960051_Inspection_20210929

Facility Number
i1
• Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0 Compliance Inspection
0 Operation li.evieu 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Ili Routine 0 Complaint 0 Follotw-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
Owner Name:
Mailing Address: V
Physical Address:
Facility Contact:
Arrival Time:
4. 5-A► -
=Sr\ e
Departure Time:
Owner Entail:
Phone:
County:
Region: /NC5
fCt, G4Sira, NC D753'
W t
Title:
Onsite Representative: CSIFRivek &Ii 1` ( Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number:
Certification Number:
Longitude:
Swine
Design Current Design Current
Capacity Pop, Wet Poultry Capacity Pop.
`eon to Finish
'i e,in t[I !'ceder
Feeder to Finish
1-arrow to Wean
Farrow to feeder
Farrow to Finish
(iilts
Boars
Other
k)ther
I.ayer
hon-I .aver
Dn Poultry
Design ('urreni
Ca wily Poo.
I -alcrs
Nl!-Laser'.
Pullets
Turkeys
.Furkr:y Puults
Other
Cattle
Design ('urrent
Capacity Pop.
[);}iry
Dairy Calf
Dairy 1lei ler
[)ry Cow
Non -Dairy
13c0-Stucker
Reef ceder
Beef I3rood (ow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: [J Structure ❑ Application Field © Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (Ifyes, 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 pan of the operation?
3. Were there any observable adverse impacts or potential advent impacts to the waters
of the State other than from a discharge?
❑ Yes Er/No El NA ❑NE
• Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑No El NA ❑NE
❑ Yes ® o ❑ NA ❑ NE
❑ Yes f 17 ❑NA ❑NE
❑ Yes No ❑NA ONE
Puler f of 3 24412015 Continued

irility Numbe :4 _ rj
bate of Inspection: _
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. I€ yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
❑ YeS
• Ye;
1:21/No ❑ NA ❑ NE
❑ No 0 NA ❑NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures obsened? ❑ Yes o 0 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
waste management or closure plan?
If any of questions 4-6 were answered. yes. and the situation poses an immediate public health or environment 91 threat, notify DWR
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
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
11. Is there evidence of incorrect land application`' If yes, check the appropriate box below.
❑ Yes
❑ Yes
a ❑ NA ❑ NE
No ❑ NA ❑ NE
❑ Yes [No ❑ NA ❑ NE
❑ Yes ▪ No ❑ NA [] NE
❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding 0 Hydraulic Overload ❑ Frozen Ground [] Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 lbs. ❑ Total Phosphorus ❑ failure to incorporate Manure/Sludge into Bare Soil
O Outside of Acceptable Crop Window ❑ Evidence of Wind L)rifc ❑ 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? dyes, check
the appropriate box.
❑ W UP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
21. Does record keeping need improvement? if yes, check the appropriate box below,
❑ Yes
❑ les
❑ Yes
❑NA ❑NE
❑ NA
❑ NA
O NA
❑ NA
❑ NA
• NE
❑ NE
NE
• NE
❑ NE
❑NA ❑NE
Di NA ❑NE
❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis [] Waste Transfers ❑ Weather Code
El Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ['Monthly and. I" Riainfatl Inspections ❑ Sludge Survey
❑ NA El NE
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
Page 2 of 3
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ tither:
❑ Yes
▪ Yes
❑ Yes
Et4c/i ❑ NA ❑ NE
5/12/2020 Continued

fracilit} Number: Ct k
Date of inspection:
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? [ryes, check
the appropriate box{es) below.
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time ofthc inspection did the facility pose are odor or air quality concern?
lfycs. 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? 1f yes, check the appropriate box below.
�] Application Field ❑ LagaonlStorage Pond ❑ Other:
O Yes
O 1 Ycs
❑ NA [] NE
Na ❑ NA ❑ NE
❑ Yes
O Yes
▪ Ycs
❑ Ycs
❑ Yes
❑ Yes
32. Were any additional problems noted which cause non-compliance of the permit or CAW1vMP?
33. Did the Revicwcr/inspector fail to discuss review/inspection with an on -site representative?
34. l)oc' the facility require a follow -rip visit by the same agency?
▪ Yes
❑ Yes
❑ Yes f No
No
Ne
▪ NA ❑ NE
• NA ❑ NE
❑ NA ❑NE
❑ NA ❑ NE
❑ NA ❑NE
❑ NA ❑ NE
❑ NA ❑NE
▪ NA ❑ NE
❑ NA ❑NE
Comments (rerer to question #): Explain any YES answers and/or any additional recommendations or an► other comments.
Use draw%begs of facility to better explain situations (use additional pages as necessary).
5 C.,
CI v 2-, 21A
SO)
Cr0?
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t CO >tr1 n r
t-L,i' q('
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3'i3
`9q7 -0031
Date: `— 2 c 2
2/4/201