090003_INSPECTIONS_20171231

0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
090003 Facility Status:
Inpsection Type:
Compliance Inspection
Reason for visit
Routine
Rate of Visit
03/3112017 Entry Time: 08:00 am
Farm Name:
French's Creek Sow Farm
Owner:
Murphy -Brown LLC
Active Permit AWS090003 ❑ Denied Access
Inactive Or Closed Date:
County: Bladen Region: Fayetteville
Exit Time: 9:00 am Incident tl
Owner Email:
Phone: [phone]
Mailing Address: IO Box 487
Warsaw NC 28398
Physical Address: 9559 Hwy 53 E
Kelly NC 28448
Facility Status: E Compliant
❑ Not Compliant Integrator.
Murphy -Brown LLC
Location of Farm:
Latitude:
34° 32' 49" Longitude: 78° 25' 07"
From White Lake, take SR 1515 around east side of White Lake to intersect NC 53 S go 7.0 miles to farm complex entrance on
Lt. Follow signs to Sow.
Question Areas:
Dischrge & Stream Impacts
Waste Col, Stor, & Treat
Waste Application
Records and Documents
Other Issues
Certified Operator. James C Smith Operator Certification Number: 17907
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Michael Ammons Phone :
On -site representative Michael Ammons Phone
Primary Inspector Robert Marble Phone:
Inspector Signature: Date:
Secondary Inspector($):
Inspection Summary:
page: 1

A
Permit: AWS090003 Owner - Facility: Murphy -Brown LLC Facility Number. 090003
Inspection Date: 03/31/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine -Farrow to Wean 2,400
Total Design Capacity: 2,400
Total SSLW: 1,039,200
Waste Structures
Disignated Observed
Type Identifier Closed Data Start Date Freeboard freeboard
Lagoon
1
19.00
58.04
Lagoon
sow
19.00
page: 2

Permit: AWS090003 Owner - Facility: Murphy -Brown LLC Facility Number. 090003
Inspection Date: 03/31/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No Na No
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? (dyes, 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)
❑
❑
❑
1 Is there evidence of a past discharge from any part of the operation?
❑
0 ❑
❑
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
Yes
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 property addressed and/or managed through a
❑
■ ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
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 Nam
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 Ibs.?
❑
Total Phosphorus?
❑
Failure to incorporate manurelsludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090003 Owner - Facility : Murphy -Brown LLC Facility Number. 090003
Inspection Date: 03/31/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Aonllcation Yes No Na No
Crop Type 1 Coastal Bermuda Grass wl
Rye Overseed
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1 Centenary sand
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
❑
N ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
■ ❑
❑
Records and Documents
Yea
No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
1101111
20. Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑ ❑
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?
❑
page: 4

Permit: AWS090003 Owner - Facility : Murphy -Brown LLC Facility Number.
090003
Inspection bate: 03/31/17 Inpsection 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?
❑
M ❑
❑
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?
❑
M ❑
❑
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 POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
2& Did the facility fail to provide documentation of an actively certified operator in charge?
❑
❑
❑
2T Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑
❑
Other Issues
Yes
No Na No
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?
❑
01111
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility?
❑
❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon 1 Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewtinspection with on -site representative?
❑
M ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

�5 lf-U —g—v`' d
T' i'vi'sioiJof Water Quality
Facility Number D 3 ® Division of Soil and Water @onservation
Q Other Agency
Type of Visit: mpliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: 046outine Q Complaint Q Follow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: _ j �� Arrival Time: Departure Time: County: y5Za,*4,--_ Region: f=:Jt Q
Farm Name:J13 C-1 /e : SIP W hoc r - Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: `jJ, n,�on3 Title: / /;0/'
Integrator: /%lv�'�i�j,�/1�[l•~L
Certification Number: / ! 5`0 7
Onsite Representative: sow--c—
r
Certified Operator: 4/QrnNs �
Back-up Operator:
Phone:
Certification Number:
Location of Farm: Latitude: Longitude:
urrent D g� Current
DesignNO
Design Current
Swine
op. Wet Poultry Cap ty Pop.
Cattle Capacity Pap.
II
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
I
Dairy Calf
INon-Layer
I
Feeder to Finish
`a
Dairy Heifer
Farrow to Wean
Dry Cow
D . P*onl " C `L P,o
Farrow to Feeder
Non-Dai
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
-.11
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)
e. 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 EC No ❑ NA ❑ NE
[:]Yes [—]No
[:]Yes [:]No
[:]Yes [:]No
❑ Yes fq No
[:]Yes ®Po
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Facility Number: ot __3 1 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes VT 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): 1 4
Observed Freeboard (in): (p �
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
0 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
[Z No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
allo
❑ 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
[2 No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): v
13. Soil Type(s): 69
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes Eff No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ®- No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
M-No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E[ No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available'?
❑ Yes
�o
❑ 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
[2-No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
RNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
KNo
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

Facility Number: q - 3 jDate of Inspection: A1.3 7--/
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes g] No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 0 No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ® No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ 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 CA WMP?
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?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
❑ Yes [T No ❑ NA ❑ NE
❑ Yes Cjg.No ❑ NA ❑ NE
❑ Yes & No ❑ NA 0 NE
❑ Yes 6 No 0 NA ❑ NE
[:]Yes ® No
❑ Yes No
[:]Yes allo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone:
Date:
Page 3 of 3 21412011

Water Q`ality
Facility NtiImn e ate r Conservation O
d Other Agency
Type of Visit: ompliance Inspection 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: rrival Time: Departure Time: fl County: '___
Farm Name: G1,4 Owner Email:
Owner Name: /f/t(erd/ a��,e �L G Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: Title: Phone:
AV
Onsite Representative: _ ..�Gw•� integrator:
Certified Operator: Certification Number: J? 9L0%
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design
Current
Design
Cnrrent
Design Current
Swine
Capacity
Pop V!'et PaultrY Capacity Pop. _ -
r... ;. ::..
Cattle Capacity Pop.
r.
an to Finish
an to Feeder
Feeder FinishWcan
Layer
Non -La er
_''�Design
Dai Cow
Dai Calf
Dai Heifer
T
rrow t
�
Cu went
D Cow
rrow to Feeder
. D . P,oultr
Ca aci
P,o
Non-Dairyrrow
to Finish
La ers
Beef Stocker
ts
Non -La ers
Beef Feeder
Boars - Pullets
Beef Brood Cow
Other
—.Turkeys
Turkey Pouets
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)?
[]Yes allo ❑ NA ❑ NE
[—]Yes ❑ No
❑ Yes ❑ No
❑NA ❑NE
❑NA ❑NE
d. Does the discharge bypass the waste management system? (if yes, notify DWQ) [] Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes CR No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes 10 No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility Number: -p Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes RNo ❑ 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:_ T
Spillway?:
Designed Freeboard (in): r� /
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [Z 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
54No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
K 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
5?L 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 [Q 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): ane
13. Soil Type(s): t-fef 07
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [KNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes O No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes KNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[]Yes
E.No
❑ NA
NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[a 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 Eg No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers [] Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes O 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 21412011 Continued

Facili Number: JDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 No ❑ NA ❑ NE
i
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes g) No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 0 No ❑ NA ❑ NE
'27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes (a No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to property 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 (K No ❑ NA 0 NE
[:]Yes � No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes gj No ❑ NA ❑ NE
[:]Yes allo
❑ Yes ® No
❑ Yes No
❑ 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--fa--cHity to better explain situations (use additional pages as necessary)
r----
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: �Q ''—Dc7
Date:,
21412011
Page 3 of 3

r
Type of Visit (D<—ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit e-f outine Q Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: JArrival Time: trp Departure Time: 0 t7 County:
Farm Name: �%`�rrr; h !i s��^�-r & _Yau z _ Z --*1­ -- Owner Email:
Owner Name: 1Gr ki J, G _ Phone:
Mailing Address:
Region:
Physical Address: // /-
Facility Contact: �%' iZ4df � Jl%O/YIS Title: Phone No:
Onsite RepresentativeIntegrator:
Certified Operator: r` v �17yf'rl2 Operator Certification Number: P'bC7
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = o = r = u Longitude: I=] ° = I = u
Design Current
Swine - ` Capacity Population
Wean Fo nto Finish
Design Current
Wet Poultry Capacity Population
❑ Layer
Design Current
CattleCapty Population
ElLa Dairyw Co
Wean to Feeder
❑ Non -Layer
❑ DairyCalf
El Feeder to Finish
ER Farrow to Wean � YOD
El Farrow to Feeder
El Farrow to Finish
EGilts
Boars
Otherx
❑ Other
Dry Poultry
'' ` ""
❑ Layers
ElNon-La ers-❑Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
❑ Dai heifer
❑ D Cow
Non -Dairy
❑ Beef Stocker
❑Beef Feeder
❑ Beef Brood Cow
=x
Number�of Structures:
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
E&No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
1 Is there evidence of a past discharge from any part of the operation?
❑ Yes
[3.No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
KNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes C&10 ❑ 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: J�/+*G�1dor
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0 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 C5No ❑ 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 [6No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
RNo
❑ 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
[3No
❑ 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
B�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 Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
ONo
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
®No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
91 No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
RNo
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
S.No
❑ NA ❑ NE
ng ,of f ietiity to�better e
r1r*e'' +nab
Reviewer/Inspector Name Phone: 9ja79�f3 7�22
Reviewer/inspector Signature: Date:
Page 2 of 3 11/18104 Continued

• Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have 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 appropirate box. ❑ WUP ❑ Checklists ❑ ❑ Maps
n Desi g p ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E&No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I ° Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
�9No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
BNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
B-No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
D,No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
RNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
54 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
RNo
❑ 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
9 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
[9 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
4 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
j9No
❑ NA
❑ NE
Page 3 of 3 12128104

(�1�msion of Water Quelrty
Facility Number ��j . Q Dtrvistou of Soil and Water Conservation
�_Otber_Agency
Type of Visit QlZompliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit outine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: -/0—/D Arrival Time. Departure Time: County: ��t� Region: jE—_� Q
Farm Name: tYrtG -r Owner Email:
Owner Nacne: Y �- j^ G Phone:
Mailing Address:
Physical Address:
Facility Contact: f 'rifle:
Onsite Representative: %_R
Certified Operator:
Bank -up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
❑ Other
Phone No.
Integrator• 01iyv;L4
Operator CertifccaIion dumber:
Back-up Certification Number:
Latitude: ❑o ❑1 ❑u Longitude: ❑0 =1 ❑ u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turke Points
❑ Other
Disc harpes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: E]
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
2 No
❑ NA
❑ NE
❑ Yes
[ENO
❑ NA
❑ NE
I2/28/04 Continued

' Facility Number: 2— Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [ANo ❑ NA ❑ NE
Stricture I Structure 2 Structure ? Structure 4 Structure 5 Structure 6
Identifier: kJ041--
Spillway?.
Designed Freeboard (in): / 12
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
5� No ❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
❑.No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
0 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
allo ❑ 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
9No ❑ NA ❑ NE
maintenance or improvement?
Waste application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
� No El NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
R-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 ❑ Evidence of Wind Drift ❑ Application Outside of Area
rWindow
12. Crop type(s)Y
13. Soil type(s)
14. Do the receiving crops differ frnm those designated in the CAWMP?
❑ Yes
PQ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
J4 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination
,❑ Yes
® No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explainsituations. (use additional pages as necessary):
//
o l�,�p
! ?tL S a�Q�L bk ]—a✓�i-r 1 r�Uf�y
Reviewer/Inspector Name Phone: 41 )-1l n-�, —33,oO
Reviewer/Inspector Signature: Date: — 10
12128104 Coannued

Facility Number: — (~j Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Wo ❑ 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 ❑ Desig
n ❑ Maps
p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
allo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
P9 No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
ER No
❑ NA
❑ 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
R[No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[ZNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
RNo
❑ 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
tRNo
❑ 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
ERNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
R No
❑ NA
❑ NE
12128104

R
Type of Visit t�omp Lance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit Routine Q Complaint Q Foliow up Q Referral Q Emergency Q Other ❑Denied Access
Date of Visit: Arrival Time: i Departure Time: , n,( County:
Farm Name: _i-�Hrz--1lU Ic ltrAP� Owner Email:
Owner Name: M/g % `1Grli!':?.f _ _ Phone: _
Mailing Address:
r
Physical Address:
Facility Contact:a4tE�::�Title:
Onsite Representative: Integrator:
Certified Operator: A / a �Iry>i Operator Certification Number:yZ�p 6
Back-up Operator: �%�fi`l�U' � /V�/r) _ Back-up Certification Number:
Phone No:
Region:
Location of Farm: Latitude: = o = r ❑ " Longitude: ❑ ° = ' [=1
Design t "Current; Design Current
MD-K§
Current
e Eapactty Populat�un Wet P Query Capacity Population
._
Cattle
apy Population
FEI
F
❑ Dairy Heifer
D Pouf '.
❑ D Cow
❑ Non -Dairy
"`
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
❑ Other
Number of Structures :,
-gib � _r. 'P6'��sY._.:e-'aC,;• _.; -.. .. _ .:. �: ��. t.iL�+�"�% 4''Y�,.:.
ean to Finish
ean to Feedereeder
to Finish
®Farrow to We
Discharges &Stream Impacts
❑ Layer ❑Dai Cow
❑ Non -La et ❑ Dairy Calf
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
1. Is any discharge observed from any part of the operation`?
El Yes
9No
❑ NA
❑ NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
❑Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? {If yes, notify DWQ}
[I Yes
❑ No
❑ NA
❑ NE
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)
El Yes
❑ No
❑ NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
❑Yes
M No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑Yes
[�NO
❑ NA
❑ NE
other than from a discharge?
12/28/04
Continued

Facility Number: — 03 Date of Inspection Imo✓ J
L
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure, 20 LI� Structure 3 Structure 4
Identifier:-G� 0
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 RNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes &No ❑ NA ❑ NE
❑ Yes PSNo ❑ 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 [3 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [ANo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes 9 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes M No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes J,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 El Evidence of Wind Drifl El Application Outside of Area
12. Crop type(s) a-'1' 94_ / (�
13. Soil type(s) C&,1-7;1 ary
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ESNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
,KNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
�91 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
RNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
RNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name ��/� ('j Phone: Q� [70
Reviewer/Inspector Signature: Date: 3—
12128194 Continued

s Facility Number: Date of Inspection �%�c3
Required Records & Documents
19. Did the facility fail to have 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 94 No ❑ NA ❑ NE
the appropirate box. ❑ W-UP ❑ Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E&No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain ,Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
&No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
O No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
KNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
R No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
10 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[R No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
R No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Ej 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
PQ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
R] No
❑ NA
❑ NE
Additional Comments and/or Drawings:
46
H,,
12128104

1 IFT)PS Z 00 8 ZfZ_
Type of Visit Crt'o-mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of visit: 3 -31- 0 $ Arrival Time: /1 : ZO m Departure Time: 2 f4 ,,r County: 'F!Q d eta Region:
Farm Name: /�— "S e- C-Al 5LT Owner Email:
Owner Name: _ /,'t u'�'P� Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: �� Su �V�"*--
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: =0 0' =« Longitude: [�° [=' ="
Design Current Design
Swine Ca aeih Po ulatton Wet Poult Ca act
p p ry p ty
Current Design Current
Po ulation Cattle
p W :. Capacity Population
❑ can to Finish
❑ Layer
I
I
❑ Dairy Cow
❑ canto Feeder
❑ Non -Layer
I
❑ Dairy Calf
Feeder to Finish
Dry Poultry —
❑Lavers
❑ Dairy Heifer
❑ Dry Cow
Farrow to Wean ZZ100
❑ Farrow to Feeder
❑ Nan -Dairy
❑ Farrow to Finish
❑ Beef Stocker
❑ Gilts on -Layers
❑Feeder
Pullets
❑ Boars
❑ Turkeys
Other ❑ Turkey Pouts
❑ Other ❑ Other
❑Beef
❑Beef Brood Cow
-:_:�--
Number of Structures:
Discharges & Stream Impacts
Is any discharge observed from any part of the operation? ❑ Yes JNo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
0 No
❑ NA
❑ NE
b. Did the discharge reach waters of the State" (If yes, notify DWQ)
❑ Yes
[d No
❑ NA
❑ NE
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)
❑ Yes
10 No
❑ NA
❑ NE
?. Is there evidence of a past discharge from any part of the operation?
❑ Yes
?No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
Afl No
❑ NA
❑ NE
other than from a discharge'?
Page I of 3
12128104
Continued

i
Facility Dumber:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
09 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
01 No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z S Z
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
W No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
[% No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
�No
❑ NA
❑ NE
8. Do any of the stuctures 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
[�M No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
LM No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
V]No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Ln, 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 Area
// rGP3 e_ , �1 l ,/
12. Crop type(s) r31fAA ld�-- C /�� J �IKkL� at-WFA1 . S
13. Soil type(s) ee^ �G1►la • x•�
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[� No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
�1 No
❑ NA
❑ N E
17. Does the facility lack adequate acreage for land application?
❑ Yes
Pfl No
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
?No
❑ NA
❑ NE
Reviewer/inspector Name�� ,q� Phone: /Q. 5�33.33ae
Reviewer/Inspector Signature: Date: 3 -31- 2069
Page 2 of 3 12128104 Continued

E __w
Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Qj No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes B No ❑ NA ❑ NE
the appropriate box.
❑ wUP El Checklists El Design El Maps [:3 Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [ff No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [" No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ),NNo ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
ElYes
rVj
W No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
M No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
)K No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
P No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
P?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
4 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
A No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewerhnspector fail to discuss review/inspection with an on -site representative?
❑ Yes
PErNo
❑ NA
❑ NE
Page 3 of 3 12128104

Type of Visit t9-Compliance Inspection Q Operation Review Q Structure Evaluation () Technical Assistance
Reason for Visit QWK16-utine O Complaint O Follow up Q Referral 0 Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: 3L Pw Region:
Farm Name: Fr r. n c_.A PJ Cy r - f [ .5 a W 15Qn"'`-- Owner Email:
Owner Name: _/i�%1.�d`�1aY1�' i f �1/J'�i� Phone:
Mailing Address:
Physical Address: p-
Facility Contact: Title:
Title:
Onsite Representative: :� L
Certified Operator: �`11011
�"�; C
Phone No:
Integrator•
Operator Certifica 'on Number:�� ss-3
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = o = , = Longitude: = ° [= 4 = "
Design :M1,�CurrEnt
Swine Capactty,.;l?opulat'on
Wet Poultry
Design
Capacity
Current Design Current
Population Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑Dai
Cow
❑ Wean to Feeder
❑Non -La er
❑
Da Calf
❑ Feeder to Finish
Farrow to Wean bt7 O D I)ry Poultry
❑ Farrow to Feeder
❑ Farrow to Finish El Layers
❑ Gilts ❑ Non-Layers
❑ Boars ❑Pulle
O#her "'r ''` ❑ Turkeys
_ _ _ ,;? ❑ Turkey Poults
❑ Other` ❑ Other
❑
Dairy Heifer
❑
Dry Cow
El
Non-Dairy
El
Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
:;Number of Structures:
Discharges & Stream Impacts
1. 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?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c_ What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
En No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
N No
❑ NA
❑ NE
other than from a discharge'?
Page 1 of 3
12128104
Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes CK 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: .SOS iij S
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):^
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes 0 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 RNo ❑ 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 [V 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 59 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 [.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 ElApplication Outside of Area
12. Crop type(s) /5 -er M to Q CT a' �_' e Zi ft
13. Soil type(s) 7rtay- y _
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Q,No ❑ NA [:1 NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes (] No ❑ NA ❑ NE
16_ Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes EM No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes 91 No ❑ NA ❑ NE
Comments (refer to question 9:.Eplain,any.YES answers and/orMrecommi�:111tions ar any other commentsse drawingsof facility to better explainr,sitnations. {use adnecessary):
12,W _�J�l� a� rl Lj 4 y Yi , C2,r, rl—, d ®� e-
a a rin iu r?- D-F�F-1cr
Reviewer/Inspector Name 3 M fiYvk�_ �� _ Phone: 222:1/13-3.320
Reviewer/Inspector Signature: Date:
Page 2 of 3 12178104 Continued

Facility Number: —,93 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes J No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [KNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps
p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
29 Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes EX No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes J@ No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[K No
❑ NA
❑ 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
No
❑ 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
0 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
f4 No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
RNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
19 No
❑ NA
❑ NE
Page 3 of 3 12128104

/1(5 eN jLw_a( 41 _//— ZOO 8 &P,
(Type of Visit 8'ompliance Inspection Q Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit outine Q Complaint Q Follow up Q Referral O Emergency O Other [I Denied Access
Date of Visit: 13 ;31 Arrival Time: 2%32 Departure Time: Z; S/O County: ���� Region: /` -rg
Farm Name: Zre_tiC4 S 7<Ylyz Owner Email:
OwnerName: 1 u4PZ Ul' Al_ Phone:
Mailing Address:
Physical Address:
Facility Contact- At `�Title:Phone No:
Onsite Representative: R,:z Ar Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: =] o =] ' [—] Longitude: = o F--J ' = "
Design Current
Design Current '' Design Current
Swine C**apaeity Population
Wet Poultry
C*apacity Population :_ Cattle Capacity Population
❑ Wean to Finish 110
Layer I
❑ Dairy Cow
Wean to Feeder
10 Non -La er
❑ Dairy Calf
❑ Feeder to Finish
., ❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
j El Dry Cow
❑ Farrow to Feeder
Discharges &Stream Impacts
1. Is any discharge observed from any part of the operation'?
El Yes
Qj No
❑ NA
❑ NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
El Yes
� No
❑ NA
❑ NE
b. Did the discharge reach waters ofthe State? (If yes, notify DWQ)
❑Yes
RI No
❑ NA
❑ NE
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)
El Yes
l2i No
❑ NA
❑ NE
2. is there evidence of a past discharge from any pan of the operation?
El Yes
03 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
M No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12/28/04
Continued

Facility Number: 19� Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [ffNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ONo ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Tj
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
VNo
❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
ONo
❑ 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
P No
❑ NA ❑ NE
8. Do any of the stuctures 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
0 No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
�RNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect 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 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) .p er. a y�} - "rain/ (0,53
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[%No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
51 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
V1 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`?
❑ Yes
(YNo
❑ NA
❑ NE
Comments (referto question#): Explain any YES answers and/or anv recomme..ndations or any other comments ,
Use drawings of facility to better. explain .siti ahons'(use additional pages as necessary):,
Reviewer/Inspector Namc r ., S ! Phone: 9, 3 3' 3 0
Reviewer/Inspector Signature: Date: 3 -31— ZOD S
Page 2 of 3 12128104 Continued

Facility Number: 40 — Date of Inspection 13 3/-4
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [�R No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes VNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 7No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes P No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes V No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
P No
❑ NA
❑ 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
FYNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
V'No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
PkNNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
RNo
❑ 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
,MNo
❑ 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
JPNo
❑ 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
0 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
,PNo
❑ NA
❑ NE
Page 3 of 3 12128104

Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ®Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: 3: ZS'.,� Departure Time: .3= :3z County: 19fd 4-Al Region: IC�0
Farm Name: Ire �.G�SOLJ4YrtiI0�P Owner Email:
Owner Name: %11i u Ve /,, L __ B� lwT Kl Phone:
Mailing Address:
Physical Address:
Facility Contact: I Title:
Onsite Representative: �o nrc�L4 A,4 q a ykLr
Certified Operator:
Back-up Operator:
// Phone No:pp
Integrator: _ Z,t!Z4' i G7kZ-LJAJ
or f
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: 0 0 = c = fl Longitude: FI ° = 6 a N
Current
Design Current
Design Current
EP,CiPOIIesign
Swine ty
ation
Wet Poultry Capacity Populatiop
Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
I JE1 Non -Layer
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
Farrow to Wean 2oD
Dry Poultry ' .a
❑ D Cow
❑ Farrow to Feeder
"?r, x " "
El Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
-
❑ Turkeys
Other
❑ Turkey Pouits
N It ` � W
❑ Other
❑ Other
Number ofgStruetures:
Discharges & Stream Im acts
1. 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?
❑ Yes
No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
toNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation'?
❑ Yes
1�fl No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
0 No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

r
Facility Number: Q —03 Date of Inspection G-47-
tii
Waste Collection &'Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [)] No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ® No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
h
Designed Freeboard (in): %
Observed Freeboard (in): 3 % Orr
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ENo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes [VNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7_ Do any of the structures need maintenance or improvement? ❑ Yes VNo ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes VNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes W No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes WNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 1� 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)
6 V,
13.
Soil type(s) Ce-
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
y No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
V3 No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
09 No
❑ NA
❑ NE
18.
Is there a lack of property operating waste application equipment?
❑ Yes
WNo
❑ 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):
Reviewer/Inspector Name �eV S Phone *0 �ZZ —/5OV
Reviewer/Inspector Signature: R.e'� Date: di— 7—]w (o
Page 2 of 3 12128104 Continued

Facility Number: Q — Q3 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes VNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes un No ❑ NA ❑ NE
the appropriate box. ❑ WIJp ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [9 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
[� No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[;RNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
P No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
CgNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
VNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
Wo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[P No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
5a 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?
[I Yes
V] 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
r7oNo
❑ 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
P9 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
VNo
❑ NA
❑ NE
Additionai Comments and/or Drawings:
Page 3 of 3 12128104

Type of Visit O'Lompliance 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 ❑ Denied Access
Date of Visit: /G%�-D Arrival Time: Departure Time: County: It Region: /Exo
Farm Name: 1C .S "J Par „1 Owner Email:
Owner Name: Phone: /' ►�,y
Mailing Address:
Physical Address: �„ ��d,'T pf LAmL dale,
Facility Contact: s7 ZE&.waO'no 2-,el I Title: Phone No: 027L
Onsite Representative: /e r_ •� �, ; ,. , /�'1 C- d r e" Integrator: M1.1 t >7
Certified Operator: �t/ zn ✓` Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: ❑o =, ❑« Longitude: =° =, =
DesignCurrent Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish 10 Layer
❑ Wean to Feeder 10 Non -Layer
❑ Feeder to Finish
Farrow to Wean tea
❑ Farrow to Feeder
❑ Farrow to Finish 9
❑ Gilts
❑ Boars
i
Other
❑ Other �.
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ TurkeX Poults
❑ Othcr
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field El Other
L-
a. Was the conveyance man-made?
b_ Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non-Dai
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: ❑,
d. Does discharge bypass the waste management system'? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes
C9 No
❑ NA
❑ NE
❑ Yes
jd No
❑ NA
❑ NE
❑ Yes
CK No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[4 No
❑ Yes RNo ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
12128104 Continued

Facility Number: — 03
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
M No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
M No
❑ NA
❑ NE
Structure I: Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: .50W
Spillway?:
Designed Freeboard (in): J' 9
Observed Freeboard (in): 3 3
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
[A 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
2 No
❑ NA
❑ NE
& Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 0� No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require El Yes � No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [Z 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 > l0% or l0 lbs []Total Phosphorus [:]Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ 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
[ZNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
R Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑
Yes
KNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application'?
❑ Yes
[XNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
® No
❑ NA
❑ NE
a, 3
Reviewer/Inspector Name �%►—Yl� G fj Phone: A /_4V
Reviewer/Inspector Signature: Date: // 7 I r
12128104 Continued

4 • , l
Facility Number: —p Date of Inspection a
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 10 No ❑ NA ❑ NE
20_ Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes J4 No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ DesignMaps
❑ Ma El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. InYes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis C4 Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
Ud No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
(9No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
4 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
EZNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
W No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
®.NA
❑ NE
Other lssues
29.
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
29 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
X 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
� No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
El Yes
4 No
❑ NA
❑ NE
a �, u I1.�'GJ cc /?I�� O rJ�; L ,p9l,
Y JI
12/2VO4

Type of Visit 0 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 o Date of Visit: /a.:P& Time: : %r
O Not Operational Q Below Threshold
ermitted [3 Certified 13 Conditionally Certified 13 Registered Date -fit Operated or Above Threshold-
, � �� '
Farm Name: -��i( s CrF. [t..� _��rt.. --� - r County:
Owner Name: Al m,2 , -- -- Folds _. Phone No: `j'/0 - G G 9 - , & `12
1ating Address- .. .Qox -„-„7S
9 -- - Rau Hill
..��........_............ �— ..SG.......___........
Fatality Contact. d ' el ,, --- ---- __-- Title:
Phone No:
Onsite Representative: Integrator. /411/f.�
Certified Operator: _ .i✓ t! - - ------ _ , Operator Certification Number:. --
Location of Farm:
AL
asi�ine [3Poultry ❑ Cattle ❑ Horse Latitude ` " Longitude • �u
Discha,mes & Stream Impa
1. Is any discharge observed from any part of the operation? ❑ Yes 9W66
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes 21go'
b- If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ yes BM
c. If discharge is observed, what is the estimated flow in ga lmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes 91q0—
2. Is there evidence of past discharge from any part of the operation? ❑ Yes B-No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes M4o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes E�wb
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier- 1
Freeboard (inches): 3 H
12112103 _ Continued

. Facility Number: _— Date of Inspection !O
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
❑ Yes
2-go'
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 maintenancerimprovement?
❑ Yes
CI No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
21qo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
2Mo
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
0Qo
11. is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
21ro
❑ ExcessivePonding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
��
12. Cr--type ICaer/►iide► S.wri�l rail
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
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
NKo
16. is there a lack of adequate waste application equipment?
❑ Yes
moo'
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge actor below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
[�o
19. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
mwo-
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
QW0
Air Quality representative immediately.
Co�mme�,(x e#i�ar to won �) � Eaaa�Y> �a�s ar nor any � or gip§ ot#eer camraa�.�� -� � V„
Use draof � �_ {a�xc: ona�Pag�� Yam_ Q�teld Copy ❑Final Notes �'- .}�r�--"�
Reviewer/Yaspector Name
Reviewer/Inspector Signature: ZzZaDate: 0G -vy
Iwlr✓vs wrrunuers

Facility Number: d9 — 3 Date of Iaspection
Ree aired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ chfld9s, dpW, maK, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ rea ❑ kaebo ❑ ysts ❑
24. Is facility not in compliance With any a piisetback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/mspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
3I _ If selected, did the facility fail to install and maintain rainbreakeers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑Stooldng-R&M ❑ ❑Bainlm ❑
❑ ec ons ❑ Annual Certification Form
❑-Yes ❑ No
❑ Yes [3-No,—
❑ Yes M.W
❑ Yes MNa-
❑ Yes 93
❑ Yes M4#6
❑ Yes ❑ 4,0
❑ Yes ER46
❑ Yes EPI&
❑ Yes ❑ No
❑ Yes EWd
❑ Yes [}No
❑ Yes Quo
❑ Yes 0- o -
❑ Yes ❑ No
12112103

Type of Visit V Compliance inspection O Operation Review - O Lagoon Evaluation
Reason for Visit ('t Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facilir►- '-umber Date of isit:
p Not O erational 0 13eI, - Threshold
Permitted j� Certified ©Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm !dame: FrT, A nc:�-P f CreGV_ S aw pdkr w, - Count-: _'Q lad"i
Owner Name: Phone No: rl -19 66 9 r •7,1Y.2
Mailing Address:
Facility Contact: _ lVde A �u rri ecr Title,
Onsite Representative: w."J�# r
Certified Operator: _ 001?/' Th u9 _ 9AOZ&' n
Location of Farm:
Phone No:
Integrator: %nttr d A w
Operator Certification Number. a2 %$ s
&Swine ❑ Poultry ❑ Cattle ❑ Norse Latitude ' 6 " Longitude 0 �• ��
Design Current
Design Current
Design Current
Swine Ca acit• Population
Poultry
Ca acit- Population Cattle
Ca acit• Population
❑ Wean to Feeder
0-aver
Dairy
Feeder to Finish
❑ Non -Laver
ENon -Dairy
Farrow to Wean
QL400
❑ Other
❑ Farrow to Feeder
❑ Farrow to Finish
Total Design Capacity
.79,00
❑ Gilts
❑ goy
Total SSLW
Number of Lagoons ID Subsurface Drains Present ❑ Laeooa Area ❑
Holding Ponds 1 Solid Traps ❑ No Liquid Waste Management System
Spry Field Area
Discharges S Stream Impacts
1- Is anv discharge observed from any part of the operation?
❑ Yes
[ No
Discharge orizinated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made?
❑ Yes
1� No
b- If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
❑ yes
1:3 No
c- If discharge is observed- what is the estimated flow in gallmin?
d- Does discharge bypass a lagoon system''(If yes. notifirDWQ)
❑Yes
%No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
LP"'* 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
11 No
Strucrre 1 Structure ? Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Freeboard (inches): '1
05IV3101
Condriued

Facility Number: 6 1 — O3 Date of Inspection ?�v
S. 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? El Yes �] No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes] No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [] No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Application
10. Are there any buffers that need maintenance/improvement? _ ❑ Yes 0 No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes 1P No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 00 No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes 14 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 q 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 No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? 1
(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?
❑ Yes
[g] 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}
No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
1$ No
Jim No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
_
Comments {refer.to quesho Ezphttn any YES answers and/orany recommenahons ar an2&h
mments. T�
I]se�drawwgsaflfa tytobetteeslilatn srtuahous.(use addmhonalapages asneeeAli
sary)' ¢Copy Fin Notes
a +� a.,
n I - _
r4 J, . ) LYeCOr AJ VIA C i'OPs l oo ks F00t ,,
,5a, I Sar.� ICJ dr G '}Q 1<<1N /ill+ Ivollet•_)d< P^/�t �+�t f�py<_V'v"5 ye-4z ',
1 N^► G .�-� O L a�p f 1 0 -ice a r w�J Ct S klC C A x Gil f 11 . J�+ tit C rt -e- X-�
k) GG
H
Reviewer/Inspector Name 42
Reviewer/Inspector Signature: Date: —�
05103101 / / I / Continued

Facility Number: 01 -O3 Date 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 ❑ 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) I
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 permanentitemporary cover? ❑ Yes No
Additional Comments andlor'Drawines:
J
05103101

n Of-
�. Divisio Water. Quality
0
- Division of Soil and -Water Conservation ,
0 Other Agency..
Type of Visit p Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 9 3 Date of Visit: 4-8-2002 Time:
0 Nut O erational 0 Below Threshold
® Permitted ® Certified [3 Conditionally Certified p Registered Date Last Operated or Above Threshold : .........................
Farm Name: ka!<tt�h.'..G��ekc.SQ.t}.E�rlat.................... ...... County: Kadfm ............................................... ERO .............
Owner Name: ................................................... 1. LtrP.hy..F:dtl[lily..FArxw............---........ Phone No: 910: 69-2.642...........................................................
MailingAddress: 1?Q.I Ox..7.S�............................................................................................ 9.0s.c.RALM ......................................................... 20.458 ..............
Facility Contact: dQ.U..1.Wc.................... ...Title: ................... Phone No:............--.....................................
Onsite Representative: Wail.D.uriftry....................... .. ...... Integrator: Iliurpby..k:Pll Wy..Far. s-..................
Certified Operator: Arthuir.W............................. &d1cia.1t:..................................... Operator Certification Number: 2,15.32 .............................
Location of Farm:
From White Lake, take SR 1515 around cast side of White Lake to intersect NC 53 S; go 7.0 miles to farm complex entrance +
on Lt. Follow signs to Sow.
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 34 • 32 50 " Longitude 78 GF 25 1 F 00 u
Design Current
Swine Canacity Ponnintion
❑ Wean to Feeder
❑ Feeder to Finish
® Farrow to Wean
2400
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I 1 ❑ Dairy I ::d
❑ Non -Layer I I Non -Dairy
❑ Other
Total Design Capacity 2,400
Total SSLW 1,039,200
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d- Does discharge bypass a lagoon system? (Ifyes, 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
%Vastc Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structurz 5 Structure 6
Identifier: ................................... ........................
Freeboard (inches): 37
05103101 Continued

Factiity Number: 9-3 Date of Inspection 4-8-2UO2
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? Yes ®No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Coastal Bermuda (Hay) Small Grain Overseed
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 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, reaps, 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
Q No violations or deficiencies were noted during this visit. You will receive no further correspondence shout 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 ❑ Final Notes
No problems observed, well maintained faun.
Reviewer/Inspector Name Paul Sherman
Reviewer/Inspector Signature: / Date: Aul-
05103101 Continued

Faeility Number: 9-3 Date of Inspection 4-8-2002
r._
Odor issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below [:j Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead aninials 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:'
05103101

IV
Type of Visit a Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 8 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number p Date of visit: D/ Time: �r� ,'�
-Not Operational 0 Below Threshold
® Permitted ® Certified [] Conditionally Certified [3 Registered Date Last Operated or Above Threshold: --- _-._.._------------
Farm Name: ...... e�!F� � �.... '� Count �Y�!�d/€�
..............................._._...... y' ........... J........._..................-.-..._....-....................._...
Owner Name........ f! .. Phone No: .... J... ." ,z///.......................
Facility Contact: ................Title:.................. one No .......................................... .........
Mailing Address: f � /��� .�
' d �..
Onsite Representative: .... lr�!.R!T.....,,rGlu:�f`........................ Integrator:-.-..
/� /
Certified Operator: ? ....... . ...........................................................�a. Operator Certification Number: .........................................
........................... ........
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 1 64 Longitude ' ° •4
Design Current
awtne
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I❑ Dairy
❑ Non -Layer I I Non -Dairy
[❑ Other_ _
Total Design Capacity
Total SSLW
Number of Lagoons : _ Subsurface Drains Present ❑ Lagoon Area JE1 Spray Field Area
Holding Ponds / Solid Traps [[]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 inan-made? ❑ Yes Na
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) [:] Yes ®'No
c. II' discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ;5 No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes .9No
3- Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes JR No
01/01/01 Continued

Facility Number: p —
Date of Inspection �
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) Iess than adequate? ❑ Spillway ❑ Yes *NO
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): ............yA X .............. .................... ..... ........... ... ................. _....... _....
.
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.) r
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes �No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes )K No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes No
Waste Application
10. Are there any buffers that need maintenancelimprovement?
❑ Yes RNO
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 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?
❑ Yes PNo
16. Is there a lack of adequate waste application equipment?
❑ Yes )9 No
17. Are rock outcrops present?
❑—Y� No ylif
18. Is there a water supply well within 250 feet of the sprayfietd boundary?
❑ On -site ❑ Off -site
Reauired Records & Documents
❑ Unknown tees— No ,r>f,4
19.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
§],No
20.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available'?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
JRNO
21.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
J4 No
22.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
Wo
23_
Did the facility fail to have a actively certified operator in charge?
❑ Yes
C*No
24.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
M'No
25.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
OR No
26.
Does facility require a follow-up visit by same agency?
❑ Yes
RNo
27.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
RNo
Odor Issues
28.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
j)iYes
❑ No
liquid level of lagoon or storage pond with no agitation?
29.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
PrNo
01 /01 /01
Continued

Facility Number: 0�7 — Date of Inspection A/ Printed on: 10/26/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below O'Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
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 2No
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 k 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 J�rNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ,j No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? RrYes ❑ No
Additional Commentsandtor rawinp:
J
5100

.®Division of Water Quality
0 Division of Soil and Water Conservation
0.0ther. Agency
Type of Visit aCompliance 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 1"ateofVisit:
®Permitted ® Certified E3 Conditionally Certified [3 Registered
Farm Name: "' o
Owner Name: ........��+ ! 1.......................... I............................
Facility Contact: ........ �!> <..................... .`......... Title:
Mailing Address: ......... !'-...��:............7� f. 1.�r1Fi ���
........................................... .....
Onsite Representative: _..................................................
4
Certified Operator: - L
Location of Farm:
&@"Time: � Printed on: 7/21/2000
Not Operational 0 Below Threshold
Date Last Operated or above Threshold: .........................
County: Z71f-Z'e-
la
Phone No:.. ........................
...... ......................
....
Phone No:
..........................................
Integrator:..
Operator Certification Number:
f
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �4 14 Longitude • 4 44
Design Current
Swine Canneity Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
;Z VeV
LKOb
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer 10 Dairy
❑ Non -Layer ❑ Non -Dairy
Other
Total Design Capacity
Total SSLW
Number of Lagoons t ❑ Subsurface Drains Present ❑ Lag,wm .Area JE1 Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed frown any part of the operation'? ❑ Yes 9No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-madc'! ❑ Yes RtNo
h. I I' discharge is observed. did it reach Water of the State? (If yes, ni�tify DWQ) ❑Yes #3 No
c. if dischar«e is observed. what is the estimated flow in gal/tnin!
d. Does discharge bypass a lagoon system? (lfyes, notify DWQ) ❑ Yes WO
2. Is there evidence of past discharge from any part of the operation? ❑ Yes Wo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 99No
Waste Collection & "Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate'!
Structure I Structurc 2 Structure
Identifier: .............p?. }.................
❑ Spillway ❑ Yes r
Structure 4 Structure 5 Structure 6
Freeboard (inches):
5100 Continued on back

Facility Number: & 9 — ,J Date Elf Inspection � Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes f: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 MNo
(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?
>i-Yes
JbNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
XNo
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
allo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN []Hydraulic Overload
❑ Yes
No
12. Crop type Ac'er-. �j,� �.,,.,� ��� i�•J —
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
91 No
15. Does the receiving crop need improvement?
❑ Yes
P No
16, Is there a lack of adequate waste application equipment'?
❑ Yes
4No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
� No
111_ Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
P No
19. Does record keeping need improvement'? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
OfNo
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
ff No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
k, No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24. Does facility require a follow-up visit by same agency?
❑ Yes
R9 No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
1P No
�4., ihA iioris:or• deficiencies -mere noted- &Whig 4his'Asit; - Y:oir will-teaeive Irio further • : • :.
�coriesporidene-a'.about:th's 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):
A.
Reviewer/Inspector Name
Reviewer/Inspector Signature: ��`� Date: 20pO 5100

Facility Number: Date of Inspection Printed on: 7/21/2000
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 ;S No
30. Mere 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? X[Yes ❑ No
Additional -Comments and/orDrawings:
S/00

Permitted © Certified Q Conditionally Certified (3 Registered 113 Not O erational Date Last Operated:
Farm Name: ......74z�......County: ....... 61 - ...............................
Owner Name:.-•-F"4�Ir/I .----.......r.�.........6..r!` ........... z�9' ZIl%
f� J 1}---•--• Phone No. - .....................
Facility Contact: Y" !rtr'.'t ....Title: L Phone No '...................
Mailing Address: .......(.....1.1.�.-.. 7 ......l...................... �SG ..1.....!rl..1...� ..!v G.......................... �� 7`.5�..
------.. ......................... .....................
Onsite Representative :.,G!!.l'.:1..�.....9Ll.h...A
............................................... Integrator: .....................................
.......
......................................................
Certified Operator:...j4 ...... L .... Operator Certification Number:.......... ....................
'�w. ...............
Location of Farm:
Latitude ' �° �•4 Longitude 0 ' 4=
Design Current ` Design Current '
Swine .• Ca aci Po ulation Pou!#ry; Ca" 'acit • ;Po "'iiI tiiiri. Little
❑ Wean to Feeders
❑Layer
❑ Feeder to Finish
_ ;
❑ Non -Layer
Farrow to Wean
2
== :-
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
:TOM Dt2si;
`]
❑ Gilts,
10 Boars
Discharges & Stream Impacts
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?
Design
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 /Sttructure 3 Structufe 4 Structure 5
Identifier: '�l�-- �i� I ` {u�-�P�% 3oW,I
i. jj 7
Freeboard (inches): �7 .. ..... .-..L............. ..................................................
.....-- • ................ ............................... :.
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes KNo
❑ Yes [(No
❑ IV/
o
/U
❑ Yes KNo
❑ Yes (�No
❑ Yes [gNo
❑ Yes fKNo
Structure b
❑ Yes ;9�40
Continued on back
3/23/99

Facility Number:D� hate of Inspection
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?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive P�onding ❑ PAN
12. Crop type tier 1 vLLteJCX- 4&,_4 / S i l • (a rcx , k--
13. Do the receiving crops differ with those designated+in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
t5. 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?
0: 10 yiglaiioris:o f def cie�tcies •mere . O ell• . )g this:visit: • Yoit will •feegiye irio (ufther • : ;
'COrrtes totWe i .. abinif this .visit_
used D4 1 s o vat all G-� 5'O &1 A&_,ei;t P/a-- , 10 1-1-14 e %V
Dec_ + 7S;L�• Or-- 5/"1Rll 6r95+-.k
li ew 4,WA4s 4atie ben,_ sp�.��e4l Sxbu,/J clime 4/ ,. 7tA;s se
Reviewer/Inspector Name
-
Reviewer/Inspector Signature: f
❑ Yes gNO
❑ Yes No
❑ Yes No
❑ Yes /No
ElYes iNo
❑ Yes t(No
❑ Yes KNo
❑ Yes P 'No
❑ Yes KNo
❑ Yes KNo
❑ Yes ONo
❑ Yes � No
❑ Yes 4No
❑ Yes ONo
❑ Yes No
❑ Yes No
❑ Yes 01 No
❑ Yes No
❑ Yes No
❑ Yes No
KYes
" 'e- I
Date: 3- 9
3/23199

Facility Number: — Date 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 ❑ 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 kINo
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ONO
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.) Cl Yes ,�j No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes K} No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? A -Yes ❑ No
3/23/99

Division of Soil and Water Conservation ❑ Other Agency
® Division of Water Quality
14PRoutine O Com faint O Follow-u V of DW ins action O Follow-up of DS►VC review O Other
Date of Inspection t?
Facility Number `
_ Time of Inspection 24 hr. (hh:mm)
13Registered ®Certified © Applied for Permit [3Permitted 113 Not Operational I Date Last Operated:....-----
Farm Name:........K�r,-...Lr�C. /4.� County:e................................................
Owner Name: ...........�..... ,.. ............... Phone No:....9/G.............................................................
.................
Facility Contact: ......1`! .........!7`t�..!Title: ................................ . .............................. Phone No:
Mailing Address: �- 7� I[ � �T�///YC -2� �....
f...........I...--------
...... ......... .
Onsite resentative:,-,,, Re ,, -- ....---_...-----
pP...........f'!................................... IntegraEor:......df1`....J
a
Certified Operator; ........ yZ4 �lit/ .. Operator Certification Number,- /�............
Location of Farm:
............ ....... ...........:......................... ............................................................................................................................................................................ �
Latitude •' �« . Longitude
"ems°Desigri< Current
='. Design Current_ Design - Current -
5wine _ � Capacity,Pgpulatian
Poultry w , ,A, Capacrty ;Population Cattle Capacity; Populat<on;,
❑ Wean to Feeder
L° ❑ Layer`. ❑ Dairy
❑ Feeder to Finish
I0 Non- I ayes [] Non-Dairy
y Farrow to Wean - Z 6d
Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design vCapaehjE
❑ Gilts
s w,
❑Boars Total S Lw-
Number'of Lagoons 1 Holding Ponds ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
-
4 F, ., , , ,. •.. :..:' A,, ❑ No Liquid Waste Management System $ ..
General
1. Are there any buffers that need maintenancelimprovement?
❑ Yes
No
2. Is any discharge observed from any part of the operation?
❑ Yes
( No
Discbarge originated at: ❑ Lagoon ❑ 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)
❑ Yes
PNo
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
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
1gNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
OkNo
7/25/97
Continued on back

Facility Number: 44 .
8. Are there lagoons or storage ponds on site which need to be property closed?
Structures 0LaLoons,I1oldint* Ponds, Flush fits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Freeboard (ft): ........ G
.............................................................................................................................
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?
❑ Yes NqNo
4
❑ Yes X-No
Structure 5 Structure 6
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 WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ...... 94—_ _ .......................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management flan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there 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 Facilitie-s 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?
........................................
❑ Yes tV No
❑ Yes gNo
❑ Yes OwNo
No.violations or deficiencies were noted dttring this:visit..You.vvill receive no ft;ir_ttier
correspondence a out this. visit.'-.','
❑ Yes A No
❑ Yes kio
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes JqNo
Cl Yes A'o
❑ Yes WNo
❑ Yes � No
❑ Yes ,U No
❑ Yes &No
mtents.(refer to question #): Explain any .YES an"s*er§ and/or any recommendations or anygotlter corrume�nts
drawings of facility to better explain situations (tile additional pages as neresssirv)
l
7/25/97
Reviewer/Inspector Name g
Reviewer/Inspector Signature: Date:

140 Routine O Complaint O Follow-up of DWQ inspection Q Follow-up of DSWC review O Other
Date of inspection M
Facility Number D 3
Time of Inspection y : SG 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: ❑ Registered ❑ Applied for Permit (ex:1.25 for 1 hr 15 min)) Spent on Review
❑ Certified ❑ Permitted Jor Inspection includes travel and processing)
❑ Not Operational Date Last Operated: _ ,.. ..... ,_....._ .... __..............-. _..._ —......
Farm Name: re €i�'�..W-.,ff _.. Counts:.. _. ... _ ..... �, ...
Land Owner Name:-"r""`../�`"�`8_re!"��............... PhoneNo:
Facility Conctact:._._ v./ Phone No: CC%��-�//
Mailing Address:��. ---------------
�....
Onsite Representative:......,. la - Integrator: e �40,.
Certified Operator ....P... .. ...... Operator Certification Number:
Location of Farm:
�.�/•ems
Latitude C�• �� 0 u Longitude �• ��'
Type of Operation and Design Capacity
'��" � ��'�N Fes✓ "°^.. ,.... ew,„.�;' �«.aa-a m2s� x z: ; �, ✓"iswr,, a»�" ✓ -s+�a ,,;- �. cs^«a <' z�-s,.s f�a ,�� ra' .,•, f'Z.�s:
R DeSIgn�CUrrent � Uesijq Current s`�-� e rr �eslgn Cn[reilt
Srvrite ATM,P ...,.
`a a.
-Ca flCi P8 ul"atipn POnitry .Ga aCl APO 111atIOn'`. ttlea C8 M O U UtJOn a
❑ Wean to Feeder �❑ La er ❑ Dairy
❑ Feeder to Finish ❑ Non -Layer ❑ Non -Dairy
Farrow to Wean .270
Farrow to Feeder
wxFarrow to Finish r&AU�S
❑ Otherv�a # bra ee 9
1Vumber,�of Lagoons f„Hald ng Ponds El Subsurface Drains Present `
M r
g¢fl rea Lagoon A , ❑ Spray Field Are £ a 1-
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes Q No
2. Is any discharge observed from any part of the operation? ❑ Yes [P No
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes QU No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes IN No
c. If discharge is observed, what is the estimated flow in gal/inin?
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? [:]Yes ® No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes QU No
4/30/97 maintenance/improvement? Continued on back

Facility Number:..1917..
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes k9 No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes J[ No
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes �No
Structures ffiayoons andlar Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than. adequate? ❑ Yes UNo
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
22�
10. Is seepage observed from any of the structures? ❑ Yes N No
It. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes EgNo
12. Do any of the structures need maintenance/improvement? ❑ Yes TKNo
(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 P[ No
Waste ADDlicatiOn
14.
Is there physical evidence of over application?
❑ Yes
10 No
(If in excess of WMP, or runoff entering waters of the State, notify.DWQ)
15.
Crop type b ' ,� 1��r ....—...._ ......._..... ..... ..... _....... _.....__... _.
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
KNo
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
P$ No
18.
Does the receiving crop need improvement?
C? Yes
❑ No
19.
Is there a lack of available waste application equipment?
❑ Yes
0 No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
[ZNo
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
gNo
For Certified Facilities!Unly
22.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
I@ No
23.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
D(Yes
❑ No
24.
Does record keeping need improvement?
❑ Yes
JR No
Comments (refer to question d#}.,`Explain'any YES�answers and/or"any recoi m hdahans or any other continents
Use drawings of facility to better explain situations. {use add�taonal pages as necessary) T a v
APO
,q+2F,9 Nod+` .+G��caE� J ��A.�/ f�-✓�F 1
�
Reviewer/Inspector Name r" '£'w
Reviewer/Inspector Signature: �c cam! d - Date: 4!
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97

i
taeEtery NEtmber.�`�.��
Division of Environmental Management T 3
f Animal Feedlot Operations Site Visitation Record 6 7 ^ 13
Date: 9 — S4
Generaf,Inhrma 4IIl
Farm Name:.
Owner Name: 11
On Site Representative•_
!Mailing
Physical
Latitude• / / Longitude: I I
ration Description, (based on design characterWa)
r: Lall
No.-- u -cl
r of Swine No. of MimaLs rypr ojPaultry Na. ojAni,nals Type of Catrle No. of Min als
Sow _,� Y vU 0 Layer 0 Dairy
Nwsery � O Nor -Layer O Beef
13 Feeder
OtherType of 1jvuma- Number of AWmah. I - -
Number of Lagoons: # (inciudr Ea ttRe Drawings and Observations the fsneboard of each lagoon)
Facility InIRRW�a ,
Lagoon _
Is lagoon(s) freeboard less than 1 foot + 25 year 24 hour storm sto aSO: Yes O No O
Is seepage observed from the. lagoon?: Yes 0 No 13
Is erosion observed?: Yes O No O
Is any discharge observed? b e Yes O No O
Q Man-made 0 Not Man-made
Cover Crop
Does the facility need more acreage for spraying?: Yes ❑ No U
Does the cover crop need improvement?: Yes 0 . No ❑
(Usr the crops which need LVnn nWW)
Chop type:_ O ate. r _ _! Acreage: ,/
Setback Criterk
Is a dwelling located within 20O feet of waste application? Yes 0 No
.Is a well located within 100 feet of waste application? Yes 0
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream? 7Y N
'Is animal waste land applied of spray irrigated within 25 feet of Blue Line Stream? Yes 0 NoA
AOL — 7ann wT 174M

�lmntanaau
Does the facility maintenance Deed improvement? Yes O No 0
Is there evidence of past discharge f om any part of the operadon? Yes O NOXk
Does record keeping need improvement? Yes O NO O
Did the facility fail to have a copy of the Animal Waste Management Plan on Doe? Yes D No O
Explain any Yes answers•
Signawre: Dane: _ � 7 /,
= - F=U&y Assesmm Unk UseAnachmw VNnAW
Drawings or Qbset-vatiom:36
�ra„_- G' S [� r� o.►� .�a,r r� f ati,.,rQ — tr.e � [ � 5 P'+' • j � '.�
(jtrol(n a
rr77 ., u 1
L �, c K �ati..
.. Sc.,.��j �1 5.-0 �-o.�re c le.o.s-z� .� sP•^ � .ti
Y Cr
LGs of IA(, D r cr-r• �l 9 [ e, vhje-r 1t Q-
t :w, r ... - . . nn=�.-� ►. �•.:•a cn saw. '�frrtr,A�lii'`r'w►JVr+a -w
' �'�r • it • aYr+-M. /`r.w ��-�.F '!� •�F! I: :� 4:.Y i.�.....wr��ra � r�.
AOI — January 170% ,

Site Requires Immediate Attention: N67
Facility No. 0 9 - /3
09-5
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: A f- S , 1995
Time: I4-,' 59
Farm Name/Owner: '"i
as -a
Mailing Address: Rt. / 8 0 97 A - I Ke-It `' /IBC Z 8 "
County: ,91,Qde -J -
Integrator: Phone:
On Site Representative: _ a i e_ Pa_rK�� Phone:&0) 66 9 - ZCo_IS
Physical Address/Location: S3 s
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: /o o0 o Fi H . Number of Animals on Site:
DEM Certification Number: ACE DEM Certification
Latitude: Longitude:
Circle Yes or No
Does the Animal Waste Lagoon hsufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches)or No Actual Freeboard: 3 Ft. O Inches
Was any seepage observed from the 2p�
n(s)? Yes o N>�o Was any erosion observed? Yes o> SO
Is adequate land available for sprayor No Is the cover crop adequate or No
Crop(s) being utilized: ,Set' u
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Ye or No
s
/O,000
Number: ACNEW
100 Feet from Wells? O'er No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue ine: Yes oR2W
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or(19 If Yes, Please Explain.
Does the facility maintain adequate waste management recur (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? e r No
Additional Comments:
_ 9'c K'i R e_J er S
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

Site Requires Immediate Attention: NO
Facility No. 0 4 - S
49- 13
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: A;y u f 8 , 1995
Time: Iq % Z q
`Farm Name/Owner: /C''e �' Ce_ s C r-t, l�ct - s� r.., % u rp A y F0041`/y Far/K s
;Mailing Address: K+. SoK _97 A-1 KrAl lic, 28i+ -S _
County: �31acnr
Integrator: Phone:
:On Site Representative: 1Ce_ ._rj Aj t.-J , Goos&r j ^ _ Phone: 9/0 Z 4144
Physical Address/Location: Ww1 67a E,
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: 70oo Nu► s Number of Animals on Site: 7 0o0
DEM Certification Number: AC DEM Certification Number: ACNEW
Latitude: Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) o
Was any seepage observed from the
Is adequate land available for s rays
!Crop(s) being utilized:_ u-04
or No Actual Freeboard: 2- Ft. 5 Inches
on(s)? Yes o No Was any erosion observed? Yes o`(&
�or No Is the cover crop adequate? 7 e or No
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellin s? Ye or No
100 Feet from Wells? es r o
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes ort�
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes ovfp
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes oi(i If Yes, Please Explain.
Does the facility maintain adequate waste management record (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? r No
Additional Comments:
Inspector Na
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

Site Requires Immediate Attention: —NO
Facility No. 09 - 0 3
09 - g'�-
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: Q ;4 s / 8 , 1995
Time: 14: 0.S
Farm NamelOwner:
Mailing Address: 9559 Cast 53 , l\ GIIy /V l Z 5'gw-g'
County: 43/ade-v -
-Integrator: Phone:
On Site Representative: Ta rr�r Taf� _ Phone: C91o) &6 9 - z G q-z-
Physical Address/Location:. E. -7 r�,%s �.a•_ !✓6t�'�� Lame- - -
Type of Operation: Swine "/ Poultry Cattle
Design Capacity: zq)o Sa L-j Number of Animals on Site: -Z �LOO
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon h ve sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes r No Actual Freeboard:_'?_Ft. O Inches
Was any seepage observed from the la n(s)? Yes o No Was any erosion observed? Yes o No
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No
Crop(s) being utilized: 45Gv- o,—
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellin s? Ye oi
100 Feet from Wells? Yes r No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes oN
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line:
No
Yes ol(�D
Is animal waste discharged into water of The state by man-made ditch, flushing system, or other
similar man-made devices? Yes No If Yes, Please Explain.
Does the facility maintain adequate waste management reco�d�(volumes of manure, land applied,
spray irrigated on specific acreage with cover crop) Yes r No
Additional Comments: L aAaoN are, Arese vi��,-_�e�.�.c Go,ud�f<
/VO Yo 1 d r T i �� C 1 h( -c:f O s
Ri c_&/"5 e. v e- 5
Inspector Nani
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

Site Requires Immediate Attention: No
Facility No. 0 9 -3
09 - F4
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: ux f I , 1995
Time: Z : O0
Farm NamelOwner: Fre ic" % lWae o h"
Mailing Address: 9559 Ca-sf- 53 Ke.il,, NC 2:2r 44S
County:
Integrator: Phone:
On Site Representative: tMtav,K Eaf=L w OLN Phone:
Physical Address/Location: M- 5-3 C, 7 h+rlta 1,;+'oe flake. -�
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: 2400 . Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes r No Actual Freeboard:__?Ft. Inches
Was any seepage observed from the la oon(s)? Yes or® or Was any erosion observed? Yes ®
Is adequate land available for spray? or No Is the cover crop adequate? ® or No
Crop(s) being utilized: Co0.s a l r
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? or No
100 Feet from Wells? i&or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or(O
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes oj�p
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes o4b) If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? �&or No
Additional Comments: 711i Sj %1 `Mspec_fi_o+n► was ca-.A' c1hxL was �-c s.xl-� v)c a_ Ci ti �r-cJn► eo)n� +ia%N i . LT
4UllK��,+i NOON T 1(I4, Cfl� Gd 'l'v�� GNTI Vim_ CL N�GNTS Of �0.S pCN �Pa :O tG/J f?t11'rt�CA %N40 CL Aleoi-b,4
b4,4 w i -4+,; fj +1� 14 5 + f�•� G �Zj r,.4,a �:_� 5 . �'�I.�� 1 N1sm V- w 4L r, k i f _ Garh; Sco llf ai f.�L__ G4J �lai[ �i[Vj
"� Ays iAO" r"_,_,p+- of cO /�tco ,/4-. iK e- 'IN5PGC'TS/w- Ob54YVG.d L,4'1 1it46�Ol cTV e.J
�COW�rN 1.14 +k bn.., 5i3Oo 'dtd NW SrgN3 O� Nu.'t}_%[NY�C1Aq/�/r4S• `-' iAa%t4�t.✓ ISa-J_b�•'M ft w, Cd
.' _ NC, Vi 01, 0M3 "—e -
ro � �+_U s a .�•Vr � a ro�...� i ►t �.:. o nt wi—: c {.. -1-i o W :.� u .S�ls<_ C�.c-o i � .iw. �.., �i �+
t>6S#,rVA CaT 0. V-V.S,ly eT 4: S— 14 �ali6w-v��taS�tt�7r.,J wi \� �� C�ti�.�C��� f N Neov
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.