Finish
I
T ❑ Dairy Heifer
�," ❑ Farrow to Wean
;'� D Poult
t y ry
,
❑ D Cow-
❑ Farrow to Feeder
"'
.:: ❑ Layers
`"n ❑ Non -Dairy
«. El Farrow to Finish
'. El Beef Stocker
❑Gilts
�- ElNon-Layers
El Beef Feeder
❑ Boars
.--' ❑Pullets -
e
❑ Beef Brood Cowl
r�.
._ - ❑ Turke s
,
Other
El Turkey Points
«
❑ Other
�„ ❑Other
;, Number of Structures
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes XNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
[--]Yes [--]No
❑ NA
❑ NE
0
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes X.
❑ NA
❑ NE
❑ Yes )<No
❑ NA
❑ NE
Page I of 3 12128104 Continued

Facility Number:97 — �� • Date of Inspection /O Z/ •
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
❑ Yes !DCI No
El Yes �❑ No
❑NA ONE
❑NA ❑NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:f
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):—T
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes lei 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 I!� No ❑ NA ❑ NE
through a waste management or closure plan? / 111
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 } I ❑ NA El NE
8. Do any of the stucmres lack adequate markers as required by the permit? ❑ Yes �{J 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 ,1�J 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 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift II❑ Application Outside of Area
12. Croptype(s) CAM S/L<is�L �CJGty,'t r , �MSt6� ayrciiv� A,41
13. Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
❑ NA
ElNE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes VNo
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes No
ElNA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes m No
❑ NA
El NE
18.
is there a lack of properly operating waste application equipment?
❑ Yes X.
❑ NA
❑ NE
Commenfs(refer to question.#):'Explain any YES answers and/or any recommendations or any other comments r ""
Use drawings of facility to better explain situations. (use additional pages as necessary) "' r
r% C�,H�e eulu�d �ron� eMbR,+kMerL�q? L�o�s 6 Kee? eyz ov% Oo , LT
/mold,
3, 73.ci fl eneeJ CJ4s� fmJ OJA 4tciw /and
Reviewer/Inspector Name1 Phone: -V627_
—r
Reviewer/Inspector Signature: �' Date: O 2( 0
Page 2 of 3 12128104 Continued

• , • Facility Number: — � of Inspection d
Required
Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes XNo
❑ NA ❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes 1251 No
❑ NA El NE
the appropriate box. ElWUP El Checklists El Design El Maps El Other
�����///\
.
21.
Does record keeping need iimprovement?
❑ Yes �p No
❑ NA El NE
� w Waste Application eekly Freeboard Waste Analysis Soil Analysis EnWaste Transfers \8
Rainfall Stocking Crop Yield 120 Minute Inspections Monthly and V Rain
Inspections Bather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes ZCNo
❑ NA ❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ❑ No
/NA El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes �No
//(I NA El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
[I Yes ❑ No
pD NA El NE
-❑
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes KNo
NA ❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes _�(No
❑ NA ❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes No
❑ NA ❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ yes No
❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes KNo
❑ 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 KNo
❑ 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 J�No
❑ NA ❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes kNo
❑ NA ❑ NE
Additional Comments an'd/or,Drawings
r
zm n4
4-77d
'Z la/lSL!/ e-O.Gc7_46 l Jl0"1j6 J, c^rf a tilt q �yi/Sf�J,
10 49122,010
Lv/lec4onJw7b /ab Jzr 1'4'd7llff
z
Page 3 of 3 12128104

oaoF wArE9QG Incident Report
y
}_ ti
O ` ReportNumber: 201001681 Nod -CZao- QG, 05 q l
Incident Type: Non -Compliance Reporting
Category: APS- Animal
flndident Stinted: �02/08/2010
County: Wilkes
City:
Farm #: 097-0018
Responsible Party:
Owner:
Pertnit: AWC970018
Facility: Robert Hayes Farm
First Name: Robert
Middle Name: M
Last Name: Hayes
Address 1701 Mining Ridge Church Rd
City/State/Zip: Elkin NC 2862180
Phone:
Material Category: Estimated Qty: UOM
DD:MM:SS Decimal
Latitude
Longitude:
Location of Incident
Address:
City/State/Zip
Mining Ridge Church Road
On -Site Contact:
First/Mid/Last Name:
Company Name:
Phone:
Pager/Mobile Phone: /
Reported By:
First/Mid/Last Name:
Company Name:
Address:
City/Slate/Zip:
Phone:
Pager/Mobile Phone: /
Chemical Name
Position Method:
Position Accuracy:
Position Datum:
Reportable City. lbs. Reportable City. kgs.
Report Created 05/14/10 01:18 PM Page 1

•
•
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
Water Supply Wells within 1500ft
0 Access to Farm
Mi Structure Questions
Directions:
Comments:
Conveyance:
Estimated Number of fish?
(Above Ground or Under Ground)
Unknown Groundwater Impacted: Unknown
0 Animal Population
M Spray Availability
Report Created 05/14/10 01:18 PM Page 2

u
Access to Farm
Farm accessible from the main road?
❑ Yes ❑ No ❑ NA ❑ NE
Animal Population
Confined? ❑ Yes ❑ No ❑ NA ❑ NE
Depop? ❑ Yes ❑ No ❑ NA ❑ NE
Feed Available? ❑ Yes ❑ NO ❑ NA ❑ NE
Mortality? ❑ Yes [:]No ❑ NA ❑ NE
Spray Availability
Pumping equipment?
❑ Yes
❑ No
❑ NA ❑ NE
Available Fields?
❑ Yes
❑ No
❑ NA ❑ NE
Structure Questions
Breached?
❑ Yes
❑ No
❑ NA ❑ NE
Inundated?
❑ Yes
❑ No
❑ NA ❑ NE
Overtopped?
❑ Yes
❑ No
❑ NA ❑ NE
Water on outside wall?
❑ Yes
❑ No
❑ NA ONE
Poor dike conditions?
❑ Yes
❑ No
❑ NA ONE
Waste Structure Type Waste Structure Identi inches Plan Due Date
Plan Recieved Date Level OK Date
Waste Pond WASTE POND 18.00
Event Type Event Date Due Date
Comment
Incident closed
Requested Additional Information
Report Received
Referred to Regional Office - Primary Contact
Report Entered 2010-05-13 12:51:56
Incident Start 2010-02-08 08:00:00
Report Created 05/14/10 01:18 PM
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
DWQ Information:
Report Taken By: Report Entered By: Regional Contact:
Melissa Rosebrock
Phone
DatelTime: 2010-05-13 12:51:56 PM
Referred Via:
Did DWQ request an additional written report?
If yes, What additional information is needed?
Report Created 05/14/10 WAS PM Page 4

IType of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visi Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: �� Departure ime: County: W Region:
Farm Name: �Owner Email:
Y J T
Owner Name: Phone: ��
n � .
Mailing Address: 1 44 4 4A�,i(• . �J�r•�'�
Physical Address:
Facility Contact: itle: Phone No: T� 1I�s
Onsite Representative: Integrator:
VCertified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: [= o = ' = « Longitude: [� e
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify 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
xo
❑ NA
❑ NE
�❑
KKQ Yes
❑ No
❑ NA
❑ NE
12128104 Continued

Facility Number: — • Date of Inspection ,— ` I •
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
Struct re I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Desi tied Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
,KNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
��,.//
L]�No El NA [I 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? 0 Yes
[,3 No El NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes
LXNo ❑ 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
*o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
PNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
NIo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibis ❑ 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) ( V
13.
Soil type(s) Q
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o ❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
[INA
JN'o
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yeso
[INA
ElNE
17.
Does the facility lack adequate acreage for land application?
ElYesEl
NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
[I Yes
No ❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any'recommendations'or any'bther comments - �
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name jZ00
Reviewer/Inspector Signature:
1 Phone: I I I_
Date: IA l G

10
Facility Number: — D• of Inspection 11ACLIKU49
Required Records & Documents lI
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
[I Yes W/�.o
ElIcy Yes No
❑ NA ❑ NE
❑ NA ❑ NE
21. Do record keeping need,,ii irovement? ❑ Yes r No ❑ NA ❑ NE
ante Applicati n L'J Wee Freeboard ante Analysis 'P Soil An is Waste Transfers T
Rainfall Stocking Crop Yield 120 Minute Inspections onthly and 1" Rain Inspections UWeatherCode
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?
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 Ao [❑//NA ❑ NE
❑ Yes ❑ No O NA ❑ NE
❑ Yes No
❑ NA
❑ NE
❑ Yes
IP(NA
❑ NE
, (No
❑ Yes t2lNo
❑ NA
❑ NE
❑ Yes No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
dNo
❑ NA
❑ NE
❑ Yes
iNo
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
1A No
❑ NA
❑ NE
Additional Comments;and/or'Draw�ngs,,»�
bs C06 Ce-
'.�a�-e — ��o� l� • n1�ToI�I Anakilses Li
a d in �� t
122&1o4

Facility Number q 1
Division of Water
0 Division of Soil and
0 Other Agency
I
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 5
Farm Name: f�
Owner Name:
Mailing Address:
Physical Address:
Facility Contact
Onsite Representative:
Certified Operator: _
Back-up Operator: _
Location of Farm:
Arrival Time: Q v Departure Time: LL1_13.J County: bill I K25 Region: MS R
t HUj j al N. -t061
Church P_oa� .
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
al
Owner Email:
Phone:
R 5 —7
— YJ &
7
.10 Q Kin
I KI C-
a 86
4
Phone No: I 5 ❑ — 4 l %!
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: [M 0 W , ®�� Longitude:
e9 , Le 6ni6 ►y11nin5
Design Current Design Current
Capacity Population • Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ La ers
❑ 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?
Cattle
0
e
Design Current
Capacity Populatioy
Dairy Cow
Dai Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: W
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 P No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes 0 No ❑ NA ❑ NE
NYes []No []NA FINE
12128104 Continued

Facility Number: 1— • Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes jNo ❑ 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
Identifies
1 � Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ yes [ No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes O(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 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑Yes W 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
maintenance/improvement?
❑ Yes [�No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes I�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 Winq 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
[�1[ No
❑ NA
❑ NE
No
❑ NA
❑ NE
INNo
❑ NA
El NE
o
❑ NA
❑ NE
No
El NA
❑NE
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
0
i 4
IReviewer/Infector Name Q (�� Phone: ,I I— Saf4 I
Reviewer Spector Signature: Date: (D 1 /t
Z/ I2128104 Continued

40
Facility Number: 1— $' •ate 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 appropirate box. ❑ WUP ❑ Checklists ❑ Design [I Maps [I Other �
21. Doe rrecord keeping need�i�/J_Provement' i€�es;roh ❑ Yes No ❑ NA ❑ NE
,LN�I/Waste Applic tion need
Freeboard Waste Analysis Soil Analysis Waste Transfers/ ❑
l_y Rainfall atocking 5/crop Yield 120 Minute Inspections E Monthly and V Rain Inspections M7eatherCode
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
(1Q No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
,❑ No
[XNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
VA
El NA
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
[(NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
XNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
l%No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
L]G No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
*o
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
KNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
a . Wb'rd still Pest resulfs? fly!
�Cq libratiare-aAer Irr��Q lion Due- ®V-`fiber WOK
12128104

I Facility Number Lj I H T IT
Type of Visit C mpliance Inspection
Reason for Visit Routine 0 Complaint
Dateof Visit (CIS
Farm Name:
Owner Name: tw It
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: _
Back-up Operator: _
Location of Farm:
I4wy a -I
Swine
Other
❑ Other
Division of Water Quality 9 : 30/ /0 ' 00 f
0 Division of Soil and Water Conservation
O Other Agency
0 Operation Review 0 Structure Evaluation 0 Technical Assistance
0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
!4
Arrival Time: El 0 — Departure Time: �til County: IN I I K- Region: IL) Lv
e Ch-►4
Owner Email:
Phone: 01S % — 9,34 7
re -A Pj E 11<i in , /UC- a- 86 d-j
Phone No: I S % —i 1,7L
Integrator:
Operator Certification Number:
Back-up Certification Number:
(I—d leF+). Lei
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Puuets
❑ 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?
Longitude: L-4zT
F 0r)+t) 1M►11in
5 h o a I U }� rar,'c
Design Current
Cattle Capacity Population
QR Dairy Cow
El Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: -®
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 IiiNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
0
❑ o
❑ NA
El NE
El Yes
IfNo
❑ NA
❑ NE
Yes
❑ No
❑ NA
❑ NE
12128104 Continued

Facility Number: — . Date of Inspection I 1 I I 1 < IO
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?
[ructure I Structurel2 Structure 3 Structure 4
Identifier: �Q���O��e-C S+q_CY.
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
❑ Yes //❑ No
Structure 5
❑ Yes *o
❑ NA ❑ NE
❑NA El NE
Structure 6
❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes �[// Io El NA [I NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes �{ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes )4 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10.
Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
No
❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
h(J 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 Drift ❑ Application Outside of Area
12.
Crop type(s) bN v'— t O ONE
13.
Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
No
t�
El NA [I NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
NA NE
[IElo
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
�L,.&/No
TT
I]Q''No
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application? ❑ Yes
No
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
NNo
❑ NA ❑ NE
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
0 Cvu- 0_r\ lL rn eve -L v t° jet - e d e ��S ._ � oohs food I
3e jJozd AAOve 7
Reviewer/Inspector Name C Phone: D1 I —S I I
Reviewer/Inspector Signatu Q Date: _11 1 I S - 1
r 12128104 Continued

Facility Number: — to of Inspection r"'7 7 •
Reunited Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes y�jNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ s Map El
21. Doe record keeping need im vement? ❑ Yes �No ❑ NA ❑ NE
taste Applic tion Wee Freeboard aste Analysis Soil Analysis
p(J Rainfall tocking Crop Yield �120 Minute Inspections pSMonthly and I" Rain Inspections Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
[ No
777[I
[I NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑,, Yes
No
0NA
❑ 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
VNA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
*o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
WA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
o
ElNA
ElNE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
ElYes
tNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
32.
General Permit? (ie/ discharge, freeboard problems, over application)
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
o
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Comments and/or
a� �alibra�-ion �m' / SPrec�der ? 1Jue a a; n ®e�• aoo8( Nit �e
�1 a607 561 �e5{ ? lirnedl
3T F+. 5 ��•
(1) FvT� _ 3� = Ta is�A
43ts6°s$�{`°�
Di poll ° I FIDUD (co Pk) gin pre 65 01r2
12/2&104

Division of Water Quality
Division of Soil and Water Conservation
❑ Other Agency rr--tt
Facility Number: 970018 Facility Status: Active Permit: AWC970018 Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Data:
Reason for Visit: Routine County: Wilkes Region: Winston-Salem
Date of Visit: 10/10/2006 Entry Time: 10:00 AM Exit Time: 12:00 PM Incident #:
Fans Name: Robert Haves Farts Owner Email:
Owner: Robert M Haves Phone: [phone]
Mailing Address: 1701 Mining Ridge Church Rd Elkin NC 286218035
Physical Address:
FacilityStatus: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm:
Latitude: 36'19'16" Longitude: 80"55'40"
Hwy. 21 N. of Elkin to Old 21. Left onto old 21 then left onto Mining Ridge Church Rd. fans is located at intersection of Mining Ridge
Ch. Rd. and Shoaly Branch Rd.
Question Areas:
0 Discharges & Stream Impacts
jj Records and Documents
Certified Operator: Robert M Hayes
Secondary OIC(s):
On -Site Representative(s): Name
24 hour contact name
On -site representative
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Waste Collection & Treatment Waste Application
Other Issues
Robert Mickey Hayes
Robert Mickey Hayes
Operator Certification Number: 21407
Title Phone
Phone: [phone]
Phone: [phone]
Phone:
Date:
Inspection Summary:
7. Woody vegetation removed. To be seeded this Fall.
21. 2006 soil test results ok.
21. Records are in excellent shape!
24. Calibration completed for irrigation. Not due again till Oct. 2008. Don't forget to complete spreader calibration, though.
7/21/06 waste analyses:
Irr--2.5 lbs. N/1000 gal.
Broadcast=25.6 lbs. N/ton
Page:1

Permit: AWC970018 Owner - Facility: Robert M Hayes Facility Number: 970018
Inspection Date: 10/10/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle
O Cattle -Other
1
Q Cattle - Dairy Heifer
2
O Cattle - Dry Cow
1
O Cattle - Milk Cow
136
84
Total Design Capacity: 136
Total SSLW: 190,400
Type Identtfier Closed Date Start Date Designed Freeboard Observed Freeboard
taste Pond WSP 36.0(
!et Stack VJET STACK 48.0(
Page: 2

Permit: AWC970018 Owner- Facility: Robert M Hayes
Facility Number: 970018
Inspection Date: 10/10/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts Yes No NA NE
1. Is any discharge observed from any part of the operation?
❑
■
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
■
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
■
❑
❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
■
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
■
❑
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a
❑
■
❑
❑
discharge?
Waste Collection, Storage & Treatment
Yes
No
NA
NE
4. Is storage capacity less than adequate?
❑
■
f_l
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large trees; severe
❑
■
❑
❑
erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a waste management ❑
■
❑
❑
or closure plan?
7. Do any of the structures need maintenance or improvement?
■
❑
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits,
❑
■
❑
❑
dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑
■
❑
❑
improvement?
Waste Application
Yes
No
NA
NE
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or
❑
■
❑
❑
improvement?
11. Is there evidence of incorrect application?
❑
■
❑
❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
Page: 3

Permit: AWC970018 Owner - Facility: Robert M Hayes
Facility Number:
970018
Inspection Date: 10110/2006 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Waste Application
Yes No
NA NE
PAN?
❑
Is PAN > 100/o/10 lbs.?
❑
Total P205?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
Crop Type 1
Com (Silage)
Crop Type 2
Small Grain (Wheat,
Barley,
Oats)
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
❑ ■
❑ ❑
Pian(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 property operating waste application equipment?
❑ ■
❑ ❑
Records and Documents
Yes No
NA NE
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑ ■
❑ ❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑ ■
❑ ❑
If yes, check the appropriate box below.
WUP?
❑
Page: 4

Permit: AWC970018 Owner- Facility: Robert M Hayes
Inspection Date: 10/10/2006 Inspection Type: Compliance Inspection
Records and Documents
Checklists?
Design?
Maps?
Other?
21. Does record keeping need improvement?
If yes, check the appropriate box below.
Facility Number: 970018
Reason for Visit: Roane
Yes No NA NE
❑
❑
Cl ■ ❑ ❑
Waste Application?
❑
120 Minute inspections?
❑
Weathercode?
❑
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
❑
Inspections after> 1 inch rainfall & monthly?
❑
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
❑
Stocking?
❑
Annual Certification Forth (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?
❑
E ❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
❑ E
❑
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?
❑
❑ ■
❑
Otherissues
Yes
No NA
NE
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
❑
E ❑
❑
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: AWC970018 Owner- Facility: Robert M Hayes
Facility Number:
970018
Inspection Date: 10/10/2006 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Other Issues
Yes No
NA
NE
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
O ■
❑
Q
32. Did ReviewerAnspector fail to discuss reviewlnspection with on -site representative?
❑ ■
n
n
33. Does facility require a follow-up visit by same agency?
❑ ■
n
n
Page: 6

Type of Visit ACompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit P Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Q 1Q_ _ Arrival Time: Q 60 Departure Time: a'e County: �!-L.L? Region: LADSRZ
Farm Name: �Uex- k etS'' ray—m Owner Email: f p c 2
Owner Name: RPbetr+ 1M" \ • I�-e5 D . Phone: I ' IS -7 — 836 7
Mailing Address: t QI^ 1► 1 1� ynQ f 1 C h 2ci� , E l Kin NC- 78(0
Physical Address:
Facility Contact:
Onsite Represents
Certified Operatm
Back-up Operator:
Location of Farm:
Phone No: q 5 / �7
Integrator:
Operator Certification Number: r `4 1)
Back-up Certification Number:
Latitude: r;5Qo ®' ®u Longitude: o �' FWD
jal -Vo Otdal lei+ - U onto MW
I �� eh- g4.
`
�41 a+
i vi r Ser ion tO S 1
rave C.h ",
Design ugent
�Populafion
Design
Current
Swine
Capacity Population
Wet Poultry
Cattle Capacity
Population
❑ Wean to Finish
❑ La er
DairyCow
❑ Wean to Feeder
ILI Non -Layer
I
Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Layers
La
❑ Non -Dairy
❑ Farrow to Finish
❑ Non -Layers
El Beef Stocker
❑ Gilts
El Pullets
El Beef Feeder
❑ Boars
❑ Turkeys
❑ Beef Brood Co
Other
❑ Turkey Poults
❑ Other
Number of Structures:
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
0
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes IvNo
❑ NA
❑ NE
❑ Yes ANo
❑ NA
❑ NE
Page I 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?
Strnrhve I .. Structure 2 Structure 3 Structure 4
Identifier: YV 'A J 1 C f I
Spillway?: L
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
❑ Yes ❑ No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
❑ Yes )�No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Yes ❑ No [I NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes 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 o ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes TT`` �No ElNA ❑ NE
ElExcessive Ponding ❑ Hydraulic Overload ElFrozen Ground [IHeavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes NNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 11,
No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes �,.,/ No IV NA El NE
17. Does the facility lack adequate acreage for land application? ❑ Yes D➢ No El NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 'K N` o ❑ NA ❑ NE
Comments (refer to question 11): 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):
�nlood y Y92'i"cn ?
fie.
-set?
Reviewer/Inspector Name Phone: I ( of b
Reviewer/Inspector SignatureU]fffl I A4IL _ ] AJJ4 I6fi b / Date:
Paee 2

Facility Number: C+ —�� Ote of Inspection /
Required Records & Documents �(
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes L�([,kNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Doe ecord keeping need ii/mprovement?L ejcc. ❑ Yes No ❑ NA ❑ NE
Waste Application IvJ W�ee�kly FreeboarV120
Waste Analysis Soil An ysis Waste Transfers 3tivrrl
Rainfall 2/stocking Crop Yield Minute Inspections " onthly and V Rain Inspections Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
LYNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
O� 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?
ElYes
❑ No
*A
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
�] No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NE
Other Issues
//////�NA
28.
Were any additional problems noted which cause non-compliance of the permit or CA WMP?
❑ Yes
�5
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
o
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
El Yes
to
❑ NA
❑ NE
Additional Comments and/or Drawings:
1
I = �.S lta•N�l000�P. &F= 4p 11.E RP5P 7.3j
S = oj5. le lb. +0rgN LaTonSb •7
lA�u.c
Page 3 of 3 12128104

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 970018 Facility Status: Active Permit: AWC970018 ❑ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Reason for Visit Routine County: Wilkes Region: Winston-Salem
Date of Visit: 10/12/2005 Entry Time:09,35 AM Exit Time: 12:50 PM Incident #:
Farm Name: Robert Haves Farm Owner Email:
Owner. Robert M Haves Phone: [phone]
Mailing Address: 1701 Mining Ridae Church Rd Elkin NC 286218035
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 36°19'16" Longitude: 80°55'40"
Hwy. 21 N. of Elkin to Old 21. Left onto old 21 then left onto Mining Ridge Church Rd. farm is located at intersection of Mining Ridge
Ch. Rd. and Shoaly Branch Rd.
Question Areas:
Discharges & Stream Impacts
Records and Documents
Certified Operator: Robert M Hayes
Secondary OIC(s):
Waste Collection & Treatment Waste Application
Other Issues Technical Assistance
Operator Certification Number. 21407
On -Site Representative(s): Name Title Phone
On -site representative Robert Hayes Phone: [phone]
24 hour contact name Robert Hayes Phone: 336-957A186
Primary Inspector. Melissa Rosebrock Phone: [phone]
Ext.383
Inspector Signature: Date:
Secondary Inspector(s):
Phone:
Phone:
Inspection Summary
7. Must cut woody vegetation on embankment. NOV next time.
8. Marker was reset in June.
18. Need pressure gauge on irigation gun.
21. 2005 soil test results look ok. Waste sample for March/April 2005 applications was ok, too.
21. 7/26/05 waste analysis was a little outside the 60-day window:
5.3 lbs. N/1000 gal.
Page: 1

Permit: AWC970018 Owner- Facility: Robert M Hayes Facility Number: 970018
Inspection Date: 10/12/2005 Inspection Type: Compliance Inspection Reason for Visit: Rouline
Regulated Operations Design Capacity Current Population
Cattle
O Cattle - Milk Cow 136 104
Total Design Capacity: 136
Total SSLW: 190,400
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
Neste Pond WSP 18.00
Net Stack WET STACK 48.00
I
Page: 2

Permit: AWC970018 - Owner- Facility: Robert M Hayes
Facility Number: 970018
Inspection Date: 10/12/2005 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? ❑ ■ ❑ Q
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
■
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWO)
❑
■
❑
❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWO)
❑
■
Cl
❑
2. Is there evidence of a past discharge from any part of the operation?
❑
■
Q
❑
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.eJ large trees, severe erosion,
❑
■
Cl
❑
seepage, etc.)? -
6. Are there structures on -site that are not properly addressed and/or managed through a waste management or
❑
■
Q
Q
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
❑
■
Q
❑
improvement?
Waste Application
Yes
No
NA
NE
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement?
❑
■
❑
❑
11. Is mere evidence of incorrect application?
❑
■
❑
❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/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
Corn (Silage)
Crop Type 2 Small Grain (Wheat,
Barley, Oats)
Crop Type 3
Crop Type 4
Page: 3

Permit: AWC970018 Owner- Facility: Robert M Hayes Facility Number: 970018
Inspection Date: 10/12/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No NA NE
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?
Cl
■
❑
❑
18. Is there a lack of property operating waste application equipment?
■
Cl
❑
❑
Records and Documents
Yes
No
NA
NE
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
Cl
■
❑
❑
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?
Cl
Other?.
❑
21. Does record keeping need improvement?
❑ ■ ❑ ❑
If yes, check the appropriate box below
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
Cl
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?
Cl
■
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
■
❑
Cl
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?
❑
■
Cl
❑
Page: 4

permit AWC970018 Owner- Facility: Robert M Hayes Facility Number: 970018
Inspection Date: 10/12/2005 Inspection Type: Compliance Inspection Reason for Visit Routine
Records and Documents Yes No NA NE
27. Did the facility fail to secure a phosphorous 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 those
mortality rates that exceed normal rates?
30. At the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air Quality
representative immediately.
31. Did the facility fail to notify regional DWO of emergency situations as required by Permit?
32. Did Reviewerlinspector fail to discuss reviewlnspection with on -site representative?
33. Does facility require a follow-up visit by same agency?
Technical Assistance
34. Waste plan revision or amendment
35. Waste plan conditional amendment
36. Review or evaluate waste plan w/producer
37. Forms need (list in comment section)
38. Missing components (list in comments)
39. 2H.0200 re -certification
40. Five & Thirty day Plans of Action (PDA)
41. Irrigation record keeping assistance
42. Organize/computerization of records
43. Sludge evaluation
44. Sludge or Closure plan
45. Sludge removal/closure procedures
46. Waste structure evaluation
47. Structure needs improvement
48. Operation & maintenance Improvements
❑ ■ ❑ ❑
Yee Mn NA NF
❑ ■ ❑ ❑
❑ ■ ❑ ❑
❑ ■ ❑ ❑
❑ ■ ❑ ❑
❑ ■ ❑ ❑
❑ ■ ❑ ❑
Yes No NA NE
Page: 5

Permit: AWC970018 Owner- Facility: Robert M Hayes
Inspection Data: 10/1212005 Inspection Type: Compliance Inspection
Facility Number: 970018
Reason for Visit: Routine
Technical Assistance
Yes No NA NE
49. Marker check/calibration
❑
50. Site evaluation
❑
51. Irrigation calibration
❑
52. Irrigation system design/Installation
❑
❑
53. Secure irrigation information (maps, etc.)
❑
❑
54. Operating improvements (pull signs, etc.)
❑
55. Wettable acre determination
❑
56. Evaluate WAD certification/rechecks
n
n
_
57. Crop evaluation recommendations
❑
n_
58. Drainage work/evaluation
❑
59. Land shaping, subsoiling, aeration, etc.
❑
Cl
60. Runoff control, stormwater diversion, etc.
❑
61. Buffer improvements
❑
n_
62. Field measurements (GPS, surveying, etc.)
❑
63. Mortality BMPs
❑
64. Waste operator education
❑
nEl
65. Operation & maintenance education
❑
66. Record keeping education
❑
11
67. Croplforage management education
❑
n_
68. Soil and/or waste sampling education
❑
n
69. PLAT Assessment
❑
❑
Page: 6

•
Permit: AWC970018 Owner- Facility: Robert M Hayes Facility Number: 970018
Inspection Date: 10/1212005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Technical Assistance
70. Other
Yes No NA NE
❑
Page: 7

of Visit h Compliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 9 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of visit: ' t ' f Arrival Time: ® Departure Time: aSiJ County: Region:�
Farm Name: RD jp�-}— l-i�P-S Fa no Owner Email:
Owner Name: Y1er /Y n, Phone:
Mailing Address: 1101_mini nQ I.� e. l�h. I�Ct ., F I_V,'# t tiC F (a Z
V
Physical Address: SO A,,- nJ
Facility Contact: ' le:
Onsite Representative:
kQA_�
Certified Operator: C.C7ber'% 1V I . Q
Phone No: L rtS t o
Integrator:
Operator Certification Number: oZ
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: ®o ®1 F/_Q.. Longitude: EW Eat EO
+�wy a1 N +0 o al LEe-4), �O'jo Minin`9^ �•IldrCh. /2d.
Fo_rrn 6L+ 'Iniex' s echo A I" 5 koalL Bran
Swine
Other
❑ Other
Design Current Design Current Design Chrrent
Capacity Population Wet Poultry Capacity Population Cattle Capacity Populati n
❑ Layer DairyCow
❑ Non -La et
Dry Poultry
❑ La ers
❑ Non -Layers
❑ pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El
Dairy Calf
❑
Dairy Heifei
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocket
❑
Beef Feeder
❑
Beef Brood Co
�I
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: FZT 3
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 f*No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
0
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes >No []NA ❑ NE
❑ Yes > No ❑ NA ❑ NE
12128104 Continued

Facility Number: — • Date of Inspection � tUTM50
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: P jj %KW f 5iQ C 14L_
Spillway?: e.
5
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
El Yes [] No
Structure 5
❑ NA ❑ NE
El NA ❑NE
Structure 6
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes )(No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? XYes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA XNE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes XNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application ��
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes )ETNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes PlAIo ❑ NA ❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[-]PAN [--IPAN > 10% or ] 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) �,orTSQ �l a rat n
13. Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
5?,No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
;8�o
❑ 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
Wo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
A Yes
❑ No
❑ NA
❑ NE
0.2we>C&A v iorl V %-6und his 2 KO -St but •'iI-e45— ND Vlj9-j - }i
Mac,ex-Y, ere- Se_-F. ? 46ex-Ve, d u_ `% Afe-de r)
Reviewer/Inspector Name ,*, Phone:l
Reviewer/Inspector Signatuh4jjDate: 10Z loar
12128104 Condnued

Facility Number: , — DInspection — TS
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 "``�o ElNA ❑ NE
the appropirate box. ElWUP ElChecklists ElDesign ❑ Maps ElOther TTTT
21. Do s record keeping need improvement? If yej
theappropriate box below. ,�, /❑ Yes t�Io❑ NA ❑ NE
WasteAppli�licaa[tion ❑Wee/lyly Freeboaraste Analysis ❑ WIAnalysis E34ste Transfers Q�enueaiRainfall L_fYJtocking LPCrop Yieldinute Inspections ❑ Monthly and 1" Rain Inspections GNeather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes XNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? /I ❑ Yes ❑ No
24. Did the facility fail to calibrate waste application equipment as required by the permit? �C `06❑Yes �No
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes tk o
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
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?
Additional Comments and/or Drawings:
al aoOS soil +e-5+ resin t .
5/ ! B 0 0 S Po u I a 3• (� I tars - N
IWs N��atJ
OL to
❑ Yes No
ElYes !!l*o
❑ Yes No
❑ Yes I)�No
El NA El NE
D<NA ❑ NE
❑ NA ❑ NE
L�,NA El NE
❑ NA ❑ NE
[/NA ❑ NE
El NA ONE
❑ NA ❑ NE
El NA ❑NE
❑ NA ❑ NE
❑ Yes [(No ❑ NA
❑ Yes 'WNo ❑ NA
❑ NE
❑ NE
12128104

Facility Number 97 18 Date of Visit: 1 7/14/2004 Time: 1225
Q Not Operational Q Below Threshold
® Permitted ® Certified 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: .........................
FarmName: Robert.Haies..Earm.................................................................................... County: Wjlk5 ................................................ \ .SRQ........
Owner Name: liubCrj.M.............................. Hans .......................................................... Phone No:(33b1.9S.7.:6.3.(e7.........................................................
Mailing Address: 1.7.Q1.11llalAlg.l;Itlge..QIUA[c11.]i0afl.............................................. Akio ... NC................................................................ 2H621..............
Facility Contact: Iiabett.N, .11a75.........................................Title:................................................................ Phone No:(jJ.,33.6.QS.7..41fl6.................
Onsite Representative: llolnart..(1!jdwy.1.HaXes......................................................... Integrator:......................................................................................
Certified Operator: Rokelrt..lY1 .............................. Hayes ................................................ Operator Certification Number: 21AA.7..............................
Location of Farm:
Hwy. 21 N. of Elkin to Old 21. Left onto old 21 then left onto Mining Ridge Church Rd. farm is located at intersection of
Mining Ridge Ch. Rd. and Shoaly Branch Rd.
❑ Swine ❑ Poultry ® Cattle [I Horse Latitude 36 • 19 16 Longitude 80 • 55 40
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons
2
Design ' Current Design Current 'r
Poultry Capacity Population Cattle' Capacity Population
❑ Layer I IN Dairy 136 85
❑ Non -Layer I I[] Non -Dairy
❑ Other
Total DesignCapacity136
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?
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?'
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: ......Waste.P.ond..... .........wxt.Stack....... .................................... ................................... ................................... .......
❑ Yes ® No
❑ Yes []No
❑ Yes []No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Structure 6
Freeboard (inches): 30 48
12112103
Continued

Facility Number: 97-18 Date of Inspection 7/147004
5. Are there any immediate threats to the mtegrity of any of the structures observed? (ie/trees, severe erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ® No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? OR Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ® No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? If yes, check the appropriate box below. ® Yes []No
❑ Excessive Ponding ® PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type 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
® No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No
15. Does the receiving crop need improvement?
❑ Yes
®No
16. Is there a lack of adequate waste application equipment? ❑ Yes ® No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ® No
Air Quality representative immediately.
L.et . b. :...uu6:.... H\:- V-1-:..-e n., VBQ-I :.eo,n..c .-Al .. ....v..... rrM6ne-rnmmonfe=
{ ❑ Field Copy ® Final Notes
Need to cut the woody vegetation on the comer of the embankment.
Soild waste is stockpiled in field across the road. Operator plans to clear some wooded land and apply the solid waste to this area.
Need to add this field to the WUP.
1. Operator possibly (probably?) over -applied on the field borders of the following areas:
-1996 (17-1), T-10092 (17-1), T-1935 (F-1, 2, and 3), and T-357 (F-1 and 2)
:annot determine application rate until the waste analysis is completed. Operator irrigated cattle waste onto the "wettable acres" then
pplied liquid N to the entire field which was ok. He then applied poultry litter to the field borders.
3. Operator is awaiting the waste analysis to calculate a PAN balance. Check June 2004 applications next visit.
3. 2004 soil analysis results are ok.
3. When calculating PAN balance for waste applied to the buffer areas only, use actual buffer area acreage. See technical specialist.
Reviewer/Inspector Name
Reviewer/Inspector Signai
12112103
Date:

Facility Number: 97-18 1)�of Inspection 7/14/2004 •
Required
Records & Documents
21.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
22.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
®No
23.
Does record keeping need improvement? If yes, check the appropriate box below.
® Yes
❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
®No
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
®No
28.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
®No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form []Rainfall []Inspection After V Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

(Type of Visit OLCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Al Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit:
Permitted 0 Certified [3 Conditionally Certified 13 Registered
Farm Name:......e-�-i .._.e.__Q(� .m.......................
Owner Name: _\,_.
Mailing Address: I_/O._._.' 1.11.111.1q...._.. __..�`�!!._._._._
Time:
Date Last Operated or Above Threshold: .......
County:. �.�..� aa _............G. .........
Mr
Facility Contact: ..Title: ........ ......................... ... .... —.......... Phone No:
entative•
Onsite Repres....,�,:,-.0 _,T...__.l._'. �..._._.._.....{� Integrator: _._.......... ._ ......_..
Certified Operator ...........
...__._........__._....__.. ......... Operator Certification Number:._.-
Location of Farm:
u5 ho i-o 2--i7, ro tia us a a Lef on `
O Leff 6Z MininQ
❑ Swine ❑ Poultry Cattle ❑ Horse Latitude• " Longitude ®'
Destgn urrent °= De9gn Current i y ,Design <Currvnt
c.. _ -
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes YNa
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
V ��SG•turu,,e� i Struc e 2 Structure 3 Structure 4 Structure 5 Structure VX
Identifier: l...Q_.__..._ . ..
Freeboard (inches):
12112103 �� Continued
l��

Facility Number: - • Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ tree�evere erosion, `,
[]yes ®No
seepage, etc.) ,`,�//
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ®No
closure plan? '' ``
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ) �[
7. Do any of the structures need maintenance/improvement? IA Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenlancemprovement? 0 Yes )(No
9. Do any smctures lack adequate, gauged markers with required maximum and minimum liquid level []Yes j�No
elevation markings? '' ``
Waste Application
10. Are there any buffers that need maintenancelmtprovement? ❑ Yes No
11. Is there evidence of over application? If yes, check the appropriate box below. Yes ❑ No
❑ Excessive Ponding AN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop typeAD
13. Do the receiving crops differ with those designated in fe Certified Animal Waste Management Plan (CAWMP)? ❑ Yes No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes No
b) Does the facility need a wettable acre determination? ❑ Yes No
c) This facility is pended for a wettable acre determination? ❑ Yes No
15. Does the receiving crop need improvement? ❑ Yes o
16. Is there a lack of adequate waste application equipment? ❑ Yes No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below _E3-yer-Et3
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes-A.
es No
roads, building structure, and/or public property) �/
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes - No
Air Quality representative immediately.
-tc Q'U_* l.A-J"—
Reviewer/Inspector Name �]
Field Copy ❑ Final Notes
Reviewer/Inspector Signature:
71 /1 141]
Date:

Facility Number: - Nof Inspection c4
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 ❑ gI board ❑ Waste Analysis ❑IS 71 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
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes28.
jNo27.
Does facility require a follow-up visit by same agency?
❑ Yes
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
XNo
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?
❑ Yes
❑ No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
7
No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit
T— 1535- F-3
T

Assistance Site Visit
• DAWn of Soil and Water Conservation
O Natural Resources Conservation Service
O Soil and Water Conservation District
O Other...
Facility Number 97 - 18 Date: /1/04 Time: 9:30 Time On Farm: 90 WSRO
Farm Name Robert Hayes Farm County Wilkes
Mailing Address 1701 Mining Ridge Church Road Elkin NC
Onsite
Representative Mickey Hayes Integrator
Operation Review
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ No Animals -Date Last Operated:
❑ Operating below threshold
❑ Swine ❑ Poultry N Cattle ❑ Horse
Design Current
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Phone: [phone]
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
® Dairy
❑ Non -Dairy
136
88
❑ Other
28621
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes N no
2.
Is there evidence of a past waste discharge from any part of the operation that waste reached
❑ yes N no
surface waters or wetlands?
3.
Does any problem pose an immediate threat to the integrity of the waste structure (large trees,
❑ yes Ono
seepage, severe erosion, etc.)?
4.
Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding
❑ yes Ono
requiring DWQ notification?
5.
Is there evidence of improper dead animal disposal that poses a threat to the environment
❑ yes Ono
and/or public health?
6.
Is the waste level within the structural freeboard elevation range for any waste structure?
❑ yes Ono
Structural Structure 2 Structure 3 Structure 4 Structure 5
Identifier WSP j Wet -stack
Level (Inches) 36 48
CROP TYPES ICom, Silage Ismail grain silage
SPRAYFIELD
SOIL TYPES PcC2
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

,in
Facility Number 97 - 18 Date:
411/04
PARAMETER
QQ No assistance provided/requested
[18. 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
❑
❑
[112. Waste structure integrity compromised
28. Forms Need (list in comment section)
❑
❑
[113. Waste structure needs maintenance
29. Missing Components (list in comments)
❑
❑
[114. Over application >= 10% & 10 lbs.
❑
❑
[115. Over application < 10% or < 10 lbs.
30.21-1.0200 recertification
❑ 16, Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
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
❑ 21. Crop needs improvement
35. Sludge or Closure Plan
❑
❑
[122. Crop inconsistent with waste plan
36. Sludge removal/closure procedures
❑
❑
37. Waste Structure Evaluation
❑
❑
[123. Irrigation maintenance deficiency
❑ 24. Deficient sprayfield conditions
38. Structure Needs Improvement
❑
❑
39. Operation & Maintenance Improvements
❑
❑
40. Marker check/calibration
❑
❑
Reaulatory Referrals
41. site evaluation
❑
❑
❑ Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
❑
❑
El Other...
43. Irrigation system desigNinstallation
Date:
44. Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45.Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
46. Wettable Acre Determination
❑
❑
1 • Mr. Hayes has seeded grass in the denuded
47. Evaluate WAD certification/rechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
area of the cow lot adjacent to the creek.
2
49. Drainage work/evaluation
❑
❑
50. Land shaping, subsoiling, aeration, etc.
51. Runoff control, stonnwater 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. Cropfforage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

Facility Number 97 - 18 Date: 4/1/04
7 Ibs.N/1000 gals. I
Soil samples dated 2-25-04
Facility and records look good overall.
TECHNICAL SPECIALIST lRocky Durham
SIGNATURE
Date Entered: /2/04
Entered By: lRocky Durham
03/10/03

0 toti of Water Quality;
0 aion of Soil and Water` Conservation
0 Other Agency
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0• Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 97 18 Date of Visit: 04/22/2003 'rime: 1300
0 Not Operational 0 Below Threshold
0 Permitted ® Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ..............
Farm Name: RQherl.Hayes.farin.................................................................................... County: WiJUS ............................................... W.SRQ........
Owner Name: R.akert.M...........................:.. Hayes .......................................................... Phone No: (a 1.95Z-83fi2........................................................
Mailing Address: 1.7.Q.1.Miniug.Ridge..Cltarcll.Road.............................................. Ellin ...1NC................................................................ 2B621..............
Facility Contact: R.Qbeft.Hayes.................................................Title:................................................................ Phone No: ccll.3.36,9.5.14.18.6 ...............
Onsite Representative: M1rk9Y..Aad Nina.Hayes........................................................ Integrator:......................................................................................
Certified Operator:Robgjr.t..M............................. Hayes................................................ Operator Certification Number: Z1..40.7..............................
Location of Farm: _
wy. 21 N. of Elkin to Old 21. Left onto old 21 then left onto Mining Ridge Church Rd. farm is located at intersection of
ining Ridge Ch. Rd. and Shoaly Branch Rd.
❑ Swine [I Poultry M Cattle ❑ Horse Latitude 36 • 19 16 Longitude 80 • 55 40
Design Current
Swine Canacitv Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current
Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Other
Design Current
Cattle Ca acity Po ulation
IN Dairy 100 101
❑ Non -Dairy
Total Design Capacity 100
Total SSLW 140,000
I Number of Lagoons �0 ❑ Subsurface Drains Present JFEI Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps 2� ❑ No Liquid Waste Management System
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes M No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes M No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes M No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? M Spillway M Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...... Waste.pond..... .... W.atldry.stack................................................................................................................................................
Freeboard (inches): 15 48
05103101 �yDO 1h J Continued

Facility Number, 97—IS Date of Inspection 04/22/2003
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trJOevere erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
i
❑ Yes N No
❑ Yes N No
❑ Yes N No
N Yes []No
❑ Yes N No
Waste Application
,
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
ONO
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
ONO
b) Does the facility need a wettable acre determination?
❑ Yes
ONO
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
■�E4Q•'
N Yes ❑ No
❑ Yes N No
❑ Yes N No
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
3. Waste level is 3' above max. liquid level.
19. 2002 soil test results ok.
8. Need to move fence in the dry cow lot back at least 25' in low area near creek within 30 days.
19. Records look good. Waste sample has been sent to Raleigh and operator is waiting on results to complete PAN balance. Check next
visit.
22. Facility did not contact WSRO prior to inspection since operator says that waste level went above max. liquid mark yesterday and he
knew I was visiting today.
Reviewer/Inspector Name Melim Rosebrock
Reviewer/Inspector5ignature Date: q2 3
05103101 f Continued

Facility Number: 97—IS UatI Inspection 04/22/2003 •
1 •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes []No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes N No
28. 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)
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
Facility has revised CAWMP for 136 cattle.
Must contact DWQ before deviating from CAWMP. Suggest contacting SWCD for assistance in calculating acreage and flow
for "emergency" irrigation of waste.
J
O5103101

/ PM
Type of Visit (W Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit:
Permitted Certified [3 Conditionally Certified E3 Registered
Farm Name: 12 � eve ]- ,e 2t r—M
Owner Name: P20%i- I' I , 4&4.4 ie,5II
Mailing Address: 1 -7,49 ! m In I r) o i2IQ a P aide
Facility Contact:
Onsite Representative:
Certified Operator: (20K)e +
Location of Farm:
Time: 00
Date Last Operated
1or,Above Threshold: _
County ✓ v ; / Les
Phone No: 33 4P. 9S 7, 5S.3& 7
P2oaj , e1 j6 h )OC- .286Z/
Phone No: e0 U 95-7- g196
Integrator: /�
Operator Certification Number: 2 I4 v
-77 -tit, 14wy zi N, Le j �or)4o o 1d I+wy 21..Le44 o i n i nj 1 e
❑ Swine ❑ Poultry O Cattle ❑ Horse Latitude ®' [TTI ®- Longitude ®* ®, M-
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)
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
Strruuctur I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: � �i-��-���G�
Freeboard (inches): 15
05103101
'IL
❑ Yes ❑ No
❑ Yes ❑,/No
❑ Yes pQ No
❑Yes No
14Yes NNo
Structure 6
Continued

•
•
Facility
Number: qj— Date of Inspection 2 Z�
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
❑ Yes
No
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
Yes
No
9.
Do any sructures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
No
Waste Aoolication
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
l 1.
Is there evidence of over application? ❑ Excessive Pondjyg PAN ❑ Hydraulic Overload
El Yes
yANo
IXI No
7�
12.
Crop type
13.
Do the receiving crops differ with tose designated in th iArtified 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
Z No
c) This facility is pended for a wettable acre determination?
❑ Yes
0 No
15.
Does the receiving crop need improvement?
❑ Yes
o
16.
Is there a lack of adequate waste application equipment?
❑ Yes
No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
�..,/
I]0 No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
T`
(ie/ WUP, checklists; design, maps, etc.) ✓ / /
❑ Yes
No
19.
��
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design? _
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
/❑ Yes
XNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
XNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
A Yes
❑ No
0 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit
_� _ _`.. _. _ ._,
'6ommeats (refer to question#): < xplain anp,YES ansWirs and/onany reeommendstions or anv other_fco_mments.
`Use drawings of facility: to better explain sitaatioos. (ose,addrnonal pages as necessary) f�j( Field Conv El Final Notes -
-'S"t'.
tio ot
"
-
_
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 7-
05103101 Continued

Facility Number: — g *of Inspection 22 •
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? �,�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? ElYes ANo
32. Do the flush tanks lack a submerged fill pipe or a petmanent/temporary cover? o % Q No
-Aaamonat Comments and/or Drawings: -
i 9. ZCO 2-
/ ►,. ,;
ARn
05103101

Facility Number 97 18 Date of Visit: 6l25/2002 'rime: 1205
Not Operational 0 Below Threshold
■ Permitted ® Certified 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: .........................
Farm Name: &beet. ayes.P,arni.................................................................................... County:w2kcs ............................................... WS.BQ........
Owner Name: R.Rbett.111 .............................. Hans .......................................................... Phone No: Q361.9,57.-A-36t7............................ _...........................
Mailing Address: 1.7.Qi.klittitlg.Ridge..Cklu�cRt.ItAat1.............. . ... ....
........................ RRiiat..N.0 .............................................................. _ UNI..............
Facility Contact: R.Rbe[t.HaXes................................................. Title: ............................. _................................. Phone No: cell.3.36.9 . 186... ....
_._...
Onsite Representative: R0bCjrl.Hay.qA............................................................................. Integrator: ..................... _.
...................... ........... . ...........................
Certified Operator:R01te1l:t.AL............................ Haye,5.............. :................................. Operator Certification Number: 2149..7........ ...................
Location of Farm:
Hwy. 21 N. of Elkin to Old 21 at SR follow old 21 to Mining Ridge church Rd. farm is located at intersection of Mining Ridge
Ch. Rd. and Shoaly Branch Rd.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • F 19 16 {{ Longitude 80 • 55 40 .<
Design Curren)1110
Design Current Design Current
Swine Ca acit P,o ulatiPoultry Ca aei $o uhttion Gattle Ca acit P,o ulation
❑ Wean to Feeder ❑ Layer ® Dairy 100 85
❑ Feeder to Finish Non -Layer I L—❑Non-Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other CIE
❑ Farrow to Finish to Design Capacity 100
❑ Gilts
❑ Boars Total SSLW 140,000
Number of Lagoons �0 Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds /Solid Traps 0 ❑ No Liquid Waste Management System
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
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:...._.Waste.P.and..... .... W.eddry.stack....................................................................................................................
Freeboard (inches): 78 42
05103101
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
[]Yes ® No
Structure 6
Continued

Facility Number: 97—[8 0 Date of Inspection 6/25/2002
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ treere 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 maintenancetimprovement?
❑ Yes
N No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
® No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
® No
11.
Is there evidence of over application? []Excessive Ponding []PAN []Hydraulic Overload
❑ Yes
® No
12.
Crop type Corn (Silage & Grain) Small Grain (Wheat, Barley,
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
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
Field Copy N Final Notes
7. The removal of trees from the embankment looks great.
17. Operator was sent a COC cover letter with "swine" in the header. Needs to be changed in Raleigh.
19. Waste and soil samples were taken in June 2002 and results are not back, yet. Need to check next inspection.
19. Tract 287 Irrigation (I) and Broadcast (B) fields (FI and 172) are kept on seperate record forms. Reviewer needs to add these two
Fortes (I and B) together to determine that total PAN has not gone over 263 lbs. N for each of the two fields.
19. Facility's new CAWMP is for 136 dairy cattle.
Reviewer/Inspector Name !M
Reviewer/Inspector Signature:
Date:
05103101 Continued

Facility Number: 97-18 D&f Inspection 6/25/2002 •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes IN 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 permanenthemporary cover?
❑ Yes
❑ No
do-ommentsau or r6wmgs: .^=4':
Facility has two forms of waste containment: waste storage pond and a dry stack. Both had more than adequate storage.
left blank are not applicable to this facility at this time.
05103101

Id PM
Type of Visit TC/ompliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit ) Routine O Complaint O Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit:
Permitted liCertified Q Conditionally Certified 0 Registered
Farm Name: L _ �II I (A l I
(w Owner Name: Jb pef+ I"A,� l
Mailing Address: b e-
Facility, Contact: ��� Title:
Onsite Representative:
Certified Operator: Plo Lerl1
es
Location of Farm:
Time:
Date Last Operated or Above Threshold:
County: �/V
JAI I I L_ C/e's
Phone No: ✓34' "! • v o,36
FI ICin INC. 86a a
p1
Phone No: 336 • f 5 7.4 M 1/
Integrator:
Operator Certification Number:
u v Latitude �-�` �" Longitude ®' ®{ ®"
❑ Swine ❑ Poultry Cattle ❑Horse g
Design Current
awmc
IL -I Farrow to Feeder I I
Number of Lagoons
'Holding;Ponds / Solid Tra
Design Current Design Current
Poultry Capacity Po ulation Cattle Ca ac•ty Population
❑ Layer Dairy
❑ Non -Layer 1 10 Non -Dairy
❑ Other
Total Design Capacity JQ d
Total SSLW
Discharges & Stream Impacts
L 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
,� 'Str'u'cm�r�_StructureStructure 3 Structure 4 Structure 5
Identifier: A fq� ex—_
Freeboard (inches): 47,
05103101
❑ Yes 9 No
❑ Yes ❑ No
❑ Yes ❑ No
. ❑ Yes ❑ No
VN
❑ Yes o
tt;5
❑ Yes No
Structure 6
Y�
Continued

i a PM
Type of Visit IP Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit %D. Routine O Complaint Q Follow up 0 Emergency Notification 0 Other ❑ Denied Access
17 Facility umber Date of Visit:
�N[
Permitted lQ Certified E3 Conditionally Certified 0 Registered
Farm Name: P=
Owner Name: 141
Mailing Address:
Facility Contact: J
Onsite Representative:
Title:
Time:
Date Last Operated or Above Threshold:
County: `✓J JAI I I K7 e S
Phone No: `-r 6' "1 S p 7' o 36 7
Phone No: 336 q S 7 • D c e' /
Integrator:
Certified Operator: I w +_-t t rl SLI Operator Certification Number:
Location of Farm:
�'­J " .rt7 I—M ®* ®1 ®u
El Swine ❑ Poultry Cattle El Horse Lafitude ` u Longitude
"Swine
Design
Capacity
Current
Population
Design Current Design Current`
Poultry Capacity Povulation Cattle Ca ac' Population
ID Layer I I Dairy 17 1 s
i JLJ Non -Layer Non -Dairy
❑Other
Total Design Capacity Q
Total SSLW �0
❑ Wean to Feeder
4
❑ Feeder to Finish
❑ Farrow to Wean
`
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
I _off_ 1 ILI Subsurface Drains Present
Traps
Discharges & Stream Impacts
L 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
Structur tructurre, Structure 3 / - Structure 4 Structure 5
Identifier: h 1
Freeboard (inches): '
05103101
❑ Yes 9 No
❑ Yes ❑ No
❑ Yes ❑ No
. []Yes ❑ No
;rt,
❑ Yes No
❑ Yes L1a No
}"
/�
'KNo_+
❑Yes
tty
Structure 671
Continued

•
Facility Number: — Date of Inspection
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
*o
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
�.(
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
❑ Yes
L7YNo
T'
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
Z.No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
*0
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
,�,,/
elevation markings?
El Yes
LH No
7�
Waste
Auulication
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
N0
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
No
12.
Crop type
13.
Do the receiving crops differ with those designated in Ac Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
No
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
No
15.
Does the receiving crop need improvement?
❑ Yes
No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
KNO
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
���XNo
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(ie/ discharge, freeboard problems, over application)
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
o
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
V No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
,}ti a n fi. a,, ,:- Wi
Comments (►efer to gtiestioau Ezplam any, YE3 ans�were and/or any recommeu bons or.an "),` Cher comments.
Use drawings of facility �to better explain situations (us'e ad'ditlonel pages as necessary): Field Copy ❑Final Notes r
UA
�-a `k 641
/0AzP\J A& 3.
U �,,.
Reviewer/Inspector Name Q ITO
Reviewer/Inspector Signature: Date:
4
O51031O1 Continued
i

0
Facility Number: —
Date of Inspection ITT
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 drill 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?
C � r
i,r-vim c o
iq. auj l Go o
05103101

C� on of Water Quality
hllsion of Soil and Water Conservation m�
O Other Agency
Type of Visit O Compliance Inspection OO Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 97 - 18 Date of Visit: 11/8/2001 Time: 13:15 -
0 Not Operational O Below Threshold
13 Permitted ® Certified E3 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: .........................
FarmName: R.oberi.flayes.F,aruk................................................................................... County: !'.F'jW s................................................ WSRQ........
OwnerName: R.ahem.M.............................. Hayes .......................................................... Phone No:(3.3.61.957..8.3b7.........................................................
Mailing Address: f.7.fl.1.MIni.Og.fiisfge..t«fuut:shAtlad.............................................. F.Ifcio...NC................................................................ 2Hft7f....... .......
FacilityContact: ..............................................................................Title:................................................................ Phone No:...................................................
Onsite Representative: Mirkey.HayEs............................................................................. Integrator:......................................................................................
Certified Operator:Rohcrt.M.............................. Hayes ................................................ Operator Certification Number:ZI.4Q.7 .............................
Location of Farm:
3wy. 21 N. of Elkin to Old 21 at SR follow old 21 to Mining Ridge church Rd. farm is located at intersection of Mining Ridge
M. Rd. and Shoaly Branch Rd. �
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • 19 16 Longitude 80 • 55 { 40
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons
Holding Ponds / Solid Traps
Design Current Design Current
Poultry Capacity Population Cattle Ca aci Popmlation
❑ Layer ® Dairy 100 90
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 100
Waste
Total SSLW
Lagoon Area J❑ 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: ...................................................................................................................................................................................................................
Freeboard (inches): 36
05103101 Continued

Facility Number: 97-18 Date of Inspection 11/8/2001
.. ioldmd uolla'• anr;emjglY /,tllunlaodd d IrvO
5. Are [here any immediatd?tbl4aff9j1118 a ts0*0tgl4Ms »�prtgd?g(ggj [n3, sevW wmjoWE auogd []Yes ®No
LOTLZ egtiojeO g11o,sjmap g-uolsulM `laarlS e1AXgg
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes N No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? N Yes []No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
N No
9.
Do any smctures lack adequate, gauged markets with required maximum and minimum liquid level
elevation markings?
❑ Yes
N No
- Waste-Aoolieatien - ----- -- - - - --- --- ----
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 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
❑ 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 (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): 0 Field Copy N Final Notes
rrigation acres should be figured on effective acres.
Waste plan should be updated to reflect effective acres and field numbers should match the maps.
7. Recommend cutting the cottonwood trees off the embankment before they become a problem
r. Hayes was having trouble irrigating waste today due to the amount of weeds and solids in the waste pond. Also, the irrigation
main line seemed to be clogged somewhere. Gra-Mac irrigation was on site today to help Mr. Hayes resolve his 1046bo 0;8;S. puv
The dead too close to the surface waters. The A'pg4an9pti�lglgge.ig
nd Mr. Hai and pipe to complete the work. tiela roa$ `sso-a mElillhl
Durham
O5103101 Continued

Facility Number: 97-18 Da Inspection 11/8/2001
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
Additional Comments and/orDrawings:
Waste analysis: 4-19-01 ALD 4.5 lbs.N/1000 gals. I, SSD 2.4 lbs.N/ton B
12-01-01 SSD 3.3 lbs.N/ton B
Soil analysis dated 5-4-01: Sample RPl is very high in copper.
05103101

RRency
f Water Quality
f Soil and Water Conservation
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
IReason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 97 ]g Date of visit: tV26/2001 Time: 1215 Printed an: 6/29/2001
10 Not Operational Below Threshold
0 Permitted 0 Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: Baker:1.H4yts.FArU................................................................................... County:Wj%cs ............................................... WSRQ........
Owner Name: 11(thcrI.M.............................. Haim.......................................................... Phone No:(3,M1.9S.7A..M.7.........................................................
Mailing Address: I.7.QI.MIAIIxIg.IiitlP�..GhtA[tI1.RAad.............................................. Elkk..N.0 ................................................................ M .621..............
Facility Contact: R.Rbc[I.HaJ:es................................................. Title:................................................................ Phone No: 33.6.9.51AIM.CeR .............
OnsiteRepresentative: Robe t.11U.4 S.............................................................................. Integrator:......................................................................................
Certified Operator:RQ]XJl:t.................................... Hayes................................................ Operator Certification Number: ZI4Q7 .............................
Location of Farm:
Hwy. 21 N. of Elkin to Old 21 at SR follow old 21 to Mining Ridge church Rd. farm is located at intersection of Mining Ridge
Ch. Rd. and Shealy Branch Rd.
[I Swine ❑ Poultry ® Cattle ❑ Horse Latitude ®• 19 16 Longitude g0 • 55 40 {{
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current
Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Other
Design Current
Cattle Ca acit Population
® Dairy 1001 91
❑ Non -Dairy
Total Design Capacity 100
Total SSLW 140,000
Number of Lagoons 1 0 JLl Subsurface Drains Present jj❑ Lagoon Area I❑ Spray Field Area
Holding Ponds / Solid Traps 0 ❑ No Liquid Waste Management System
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ® Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ® Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ® Yes ❑ No
WasteCollection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway ❑ Yes ® No
Structure'l ' Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ......Waste.P.ond........ Wet/.dry..S.tack... .................................... ......................... ......... ..............................:.......................................
Freeboard (inches): 48
05103101 `%9 s�� Continued

Facility Number. 97-IS Date of Inspection 6/26/2001 • Printed on: 6/29/2001
5. Are there any immediate threats to the 1 grity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes IN No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ® Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ® Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste ADDlication
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 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 IN No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ® No
❑ Yes ®No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Q No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
6omments refe to question lain an aas e a or any rumen boas or any o er cowmen
se wings o facili to better a lain as use additio a as ❑ Field Copy ® Final Notes
l., 2., 3., and 8. Silage leachate is discharging from end of culvert uphill from creek. Waste was not reaching waters of state at time of
inspection. EQUIP money has been approved for drop box to convey waste to waste storage pond.
3. Need to establish vegetation in diversion at end of silos (surface water drainage area). Need to also establish vegetation on hillside b
reek. See SWCD about suggestions regarding sediment run-off across the road.
7. Need to mow vegetation on dam of waste storage pond.
7. Dead cattle are buried less than 300' to creek. Need to cease using "dead hole" and find another area that is at least 300' from creek.
Reviewer/InspectorName �Me'_-Rospbrock---�_---__----�---_------
ovReviewer/Inspector Signatu Date: Q
05103101 1 v
Continued

Facility Number: 97-18 D0f Inspection 6/26/2001 . Printed on: 6/29/2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, 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
r may want to keep more than 100 confined cattle on lot (for milking and feeding). Need to see SWCD about increasing
number.
05103101

12: 00
of Visit 1
1 Compliance Inspection O Operation Review O Lagoon Evaluation
on for Vlsit $ Routine O Complaint. O Follow up O Emergency Notification O Other
=!
Facility Number Date of Visit: Time:�&�- I
�[ Q Not Operational Q Below Threshold
13 Permitted ® Certified
, /0 CoLnlditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: /....... fk1. W. ....I�n� .�5...._ffi............................. County:...... .�.�...4`.......................
iz;
Owner Name :................ +....... M..:..... . Phone No: . ....
Facility Contact:.. .......... Q ............Title :........................... .. .......................... Phone No:.3.�
Mailing Address: ....... I.._f.�..L...._.........1!.:.j..�..1..11.Q.........F....�_�`��......._�'t �U1�i1...........4`.:�-L:..tl...�i.�_!�,.n�'�G.��)
Onsite Representative:-,....�.�.... +............. Integrator: ............................. _................................. ................. ...
Certified Operator:....... Y'- _ _ ........................ Operator Certification Number:... 2_ +0
Location of Farm:
[]Swine ❑ Poultry Cattle []Horse Latitude ®' ®' Longitude ®' F
Design Curren
Swme Capacity PODUIatit
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design . Current
Poultry Cape .
a e.MY Po ulationCattle
❑ Layer Dairy
- ❑ Non -Layer Non -Dairy
❑ Other
Total Design Capacity
Total SkW
Number of -Lagoons Subsurface Drains Present jj❑ Lagoon Area 10 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?
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 gaUmin?
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
j Structured Suuytpre 2 Struct c 3 � Structure 4 Structure 5
Identificr:V of ...JIt.m.8 ... erld..... .... �.. ..54 1{r.............. ..............................
L Freeboard (inches): { p
5100
XYes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Yes ❑ No
Yes []-No
[]Yes )(No
Structure 6
Continued on back

Facility rqumber: — Date of Inspection
5. Are there any immediate threats to the in eegrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/mprovement?
9. Do any stuctures lack adequate, gauged markets with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Funding A-' PAN ❑
12. Crop type
13. Do the receiving crops differ with —those designated in the Certified Animal
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?
Overload
Plan (CAWMP)?
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?
fit; iVq•yiola«i¢tjs:oFdeficiencies -w$re noted• djtritig t�tjs;vjlsit; • Y;op wil►•Seceiye 0 fut•th....
.
cori•espo deuce: shb6i thisvisit:::::::::::::::::::::::::::::::: :
1 Y 1 1 .11 111 1 A 1 1 I
I
� I
IF
1 fI / I .. •
❑ Yes >(No
❑ Yes '�(No
Yes ❑ No
es ❑ No
❑ Yes *o
❑ Yes 9,
XI No �� ❑ Yes / No
❑ Yes o
❑ Yes o
❑ Yes VNo
[]Yes f
[IYeso
❑ Yes �No
❑ Yes XNo
❑ Yes ❑ No
❑ Yes [%Vo
❑ Yes [l(o
❑ Yes ✓�� o
❑ Yes No
❑ Yes o
❑ Yes )5,No

Facility Number: — of Inspection •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes
liquid level of lagoon or storage pond with no agitation? �7)o
27. Are there any dead animals not disposed of properly within 24 hours? "*s ❑ No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes �C.iNo
roads, building structure, and/or public property) J�
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes *0
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
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 permanenthemporary, cover? -fifes-8
Additionalomments and/orDrawings: w- --
Wcs, on dovk? Vejeh4lonon Pos+tjm 61ow bo-r-n�r�
1001.5+e Okr)a N 51 5 0/1»
DQ+e lam+ opera_+e-d > 100 Bows 7
3. Lt�Q-1 ✓tuir�- �Sc fed
. OJ
d't &P 0/6
JAL'P/
7� L05R
e

,.
rvrsron of Water Quality
vision of S �ioil and Water Conservation
Q Other Agency
Type of Visit O 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 97 18 Dalr of Visit: lY5/2000 Time: 10:30
Q Not Operational Q Below Threshold
0 Permitted N Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: RQb.cr1.11axe5.l acutt.................................................................................... County:\'.l'Akes................................................ WS.RQ ........
OwnerName: Ii.Rk rt.N.............................. Hayes........................................................... Phone No: 03.61.9SM_36.7.........................................................
Facility Contact:
Title:
Phone No:
Mailing Address: I.7.Q1.fix[1tlg.RidSf..Gtlµ[ttl.lLu�ft.............................................. ElJkjA..N.0 ................................................................ M21 ..............
Onsite Representative:
Certified Operator:ltobcjr.t....................................
Location of Farm:
Integrator:
Operator Certification Number: j1407 ..............................
Hwy. 21 N. of Elkin to Old 21 at SR follow old 21 to Mining Ridge church Rd. farm is located at intersection of Mining Ridge
Ch. Rd. and Shealy Branch Rd.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude ®• 19 16 Longitude F 80 OF 55 ®«
Design Current
Swine Vmarity Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons
Holding Ponds / Solid Traps
Design Current Design Current
Poultry Capacity Po ulation Cattle Capacity Population
❑ Layer I I IN Dairy 100 81
❑ Non -Layer I 1 10 Non -Dairy
❑ Other
Total Design Capacity 100
Total SSLW
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or 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: .............. wsp .............. .................................... ................................... .................................... .............................
Freeboard (inches): 78
5/00
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Structure 6
Continued on back

Facility Number: 97-18 Date of Inspection 1 12/5/2000
5. Are there any immediate threats to the iw-ty of any of the structures observed? (ie/ treevere 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 Application
10. Are there any buffers that need maintenance/improvement?
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
❑ Yes ® 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 ® 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?
No'yio'latiolis:or deficieneies'ivere:noted :during this: Visit::You'vvill receive no fdrth;er
coriesvondence. about this.visit..:....... .
cotton wood family trees growing on dam need to be cut before they become a problem.
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
0
Reviewer/Inspector Name Daphne Canner 7
Reviewer/Inspector Signature: Date: 5100

Facility Number: 97-18 of Inspection 12/5/2000 •
or 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
5100

Facility Number 97 1S Date of Visit: 8/4/Z000 Tina: 1100 Printed on: 0/7/2000
0 Not Operational 0 Below Threshold
E3 Permitted ® Certified E3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: KQbt tt.Haya.fRtra................................................................................... County: WAC5 ............................................... W.S.RO........
OwnerName: R.Qbfi1C1.M................`............ HAy CS........................................................... Phone No: 03.61.9S.7:8367.........................................................
Facility Contact:KQbf:tA.LM1dkCy).HU.M............................Title:................................................................ Phone No: Sko.p..33.&95.74116 ...........
Mailing Address: 1.7.Q1.MIIAitlg.liAtlg4.. lnx[t6. u1d..............................................
Onsite Representative: MI.Ck.4J:.HAySS............................................................................. Integrator:
2"ZI..............
Certified Operator: Rob9i tM . ............................ Ray-ca ................................................ Operator Certification Number: 2140..7.............................
Location of Farm: _
Hwy. 21 N. of Elkin to Old 21 at SR follow old 21 to Mining Ridge church Rd. farm is located at intersection of Mining Ridge
Ch. Rd. and Shoaly Branch Rd.
[3 Swine ❑ Poultry N Cattle ❑ Horse Latitude ®• 19 . 16 Longitude ®• 55 40
Desigu
Current
Desigu Current
Desigu Current
Swine Ca acit
P,o lotion
Poultry Ca aci P,o ulation Cattle
Ca aci P,o ulatfon
❑ Wean to Feeder
❑ Layer
®Dairy
100
52
❑ Feeder to Finish
❑ Non -Layer
- ❑Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
ILi Other
❑ Farrow to Finish
ID Capacity
100
❑ Gilts
❑ Boars
Total SSLW
140,000
er of Lagoons
�0 ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
j0H-o1Rn_M-!q1g Ponds / Solid Traps �1 ❑ No Liquid Waste Management System
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
❑ Yes N No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes N No
❑ Yes N No
4. Is storage capacity (freeboard plus storm storage) less than adequate? N Spillway ❑ Yes N No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......Waste.pand.........................................................................................................................................................................................
Freeboard (inches):78 . t
5100Continued on back

Facility Number: 97-18 1 . Date of Inspection 8/4/2000 Printed on: 8/7/2000 `
5. Are there any immediate threats to thewgrity of any of the structures observed? (ie/ trwevere erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffets that need maintenance/improvement?
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type 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?
NQ yiolatigns_ot ilefciencie$ were:noted:duriit9 this: visit::You:wilt iecei've ittj further
.rep 'cors ondence about this visit.'.' . .
Comments •refer to gnestion # : •xphun any answers and/or any recommendations or any other comma
Use drawings of fadlity to better explain sitnatioas nSe additional PCS 8S necessarn
7. Need to mow vegetation around inside of dam.
S. Need to establish vegetation on pasture below barn
19. No waste analysis for March/May applications.
❑ 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 !Melissa RWbrock .

Facility Number: 97-18 D&f Inspection 8/4/2000 • Printed on: 8/7/2000
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
5100

n
-' 0 Dmsron of�and Water.Conservation Compliance In3tion a-
llrviston ofWater-Quality - Comphance Inspection s .
r - Other Agency,-, Uperation Renew x�...
outine Q Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Facility Number Dale of Inspection
Time of Inspection 24 hr. (hh:mm)
13 Permitted 0Certified 113 Conditionally Certified Cl Registered Not O erationah Date Last Operated: ..........................
Farm Name: ..... ab?.K.T1........��.6u1`........C.a..rm................................ County: .LIIJ..�...�..QK�+�....g............................................
Owner Name: .... 1.."(_F'L�.._r.'T........(A..:...1..1_ }........................................... Phone No: .. .:...L.S7l...X.. 47..........................
Facility Contact: {ilk ... ...... 1".1..`....... .. I�a�?..Title:................................................................ Phone No: �.......Q......�._..
/� M 3� S 18
Mailing Address: ..... �7.N.1....... 11:1.1f.11.. 1 .. ..c.hurc.G�. •I. ..I...1L...q. �/L. a�sla a.�.........
Onsite Representative:.17.AJ. .l.....r.. ... ICAR,$.-T..1..... ..Q. integrator: .......................................................
Certified Operator:,,120642.j . ...... .M......... N. afz.......................................... Operator Certification Number: ...... ��� �........
Location of Farm: 1
Latitude Longitude EY19 E21' T"
Design _<CuErenY= Design Current Des�go Current _
;.;$wine Caoaeity-'Pootilation Poultry Cauicity' Pouulation t—Tattle' .Capacity ' PoPulatiou '-
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
❑ Gilts
❑ Boars
❑ Other
Total
Number of Lagoons ® -- ❑ Subsurface Drains Present ❑Lagoon Area ❑Spray Feld Area 1
Holding Ponds /,Sold Traps -� ' ❑ No Liquid Waste Management System.. - =
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? I Spillway
Structure t Structure 2 Structure 3 Structure 4 Structure 5
Identifier: Wo` "6Q'Pord
Freeboard(inches): ................1................................................................................................................................................................
❑ Yes XNo
[]Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [ No
❑ Yes XNo
❑ Yes No
Structure
IC.�
J
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes KNo
Continued on back

Facility Number: — IT of Inspection
6.
Are there structures on -site which are no properly addressed and/or managed through a waste management or
closure plan?
❑Yes
�J 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
❑ No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
IV No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
KNo
11.
Is there evidence of over application? ❑ Excessive Pending ❑ PAN
❑ Yes
No
12.
Crop type epr
13.
Do the receiving crops differ with ose designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
0
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
N0
b) Does the facility need a wettable acre determination?
❑ Yes
JFNo
c) This facility is pended for a wettable acre determination?
❑ Yes
5I0
15.
Does the receiving crop need improvement?
❑ Yes
No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
7�#o
Required Records & Documents
IT
Fail to have Certificate of Coverage & General Permit readily available? tJ%A
E}Lfes—RNo
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
WNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, wAUa aaajypis & soil sample reports)
Yes
❑ No
20,
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
O
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
rNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
1*0
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes./
0
24.
Does facility require a follow-up visit by same agency?
[I Yes
111E/No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
T�yN0
... . . . . .. . .. . . . .. .. . . .. . . .. . . ...............................
; Tq•vioptio is;o deficiencies were ppte¢• during tbis:v.➢sit' - You wail i eceiye �iti fwj thgr • ; • ;
.
- 6irespm dence: abotiti this visit: :::::::::::::::::::::::::::::::::: :
19. No tA3a5fea.noz-14sis For Ma- cje ,/MQJ °`Ppli cd*;on5
-
1 • Need to Moo vqEMorn dLrand Jam
`� N:Qed o e 61 s h vc3e- tat oh ® n pa.5+u re,
IReviewer/Inspector Name �('j�jr `�`R r,• I
Reviewer/Inspector Signature: /?n l J/AAA_ /M11 JAA7 / Date: Q QQ

Facility Number: — of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below -B-Yrs—$pia
liquid level of lagoon or storage pond with no agitation? OM I-T 01WO
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 )VNo
31. Do the animals feed storage bins fail to have appropriate cover? / OM IT— a000 wive
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? J( a='°�—Mg.
_
_tton.a.omm..e_nts an_ or __- - — �- -9 z..` z-
No+es
a
56►� Sou�p►es �� 1499 a000?
%urbini
�ree54-&A bo4-n bu i 14
Mi 1 � reco��5
kri
.,

jQ
10 Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Facility Number 97 18 Date of Inspection 6/16/99
Time of Inspection 11:45 24 hr. (hh:mm)
Q Permitted I] Certified 0 Conditionally Certified a Registered Not O erational Date Last Operated: ..........................
Farm Name: &b.crWa3.95 Fartn.................................................................................... County: wakes ............................................... llSRQ........
OwnerName: RQbect.................................... HAYCS .......................................................... Phone No: 9].9-9S.7-B36.7............................................................
Facility Contact:
Title:
Phone No:
Mailing Address: [e-mail]..ClxmECIA.Rd.................................................. EIWAAC ................................................................ 2%21..............
Onsite Representative: M1.C.k.Cy...UAym ............................................................................ Integrator:
Certified Operator:1109jr.1.11'1............................. F.lays................................................ Operator Certification Number: 21'10.7..............................
Location of Farm:
Latitude ®• 191, E-19-1, Longitude 80 • 55 42 "
Design Current
Design Current
Design Curreut
e Ca aci P,o ula -on
Poultry Ca acit P,o ulation Cattle
Ca acit P.oPulation
ean to Feeder
❑ Layer
® Dairy
76
67
eder to Finish
❑ Non -Layer
❑ Non -Dairy
r[O3Farrow
to Weanrrow
to Feeder
❑ Othernow
to Finishpacityilts
oars
Total SSLW
106,400
Number of Lagoons
❑Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps 0 ❑ No Liquid Waste Management System
Discharges $F Stream Impacts
1. Is any discharge observed from any pan of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection &. Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): ........... _jZQ .............. .................................... ................................... ................
. .................. ........................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
3/23/99 Continued on back
Printed on 8/2/2000

Facility Number: 97-18 of Inspection
6. Are there structures on -site which are n roperly addressed and/or managed through a Ve management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Pending ❑ PAN
12. Crop type Corn (Silage & Grain) Fescue (Hay) Fescue (Graze) Barley
6/16/99
❑ Yes
® No
® Yes
❑ No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
No-violatitms:oi• deftcieneie$ were:noted durii ii-this: visit -'You:will deceive ittrfurthet : :
corresipoudeh& 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
peration is not certified yet. Owner said he would probably not meet his special agreement deadline. Has been talking with DWQ.
eed to take soil samples for `99.
7 Still has curbing to do to get certified. In the process of building a free stall barn.
ecords on application of waste looked good.
Reviewer/Inspector Name (Rocky Durham v
Reviewer/Inspector Signature: Date:
on

Facility Number: 97-18 re of Inspection 6/16/99
16
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
® No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
®No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
®No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
®No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
®No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
®No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
® No
Printed on 8/ M()()

1
L
❑ Yes i o
❑ Yes [-No
❑ Yes [GAO
❑ Yes ER<
❑ Yes ❑-iQo
❑ Yes �] oo
Structure 6
❑ Yes Lytvo
16 Routine p Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number f Date of Inspection 5-l3-------
1 2 377- / [Time of Inspection 10 : ! 24 hr. (hh:mm,
E3 Permitted E3 CCertified 13 Conditrionally Certified 13 Registered 0 Not O erational Date Last Operated:
Farm Name:..._Kv..Q.FR]. ..........
tl40..Y..F.s.......... a.A.m......................... county: .......... 5............................. ._!YAR0.
Owner Name: ........ R.o..�B,.F.f.R..l...........
,.1(..i}.tLEs............................................................ Phone No: ..... 3.36.-..�5. g.3..�a...7.......................
Facility Contact:......./Y.).uli:.......l..ia4._Y.La..S..pp...................T//i��tle:.......... :.Fi...._�fl..kx::LC!l .Y.l�..... Phone No:.......$. . !?.L�..........................
Mailing Address:..... I.ZQJ.........I.N.Iu.I'r:.....
I...1.D.G>ti....A.r.N.11R .....Rp:. ................ t!1.!.N................... ..................... ......... .. _ %2.�...
OnsiteRepresentative: ....rr...�..................................................................................................... Integrator: ......................................................................................
Certified Operator: ,..,,,,,,,,t`ao,E T......... }.xE..$.............................................. Operator Certification Number: ..... ,�,y ................
Location of Farm:
.. )A/- :.. b.L.o..... .j... .... ..d..",...............
....C.....t=....,I.............................................. .................................................................................................................................................
Latitude =• 0, ©•, Longitude �• FEET
Design
'wine. Capacity
Current "
Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
INumber of_Lagoons
. -Current
❑ Other ...
Total Design Capacity.
Total ssiw
lu nuosurlace Uralns rresent lu Lagoon Area jU spray r jem Area 1
❑ No Liquid Waste Management System
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
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: LgC0oA)
Freeboard(inches): ........i2_0............... .......................................................................................................... ................................... ......
S. Are there any immediate threats to the integrity of any of the structures observed? fie/ trees, severe erosion,
seepage, etc.)
3/23/99 Continued on back R

Facility Number: — • •te of Inspection
j6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑Excessive Pending [I PAN
12. Crop type (11D
❑ Yes (Dwo
❑ Yes LINo
❑ Yes [P,Pdo
❑ Yes 92-Ko
❑ Yes H(Koo
0 ❑ Yes -tvo
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
[914o
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
UKo
b) Does the facility need a wettable acre determination?
❑ Yes
M-Ko
c) This facility is pended for a wettable acre determination?
❑ Yes
[[ No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
IT 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?
fie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? fie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes E],Ko
❑ Yes [Efo
❑ Yes j(INO
❑ Yes 0-<O
❑ Yes WXo
❑ Yes (Ko
❑ Yes DINO
❑ Yes
<0
❑ Yes
,9
IS 1440
❑ Yes
EV4o
J' iqV violatigris:oi: d,eticie,ncies •were doted' ditrilig tLis:visit; • Yoit will receive iio further • : • : •
wrrespotiden&. about: this visit.
0311�es ❑ No
Uomments (refer to question #): -Explain any YES answers and/,or--any recommendations or any other comments
Use drawings of facility_to better explain situations (use auldflianal, Ef as necessary):
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: 15=1
3/23/99

Facility Number: — of Inspection Sy.3, •
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
,,,..,!!
ICKO
liquid level of lagoon or storage pond with no agitation?
'
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
ZKO
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
®duo
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
U?Ko
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
E?Ko
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
Q]'<0
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
Q14<
dition a ° C omments.an or. rawrngs:'
3/23/99

❑ Division of Stand Water Conservation ❑
Wivision of Water Quality
Date of Inspection
Facility Number i
Time of Inspection©' D 14 hr. (hh:mm)
.L. i b p S'
Registered Certified 0 Applied for Permit E3 Permitted 0 Not O erational Date Last Operated:
Farm Name; ...... Rae P..T...... .t:�.l3. y.itr........ FIoAM......................................... County: ......... W..0 ref..S................................1N.S 0...
t�
Owner Name: ......... Dsa........&f..ru.................................................................. Phone No: ...... 2.3.L.- ... 7_57.
..... t K2
Facility Contact:
Title:
Mailing Address: .... L O.... IN,I. ...... tS.tlJ_j�rE..... G47 gPx.tf....... RA.
Onsite Representative............................................................................................................
Certified Operator:..Ab.3LZ-J,7........... J,Kq-'ES ..................................................
Location of Farm:
Phone No:
,u.'..ro.�.l...
Integrator: ............................................................. .........................
Operator Certification Number:.....L.,Jy6,7................
!k.!t'..il L..(.....?...... .....trn .......... /L� • ........................_fir... �!`.............. Q%xf ..........
.....Pr\...fizz,...f..,. ......._.....1... ....N�... rs.:!.+.:.4.... .....
Latitude ®•=' =" Longitude S'O • 5S ' Fq? T'
Design, .Current
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Cattle "`
❑ Other
Total Design Capacity C
Total SS
LW
Area JU Spray Field Area
General
I. Are there any buffers that need maintenance/improvement? ❑ Yes MKo
2. Is any discharge observed from any part of the operation? ❑ Yes M-Ko
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes OlKo
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes U-No
c. If discharge is observed, what is the estimated flow in gal/min? pla
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes MXo
3. Is there evidence of past discharge from any part of the operation? ❑ Yes l0,K6
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes E'i`O
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes QjW
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 0.1 eo
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes
7/25/97 r'
//- /'z V% A

1
Facility Number: y'7— • •
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Laeoons.Holdint, Ponds. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure l Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
............................................................................................................................................. ..............................
Freeboard(ft):...11xlr�l....................................................................................................................................................
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WNW, or runoff entering waters of the State, notify DWQ)
15. Crop type .....�F� %11......r.....................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is then: a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
UJAO.violatiow-or. defidencies.wen noted during this;visit. You:will i'eceive'nti tirtliee
correspotidenceabouffhis:visit::.':::'::': •::::: :::.::::: : :::• •: ; :: ;•:• •:
13)
❑ Yes M rvo
Structure 6
❑ Yes UNO
❑ Yes Q,1F6
❑ Yes �Ilw
ak! es ❑ No
❑ Yes �o
❑ Yes 4;,
❑ Yes ❑i<o
❑ Yes
[P Is o
[DXes
❑ No
❑ Yes
DqVo
❑ Yes
jp i e
❑ Yes
LL>Kf
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
7/25/97
Reviewer/Inspector Name :
Reviewer/Inspector Signature:�/�pagn —1-f— -,,,_t, Date:

❑ Division of Shand Water Conservation ❑ Other Agency H�6 aJ-4,111
-4,
�J Division of Water Quality
-a e�`..,d�.k.�-rs�..e..--.T��a<.,��--*";>:...•-r,-;..,-�.-tom=.: _wa--..:-» :-m..� .,�,. e..�,.�-., bs .w� a.�=aa. :'�.._. �e ;a..Ra.��R.. ,,."
JO Routine 0 Complaint 0 Follow-up of D%VQ inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection
Facility Number
Time of Inspection lY • 36 24 hr. (hh:mm)
IN Registered 17 Certified [3 Applied for Permit 1] Permitted 113 Not Operational Date Last Operated: ..........................
Farm Namc:......1! L.kK!W........r...e. � [L1n:.........................._......... County: ...........fY.4�: .............................. .S:�Q...
Owner Name:..... .................. ......... �UGQt� a rL....................................... Phone No: ..... `. O..-.357,,87...34.7.................................
FacilityContact: ..........................cy............................_.................... Tiitlep:............../.�.................................................. Phone No:...................................................
iVLailingAddress:.....I.%.Q..........L.:.If..'. r........F�{ gt,,....4, ...i7.t.11..............lr..C.�fA:..'&..................................................... ....�„�6.��....
OnsiteRepresentative:.....................�..........................................o............................................... Integrator:......................................................................................
aw
Certified Operator:..... At. 4+. ............................................................. Operator Certification Number:.........................................
Location of Farm:
Latitude �• ®'°° Longitude ®•
Design - Current �,Iksrgn ". Current Design 'Current
Swme Capacity Population Poultry Capacity, Cattle"" Capacity Population
❑ Wean to Feeder ❑ Layer Dairy s
❑ Feeder to Finish ILI Non -Layer I JLJ Non -Dairy_
- ❑ Farrow to Wean `
- ❑Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capaeity Gilts
❑ soars Total SSLW„`, . io
,.,
Number of Lagoons / Holding Ponds ` ❑ Subsurface Drains Present' ❑Lagoon Area ❑Spray Field Area p
z ', El No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field §J Other
a. Ifdischarge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any pan of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than la_oons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes M No
Cj Yes ❑ No
2 Yes
❑ No
❑ Yes
PC No
MIA
❑ Yes
A No
['Yes
❑ No
❑ Yes
CK No
❑ Yes
RNo
❑ Yes % No
❑Yes tqNo
Continued on back

4� Facility Number: 177 — 1.S7• •
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
b4 No
Structures (Lagoons.tloldine Ponds. Flush Pits. etc.)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
14 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure
6
Identifier:...................................................................................................................................................................................................................
Freeboard(ft):...........................................................................................................................................................................................:...........................
10.
Is seepage observed from any of the structures?
❑ Yes
KNo
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
No
12.
Do any of the structures need maintenance/improvement?
❑ Yes
No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
No
(If in excess of WNW, or runoff waters of the State, notify DWQ)
15.
entering
Crop type ' ..... trwv..r...fd?t/``..........................................................................................................................................................................
16.
Do the receiving crops differ with tho�designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
X No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
W No
18.
Does the receiving crop need improvement?
❑ Yes
No
19.
Is there a lack of available waste application equipment?
❑ Yes
No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
XNo
22.
Does record keeping need improvement?
❑ Yes
No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
❑ No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
o.violationsor deficiencies. were noted during this.visit. You4il} receive nu further.
correspotidehce about this:visit
Art)
ZOOut "g1ft Ut°tf/Le,
r
❑ Yes ❑ No
❑ Yes ❑ No
7/25/97
�Reviewer/Inspeclor Name:` -r r - a r.,..,.,: a.�' rn. .,tom=yre,`'�s I
Reviewer/Inspector Signature: Date: /0/36 &7

19 mouune G i ompiamt p ronow-up of owy inspection p ronow-up of oawt. review p vtner
Facility Number Date or Inspection
6/24/97
Time of Inspection 24 hr. (hh:mm)
E Registered p Certified p Applied for Permit- p Permitted 10 Not Operational Date Last Operated:
Farm Name: 4RobertHayec1arm.................................................................................... County: Wilkes WSRO
OwnerName: Robert ................................... klayes.................................................. -...... Phone No: 919-9.5.7.-.836.7...........................................................
Facility Contact:
Title:
Phone No:
Mailing Address: 1.7.0l.Mining.Ridge.lGwrch..Rd.................................................... Elkin..NC................................................................. 2862J..............
Onsite Representative:
Certified Operator:
Location of Farm:
Integrator:
Operator Certification Number:
Latitude ®. ®° ®'° Longitude
-_ -, = esrgn ;= urren, _ — esrgn urren -- -I)estgn urren
Swore Capacity Population Poultry. Capact[y-Population.: ;Cattle =' Capacity Population
v W _
ean to ee er
a'
❑ ayer'
In airy
+
_
p ee er to inns
p on- ayer
p on- airy
arrow to can p
p ter
- Total DesigmGapacity76
TotaLSSLW 106,400
— ;_
p Farrow to ee er
p Farrow to Finis=.
p Gilts
p Boars
_Nub
of Lagoons /_Holding noP ds��Y p u sur ace rams resent p agoon rea p pray ie rea
Geiferal
1. Are there any buffers that need maintenance/improvement?
® Yes
p No
2. Is any discharge observed from any part of the operation?
® Yes
p No
Discharge originated at: p Lagoon p Spray Field ® Other
a. If discharge is observed, was the conveyance man-made?
® Yes
p No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
p Yes
® No
c. If discharge is observed, what is the estimated flow in gal/rnin?
Small
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
Yes
®No
3. Is there evidence of past discharge from any part of the operation?
p Yes
®No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
p Yes
®No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
p Yes
®No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
p Yes
®No
7. Did the facility fail to have a certified operator in responsible charge?
p Yes
p No
7/25/97

ii
act t y um er: 97_18
8.
Are there lagoons or storage ponds on which need to be properly closed?
p Yes
N No
Structures (Lagoons.Holding Ponds. Flush Pits, etc.)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
p Yes
p No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure
6
Identifier:
Freeboard(ft):................................................................................................................................................................................
................................
10.
Is seepage observed from any of the structures?
p Yes
® No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
p Yes
® No
12.
Do any of the structures need maintenance/improvement?
p Yes
® No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
Yes
® No
Waste Application
14.
Is there physical evidence of over application?
p Yes
® No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ....... Caln.(Silaga.&.Grain)....... Sma11.Grain.(W. yheat,.Barle............................................................................................................
16.
Do the receiving crops differ with those designated to the Animal Waste Management Plan (A WMP)?
p Yes
®No
17.
Does the facility have a lack of adequate acreage for land application?
p Yes
® No
18.
Does the receiving crop need improvement?
p Yes
®No
19.
Is there a lack of available waste application equipment?
p Yes
®No
20.
Does facility require a follow-up visit by same agency?
p Yes
®No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
O Yes
®No
22.
Does record keeping need improvement?
p Yes
p No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
p Yes
p No
24.
Were any additional problems noted which cause noncompliance of the Certified A WMP?
p Yes
p No
25.
Were any additional problems noted which cause noncompliance of the Permit?
p Yes
p No
R
.. o vio ions.or icrencies'were.note . urtng this visit:. You. will.recerve ntr urt er .
.......
. . . . .......•...•...•...•.•.•.•.•.•........... . . .¢. . . . .pgtt. . . .s...•...•.•.•.•.•..••••. . . .. .
stion 7: 1rainmg not yet available in area for certified operators.
siotu 9: Not applicable
iments: The small discharge is from a parlor water pipe. The area below was planned by SCS to filter the water in a waterway
.r strip). This is no working.well at this time. Mr. Hayes is currently working with the district to alleviate this problem.. Several
opts have been made to install aseptic system but to no avail. Other plans are being prepared to take care of the problem. This
er should be repaired. No follow up visit will be needed. Mr. Hayes is.working very closely with thedistrict and is.doing all
we ask of him..
7/25/97
Reviewer/Inspector Name Michael W. . ardue
Reviewer/Inspector Signature: Date:

Site Requites AM Attendo-��-�-
Facility No. --qr
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE:. N,�U 9 ,1995
Time 2 D S nn
Farm Nam Mwn
Mailing Address:
L
camY; W ILkES
IntegmW.. i9Eort cfz sm r1 k _ Phone: `CIO 7 71 - Y6 0 G
On Site Representative: A one: I/D - 9S)- 3 }-
Physical Add. esslUcatioa:
�U
Type of Operation: Swine Poultry Cattle
Design Capacity: %L Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number. ACNEW
Latitude: -IL: -L• -11-" Longitude: ��• SS' .. L- Elevation: Feet
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Arlo N /A Actual Freeboard: ��L — Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or No
is adequate land available for spray? Yes or No U the cover crop adequate? Yes or No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings?oi or No
100 Feet from Was?(CCr No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or 10
Is animal wasu land applied or spray irrigated within 25 Feet of a USGS Map Blue lira? Yes or �l
Is animal wage discharged into waters of the state by man-made ditch, flushing systeilr, or other
similar man-made devices? Yes or iw If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spay irrigated on specif;acreage wit
h cover crop)? Yes or oo
Additional Comments'
Inspector Name
tee: Facility Assessment Unit
Use Attachments if Needed.