640011_Inspection_20211201

PrW
Facility Number
0 Division of Water Resources
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0 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:
Arrival Time:
Departure Time:
darn (u d ?co
Mailing Address:
Physical Address:
Facility Contact:
Owner Email:
Phone:
County:
Region: C
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
a5'r tibi
Title:
Latitude:
511 (a 5ui%c+- Ctee, K SChi
Integrator:
Phone:
Certification Number:
Certification Number:
Longitude:
E ftLi 150 on 1 cr5 we + H tom_ 1506 Cs.tyNnc al -pp 5 r .cam ter,
Swine
Design Current
Design Current
Capacity Pop. Wet Poultry Capacity Pqp.
Layer
Non -Layer
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Design Current
Cattle
Design Current
Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
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?
D Yes ❑ No 0 NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes D No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Page 1 of 3
5/12/2020 Continued

(Facility Number: - f f
Waste Collection & Treatment
[Date of Inspection: _ / 2 / jc91-51
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
1
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes ❑ No ❑ NA ❑ NE
D 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 DWR
7. Do any of the structures need maintenance or improvement? D Yes ❑ No ❑ NA D NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA D 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 D No ❑ NA ❑ NE
maintenance or improvement?
1 I . Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes D No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? D Yes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No D NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes ❑ No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ❑ No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists Design ❑ Maps ❑ Lease Agreements ['Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
O Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ['Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ['Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑Monthly and 1" Rainfall Inspections El Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ❑ NE
Page 2 of 3 5/12/2020 Continued

'Facility Number:
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? 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 ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ❑ No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ❑ No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ❑ No [] NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes ❑ No ❑ NA D NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [] No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ❑ No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ❑ 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).
LI° O'l,K'i t
,.cl.
kAirth
6-f uit‘k mod\-\,0 46) lbLQAGL-ti
Reviewer. Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: - - ai
Date:
5/ 2/2020

Notification of Change of Ownership
Animal Waste Management Facility
(Please type or print all information that does not require a signature)
In accordance with the requirements of I SA NCAC 2T .1304(c) and I5A NCAC 2T .1305(d) this form is official notification
to the Division of water Resources (D\VR) of the triu:sfer of ownership of an Animal Waste Management Facility. This
form must be submitted to D\VR no later than 60 days foltowinw the transfer of ownership.
General Information:
Picvious Natite of Farin: Reid Pou.f+e E Lt Facility No: _6(1- f-1
Previous Owner(s) f- � a•z Phone No:
New Owi►e►'(s) Name: a -err,* fA. PA tite� - _ . Phone No:_L 1- .'j6 J - l'/0
New Farm Name (if applicable):
Mailing Address: I I7.57 c te, krr,5-i NC 784,E
Farm Locution Latitude and Longitude: _34,4" c7' 3Y" f 77° .52` 372 County: a.51�
Please attach a copy of a Count} road map with location identified, and provide the location address and driving directions
below (Be specific: road names, directions, milepost, etc.): 54.(+o0LP..4L( S14 167001
a pproxi►u td, O,S.m.4es_east of REA Oak RR:Q 3R 104$)
Operation Description:
:?Frr ofSt$lira
© Wean to Feeder
O Wean to Finish
© Feeder to Finish
€ Farrow to Wean
© Farrow to Feeder
© Farrow to Finish
of Animals
Tt1,e ofSwine
© Gilts
❑ Boars
No. ol.AninruLs
Tij+eof Coale No. al'Animals
O Dairy
© Beef
7:ipe of'Potrlrra o GI Animals
Of Layer
O Pullets
()thin 1 i pe of Livestock r\irral:.nr o,f Animals:
Acreage Available for Application 2.3.0 Required Acreage: j 6 0 1
Number of Lagoons Storage Ponds- i Total Capacity._687 9 Cubic Feet (113)
r****i* ****T************* in *V+IC..*.**...***...*1***.*.* *i,...,r*********w**#.*,0,44i,
Owner / Manager Agreement
€ (we) verify that all the above information is comet and will be updated upon changing. I (we) understand the operation and
maintenance procedures established in the Certified Animal Waste Management Plan (CAWMP) for the farm named above
and will implement these procedures i (we) know that any modification or expansion to the existing design capacity of the
waste treatment and storage system or construction of new facilities will require a permit modification before the new
animals are stocked. f (we) understand that there must he no discharge of animal waste front the storage or application
system to surface waters of the state either directly through a man-made conveyance or front a storm event less severe than
the 25-year, 24 hour storm and there mast not be run-off from the application of animal waste. ( (we) understand that this
facility may be covered by a State Non-Dtschargc Permit or a NPDES Permit and completion of this form author -lies the
Division of Water Resources to issue the required permit to the new land owner.
Name of ['revio as .and Owner: Sou Belo
Signature: ,> j :�S � -�L'� e- Date: G.; I
Name of New L• nd Owner: Tr N Gt.). RvItes•
L V / -•
Signature: Date:
Name of Ma • cr (ifdifferet t from owner):
Signature:
[lease sign and return this form to: Animal Feeding Operations
N. C. Dis ision of Water Resources
Date:
' ater Quality Regional Operations Section
1636 Mail Service Center
Raleigh, NC 27699-1636
r...... 17 7111 G