450007_Inspection_20211116

DocuSign Envelope ID: 0F0F7D87-A323-465B-9229-E15B329785AA
ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
S. DANIEL SMITH
Director
NORTH CAROLINA
Environmental Quality
Certified Mail # 7017 1070 0000 1776 4358
Return Receipt Requested
December 09, 2021
Michael R Corn
Michael R Corn
735 Butler Bridge Rd
Fletcher, NC 28732
SUBJECT: Compliance Inspection Report
Small Acres Dairy
Animal Operations Permit No. NCA345007
Henderson County
Dear Permittee:
The North Carolina Division of Water Resources conducted an inspection of the Small Acres Dairy on
11/16/2021. This inspection was conducted to verify that the facility is operating in compliance with the
conditions and limitations specified in Animal Operations Permit No. NCA345007. The findings and
comments noted during this inspection are provided in the enclosed copy of the inspection report
entitled "Compliance Inspection Report".
Correct the sump pump hose in the sileage leachate area immediately to eliminate an illegal discharge to a
surface water. Notify our office once completed so we can schedule a compliance inspection.
Please respond in writing to this office by December 31, 2021, regarding your plans
or measures to be taken to address the following issues:
Provide all remaining documents and record keeping needed to complete annual inspection.
This would include but not be limited to waste application, waste analysis, PAN calculation, etc.
DEQ
North Carolina Department of Environmental Quality I Division of Water Resources
Asheville Regional Office 12090 US- Highway 70 1 Swannanoa, North Carolina 28778
828.296 4500

DocuSign Envelope ID: 0F0F7D87-A323-465B-9229-E15B329785AA
If you should have any questions, please do not hesitate to contact Timothy Fox with the Water
Quality Regional Operations Section in the Asheville Regional Office at 828-296-4664 or via email at
[e-mail].
Sincerely,
r—DocuSigned by:
scly
'-7E617A38285848C...
G. Landon Davidson, P.G., Regional Supervisor
Water Quality Regional Operations Section
Asheville Regional Office
Division of Water Resources, NCDEQ
ATTACHMENTS
11/16/2021 Compliance Inspection Report
DEQ
North Carolina Department of Environmental Quality I Division of Water Resources
Asheville Regional Office 12090 US- Highway 70 1 Swannanoa, North Carolina 28778
828.296 4500

Facility Number
3cQ
Division of Water Resources
3(45o0/ 0 Division of Soil and Water Conservation
O Other Agency
Certified Operator:
Back-up Operator:
Location of Farm:
Type of Visit: • Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
Owner Name:
Il
1b12024 Arrival Time:
Departure Time:
Stull\ saes 'n,t‘s
L c1. at t Careal
12itPu
Owner Email:
County: l pi,aegion: fly nes r• t.
Phone: $f '- LSEr - oC 7
Mailing Address: /35 a) wj-tp4 ISe. tA (� �j-'7
Physical Address: taf—±0 t Se.-$ re-SS'i6 . Mil 7.tU atC @TS fOir /,ter
Facility Contact: JIJ y( (.Qjj Title: Ljial }nail, Phone: %2 j • (123ti — s
Onsite Representative: Oe.rettc..s IM1y �lA6at-� Mit"teggrrO(�:--4
J 1181
Certification Number:
Latitude:
Certification Number:
Longitude:
Swine
Design Current
Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Wet Poultry Capacity Pop.
Layer
Non -Layer
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design
Cattle � , Capacity gip.
Dairy Cow 2,S0
ago I
�9'
Dairy Calf
Dairy Heifer
Dry Cow
Non -Daily
Beef Stocker
Beef Feeder
Beef Brood Cow
�ispharges and Stream Impacts
r any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field tgl Other:
a. Was theconveyance 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)
Cipthere 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
S (Mott pN'C net arcgr ,hG
❑ Yes a NoeFNA ] NE l
EL Yes No ❑NA El NE
VAC .m rl
Yes ❑ No ❑ NA ❑ NE
►t Yes ❑ No ❑ NA ❑ NE
❑ Yes 71No ❑ NA ❑ NE
Page 1 of 3
2/4/2015 Continued

Facility Number: ALA - 45 OD÷i
Waste Collection & Treatment
Date of Inspection:
up CI /2454
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 M No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: /-P SlitiCP
Spillway?: &etPita CherPita
Designed Freeboard (in): Gil,(® /Q.S
Observed Freeboard (in):
</Ai-. r' r14•
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 'ANo ❑ 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 tallo ❑ 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? 0 Yes r1 No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes X No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes NEZ No ❑ NA ❑ NE
maintenance or improvement?
there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA RI 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
I:A
Yes ❑ No ❑ NA ❑ NE
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
�\
12. Crop TyPe(s): ,SVlKliu� �t(Ar1ti. C V'Rtce_a CO20 ' J i byre_ ^' c<Ua4Mot.
a+w Chi ot.
S�I
13. Soil Type(s): Noe U ..Pratik.etta Gab Ras ttA
14. Do the receiving clops 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 detennination?
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?
❑ Yes No ❑ NA ❑ NE
❑ Yes s� No ❑ NA ❑ NE
❑ Yes .v4 No ❑ NA ❑ NE
❑ Yes f24 No ❑NA ❑NE
❑ Yes 71No ❑NA ❑NE
❑ Yes j2A No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists Design ❑Maps ❑ Lease Agreements ❑Other:
oes record keeping need improvement? If yes, check the appropriate box below. ig Yes ❑ No ❑ NA ❑ NE
Waste Application Weekly Freeboard EIWaste Analysis Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Paget of
❑ Yes
❑ Yes
No ❑ NA ❑ NE
No ❑ NA ❑ NE
2/4/2015 Continued

Facility Number:A
Date of Inspection: Il (((y 12.eZ4
24. Did the fgcility fail to calibrate waste application equipment as required by the pennit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
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:
❑ Yes 4 No ❑ NA ❑ NE
❑ Yes tz,No ❑ NA ❑ NE
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 rg.No 0 NA ❑ NE
❑ yes ' ,No ❑NA ❑NE
❑ Yes LANo ❑ NA ❑ NE
❑ Yes SI No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑Yes FiNo ❑NA ❑NE
ere 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?
Goes the facility require a follow-up visit by the same agency?
Yes ❑ No ❑ NA ❑ NE
❑ Yes J No ❑ NA ❑ NE
rz 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).
L404+ Pew d4nsl' a,.4- Ts_ F )C (»f1. I t ao tt1zpaled, rt°
Ar vac. Cow ^fS C'fleA .cLcurj ' s IvS�Ip n�J.
` I IG /�
14,;1 kay req.9� Rif "Mt- cWG °-" D). Car.-i'r/! i '! a
4fl rm:I RS. biaSte- 3 scraped LP-`b tZ4iD iUBI-n+a-tte cSThleOtrce_
S4ru-chweS. t- pN46t (itti e a+-ct Ott [ruts o-fe 'fro, like
�K�rSrizs (it ave,a, Wii\--Q- sus 1v.C\-o �lcicSrq V°I"A.
/Vaz&,ie 3 (en.ole.d ovtbo a maw( SPreade.- ar•-ct 5prt- rt oi-Ta
QJai-ev-io lti h-oIdn ?6 8- cN;il G>Q yu`Co +ezo T`claal
ouc,aVkQ lie rt C—orie i tt d�2 N Ir
'h4. aF f/ob1 Pn'iax.1 IJbV-?a21-Pt- ob1}.
(MkfR.a'h i .ax/ W7tC PRwid� `Urblirna.� 4E!
4rnniira AVe/A�e. /t4&/L a oP tools-sra,n rs- pads& bkote;ra'#-.)c ConG'C.
d0i 1 S Were. retorted -that -Thai taut- � Sa.ror�
tuibtaU 3)See weiot perne.
Reviewer/Inspector Name: ) )j,t. c0'F Phone: Sites Ca -I
Reviewer/Inspector Signature:
Page 3 of 3
Date:
II (IG rioVi
5/12/2020

Facility Number: iic.A.-rL/$OD
Date of Inspection: /f / /142.67.y
24. Did the facility fail to calibrate waste application equipment as required by the permit? `t ❑ Yes ❑ No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
❑NA ❑NE
❑ NA ❑NE
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
D Application Field
❑ Lagoon/Storage Pond ❑ Other:
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
❑ Yes
❑ Yes
❑ No
❑ No
D No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑NE
❑ NA ❑ NE
❑ NA ❑NE
❑NA El NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
VW$ %OrJ ,\ IDS obSa.VJe - `air
Slut-t Vta,e/ ItA,Se w*x-S Ne- ut emt14,5 eg/p. m (43.
di'Z
÷ct Novo� ct s -p TiumvP
6� �t4Wes' �yt,VG
" \ Net «11 rotato S Arauided
hh MASTS. ,gppirlen4 d-
r Puwf ded 6tf Deoefse4t
�f
.032- -eleca145
.*3L{ A -et wilt re-Vi?ti t° Ot,s�a.T
cs°^'l
Si.0 p ch u tL 'cut Cofrs ed W,wMA:CIAN2t,
dux
oced 1t
C24.14., 62t- 31 , Z-n2a
Review dlnspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
iN%eat?) aic)
d I(o�e.ds ittusr b-
Zou pA IJ CaaGu ra t,„ 1
u az4(-c (-cited,
tom- per, ara Cc s -e P w-P
'(2ecsvd S a4.. a. distesewr
¢t.4' try drd-S -p&rUVL
Phone:
Date:
Aze-v(7-(q",0
II (I b f Z bZ-i
5/12/2020

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 450007
Facility Status: Active
Permit: NCA345007 ❑ Denied Access
Inspection Type: Compliance Inspection Inactive Or Closed Date:
Reason for Visit: Routine
County:
Henderson
Region:
Date of Visit: 11/16/2021 Entry Time: 10:00 am Exit Time: 12:00 pm Incident #:
Farm Name: Small Acres Dairy
Owner Email:
Asheville
Owner: Michael R Corn Phone: [phone]
Mailing Address: 735 Butler Bridge Rd
Fletcher NC 28732
Physical Address: 1470 Jeffress Rd Mills River NC 28759
Facility Status: ❑ Compliant U Not Compliant
Location of Farm:
Integrator:
Latitude:
35° 23' 50"
At the intersection of Jeffress Road and Valley View Road ,4 miles south of the Asheville Airport.
Longitude: 82° 33' 10"
Question Areas:
▪ Dischrge & Stream Impacts
▪ Records and Documents
▪ Waste Col, Stor, & Treat
▪ Other Issues
Waste Application
Certified Operator:
Secondary OIC(s):
Operator Certification Number:
On -Site Representative(s): Name Title Phone
24 hour contact name Corn Michael
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Timothy R Fox Phone: [phone]
Date:
Inspection Summary:
Landon Davidson and Tim Fox with ARO inspected the site. Mike Corn assisted during the inspection.
The milking cows at this operation are confined to freestalls. Waste is scraped into two manure storage structures. Milk parlor
runoff and all runoff from the freestall area will flow into the holding pond.
Manure is loaded onto a manure spreader and spread onto cropland.
Water from holding pond will be irrigated on grassland adjacent to the pond when applicable.
The site is currently under Notice of Violation (NOV-2021-PC-0022).
Calibration was provided (Violation #1)
Annual Average number of animals provided (Violation #2)
Reported that soils have been sent off to be processed (Violation #3)
Inspection Item questions that need addressed include:
Page 1 of 6

Permit: NCA345007
Inspection Date: 11/16/21
Owner: Michael R Corn
Facility Number: 450007
Inspection Type: Compliance Inspection Reason for Visit: Routine
#1 & #2. During the inspection it was observed that the sump pump hose in the silage leachate pit was not functioning properly.
#9 Need to correct sump pump immediately and maintain in the future.
#11 Not all records provided during the inspection.
All waste application and required records must be provided by Decemeber 31, 2021
This would include: (PAN calculation, waste analysis, etc).
#32 Records need to be provided and sump pump corrected.
#34 ARO will re -visit to inspect records and document sump pump is functioning.
Maintain/remove any tree/shrub establishment on dam. Additionally manage burrowing animal activity that could compromise
dam.
Sump Pump should be corrected immediately and records provided by Decemebr 31, 2021.
Page 2 of 6

Permit: NCA345007
Owner: Michael R Corn
Inspection Date: 11/16/21 Inspection Type: Compliance Inspection
Facility Number: 450007
Reason for Visit: Routine
Waste Structures
Type
Identifier
Effective
Date
Built
Date
Closed Designated Observed
Date Freeboard Freeboard
Waste Pond
LIQUIDS WSP
07/15/2005
21.60
Waste Pond
SOLIDS WSP
07/15/2005
19.50
Page 3 of 6

Permit: NCA345007
Inspection Date: 11/16/21
Owner: Michael R Corn
Facility Number: 450007
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. What is the estimated volume that reached waters of the State (gallons)? unknown
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 observable adverse impacts or potential adverse impacts to Waters of the ❑ � ❑ ❑
State other than from a discharge?
Waste Collection, Storage & Treatment Yes No NA NE
4. Is storage capacity less than adequate? ❑ • ❑ ❑
If yes, is waste level into structural freeboard? ❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ larc ❑ � ❑ ❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a El • El El
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 El El El
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)? ❑
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? ❑
Crop Type 1 Corn (Silage)
Page 4 of 6

Permit: NCA345007
Inspection Date: 11/16/21
Owner: Michael R Corn
Facility Number: 450007
Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No NA NE
Crop Type 2 Fescue (Hay, Pasture)
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1 Hayesville
Soil Type 2 Rosman
Soil Type 3 Codorus
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Records and Documents
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available?
If yes, check the appropriate box below.
WUP?
Checklists?
Design?
Maps?
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?
Crop yields?
❑ • ❑ ❑
❑ • ❑ ❑
Yes No NA NE
❑ • ❑ ❑
❑• ❑ ❑
El
El
•❑ ❑ ❑
Page 5 of 6

Permit: NCA345007
Inspection Date: 11/16/21
Owner: Michael R Corn
Facility Number: 450007
Inspection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
120 Minute inspections?
Monthly and 1" Rainfall Inspections
Sludge Survey
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 equipmen
(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
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 phosphorous loss assessment (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
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,
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by 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
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
CAW M P?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
34. Does the facility require a follow-up visit by same agency?
Yes No NA NE
❑ • ❑ ❑
❑ • ❑ ❑
❑ • ❑ ❑
❑ • ❑ ❑
❑ • ❑ ❑
❑ • ❑ ❑
Yes No NA NE
❑ • ❑ ❑
❑ • ❑ ❑
❑ • ❑ ❑
❑ • ❑ ❑
• ❑ ❑ ❑
❑ • ❑ ❑
• ❑ ❑ ❑
Page 6 of 6

bit
t4
ger
q' roar
iel• .
l4•
a►
•
%
S
1,1
4, se.
9 0 :� {w t �'Y,`• -ter
% 'r 'ii +t' jr` Ir
• f7 M F'
• c:
tir
r. frr
f.p4f �' . .41 I ►fir .v ' _<r I � titr yr.
t ry it 4 f�-. `/iI�K / .. ,., 'M• r t b�. �!I i.
Ilia Y-•
,410
`qL
` �r+ 1
a / „ t.•
I
r'
ticatta A 4
.4
114

r
:`
4.
r.
Ire
i• •
A
�T.
to'
mg- fr
I
ve

•
/1
y
\t4%1' kt) iNt
-Tv 4' +\ ' t ��' ►} 464
mu
4 41
. (u 1 A., ` ll
ei a' j1 41 Ate' ` 1 � #ti v
ti i r� `1
7
Irr
• W
eTorrao
a
rrit-
I
k
I 4 1(1 4 Ikat ' \ 1 4,1 f i 4C4
"� dg e�r ': a . srill .
V
lattlk
�t 1a >, *. -t' 14,
•
Alt
.• 'ram At
wee. 4r000.

1•:• _'F' �7 � rr L
Cat k
��'�
4 •0 , «
N
Nyi
Y r 'c i r V 1 •b.'4
.J
M.v. I
►/��.:�_ =; �r .ems Y`v
•
0`/•jiaNilit;tIts
1. 1/ y
a�•��
•,Yi
•
H• \
Pp
trirSiglia "
Stu. —
Apia
R`�. i. • i •a
�.,VAL
itrajet
el VP

S
_. Y-#e
•
�, a. `{
. •,•` ,
• •<
_ • L!
— • /. 4
C. ��
4.. -
it : ? 7 a.a..:4, 4j a . - i!: ^.
� •Y•' r. -".}` ;at7<. 11% 1.!►
•z: GA_
_:"L•Lt.
Y a t ..
;•" t - .•t..
-ate Y�ry',-
(.
�• ,}•t6'��'�'+±`.j'4"� A •a
,c t,a•�` '._�_ \ , v • .., �'
•1
a:••1 �..4+
` NLyr
ri •.ri
w
�'t1 lot
or.'"
.f
Vn•
el 14
4. y{.r.
t: •..,,wywy��iii
• ...tit \
„-_...•i,1
•t Ar,'
a - sai�,a
• J....�11 .•
.� �ve4 s�:A flr .+•frr r.�•' ,t- �v.*�r�•^'r�,— .yy.,v�'-•1"-
•
":v �. �- .ifr •_ �tr`%. \ { - lr i.��►�' V.• �'r":.» ��Y"
•
r
•
r ..� 1rl«.�R l;
IAA- • �i_a.. .-a.‘..'j._:"•-
•
•
'Si.e:a -
-'•••...
�J+

•
T it 0, `-"x•.•.. 'sue• y .
1 - �,??'• _, `
1( l.%. \•
On
^ J\ �.
r
7'7 . ,1 •.��- `'..ter ..� -
fb 1 ��•i7 '• ' I�ib.
712-1%
'.T.ti +• -+
de
.1
r
ellrairr
-
1 .•,ar. i-1
w ♦•
• «•
•
• unLtq�
rt,t.
j.
P T + - ! _. .f ,ram �. J..$ ay ., 1•,•• + .•44' t•\d.•t Yr.��.• F\\\ R\ p
•.. \:• •• .,f
/i17 �♦ t1l •DIY t I - • • , y� :�, ' �• '•:.•, •� L 1 . al q. Y{{,..t••.J �1 - r• .>r�•� '• 4\1 ��
•
•. t• •' ,4 t.�"�••4'1{~1\y''G1 "�`�V e' r• l'a a•1•• let: dJ.'�
't r ,.; I
•
�' ly
• ••' ji fr'( fti
e •� J' • -mot y-
• _ •••K 4 S. -
�% j Jr% Il I , 1 .t
•
•
•
•
•
•
•
•'v ♦ • I.
n , Y . 1 4. ...
4'14A,••"+- ha
rt••
•
=ln 1 a
•
maim-
.,. psi a.
•
`41,
9
4
"it .:
*Mr. N-rtjtkint
J• . y.• yJSy, 446.14
Ara
I T Pai a•.
T
y
115:41+191(aW It -re
• �l:, • 1 a
• yM ;441, .
••4-
_ .a•.nc
r_
•t 7''�
AA-
.I,•
4 - - -
•
•
•;w ,may �. •
..• ▪ •+ .e .r f+ ,7
.,. 2 4 d. f
•
•97'•!-{:'Sr-y lam' dk
•�. � .�y�, a ry• r• �'��,�♦'I i"4"� .• ..
.•.p
•
a.•
•
.3I • -• � �' J \••'
Jet
i 4.�7•-
A —
\a
•
S‘ P
•
L ••• Vie N. .
•
•
4.
•7. • :it..
,• H _ LL
`y "r
"Ill, • a' •
..• ^ �VI.+ t�
e a A
w•., r
4
• T�
.- 01.
•
\ '
•
Sso
41r
•
•A.: .
•
a A, ii f
ri,'� , E .Mrs
a 11• ..
r • �•�F•'
p^�� = •� -
p� i
A
•
-
••
-••.
--••
▪ a A`a`�r� _`
•
•
1141. Iri
abefrn‘ik
ziatUrs,
t
rrWArt 4-
rill. 4
,' .••de• y i .•
•
,
/, `1 Ef ,1•0M♦1 t• .'" ,,:"'t.* M• 't •+
' Y N

4
t
'ay•-
`S f`` •
11
•
.,
IA,
-StZ- - s
arr - •
it's a
IP
eendtb -411`_?`
- coweiat
tbkt
•_•
.r.,_limee
a •
..:au
iTh`�alkila
. � cubit, • r
-. • MMee A,
U
-�!, t'iV
Yam'_ a
aft
_ - a+ , Vf
•
•
•.
I
C es 04 .,
i
04 to .firr.
i
Ikre
rt. nar:
*Ei �j
r �ii

'•-
r •,I •
NSW
• a.
µ
<o �h4JoOa,,j�.
y s
JL r Z 4111/1gtridiart
.f,
9r• Ala
• "'
Car is y
41 ,��r
.
�rr•f.
•
.9
K. , yr. .aa...e —
1.
I, `t, .y.
T1 ,.
••. 1• ' • It• a• G;
11. .•.sib, i. ,Y•
lTjtit V T
Sr•
•
r w . ~ . %, x
117
-iyK-t.
eAc
-•r —

t
Aft. 4.�,
r'I
get. lij
•
•
y •..ot a1
APT
Feta
9 i _.$r v _
•'--74.4411
f1•
•
2; 'r
•
Srissaim
a !.
!'d '1 5 •- 1
-
- • _ 1t I , i 1
v
, Art soy •
•
•
.y.f: •:T — _. _"t .':2 `.'i5
...747.14.):41:74b ri:111:1{711,11(1111.1:3/41.1 111•11, .rjk; ea..
1:41:147194Wilnka:74;.::::*14::177—Ct alb; .911. •
•
•
-Fa -.a
Ii

lQMattlII4'ra 6w. * ,
- touvart. G ) eta
I.
I ,.
+.mow .•a a• a-- . wrq', •-...s �irLr.-• i I+.•t _.
p! o J' ` :if, ri
l ((((((
L/ ► ry ; 1 r • .
•

•
�,V
—
•
_�. TT..+.Wry+—
401.
_'+tom... _ _ _az_-+.�_ ...
Ps. Taus--
=fir_ _.-';"....a. _. .. _ _ - • a w / re • r .
r
1 1�1 Jf T may,
_ . . i lk w \ �r-='Y'. "L • •-I.1 tom
- � -
:
. tr. t,
11k
s
fn
` .�
,a •'. i i % r ./.
Ila
ySaks a
ilf} # e
.i ri•
,...ei . 4 � y Ft '(�..
,. 1
tet
\ti i
Act
trrytt
3
;fit
aft
�►."(� — •-• �'.. �� try CY
v.
"yyi ,s,
lett
-_r -• '- --
J ir Sc+r t' '. :
r ` �._
isstl

-K
•
` n-`.
•
Ly v.•J
,'ram '-'t
•
• r_
4-
I
aR
r
4
•
•
'I
S
14

eStat
" Stey�t
IS0. e
fi.
3 `yam, •.• • .�.Th: �. 'lY' M`
4..
••• • •
.<<...
• • W y C. • 0
• - - �1Y •
... _
-i t .
J
•. .
�- et
M
- c_
air
`Zig
d Al.• �',., R et:Ky
a
Se
LI:1:i
1.-i.. .;Yet
104414
.�
W
.• •
a.
Yea
,.. 1•
`. ' 1 '—a -, !1
. W:
.
▪ •
- 144
te- _ -
--.
• - �: p
b
' 4,.
..y
r
r}
4"