090037_INSPECTIONS_20171231

a1�s� n iL
0 Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 090037 Facility Status: Active
Permit AWS090037
❑ Denied Access
Inppection Type: Compliance Inspection
inactive Or Closed Date:
Reason for Visit: Routine County:
Bladen Region
Fayetteville
Date of Visit 09/20/2017 Entry Time: 07:30 am Exit Time: 8:15 am Incident #
Farm Name: Singletary Sow Farm
Owner Email:
Owner. Golden Farms Inc
Phone.
910-285-1005
Mailing Address: PO Box 1139
Wallace NC 284661139
Physical Address: 4196 Burney Rd
White Oak NC 28399
Facility Status: Compliant ❑ Not Compliant Integrator
Murphy -Brown LLC
Location of Farm: Latitude:
34° 45' 25" Longitude:
78° 44' 15"
From White Oak on NC 53, go west 1.3 miles on River Rd (SR 1318).Tum right (NW) on
Bumey Rd 1.0 miles Turn right (north) on
Tatum and Monroe Lane. Farm entrance on right (east). Signs for # 2529-2531.
Question Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat
Waste Application
Records and Documents Other Issues
Certified Operator: Douglas Stephan Atkins Operator Certification Number: 986738
Secondary OIC(s):
On-Ske Representative(s): Name Title Phone
24 hour contact name Doug Atkins Phone:
On -site representative Doug Atkins Phone :
Primary Inspector. Bill Dunlap Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
Calibration 5-15-2017
Sludge Survey N-2.8, P-0.9 75% 1 do hope this was right before sludge removal.
page: 1

Permit: AWS090037 Owner - Facility : Golden Farms Inc Facility Humber: 090037
Inspection Date: 09/20/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean
3,500
3,500
Swine - Feeder to Finish
1.000
1,000
Swine - Wean to Feeder
400
400
Total Design Capacity: 4,900
Total SSLW: 1,662,500
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freaboard Freeboard
.agoon 1 19.50 34.00
-agoon SINGLETARY
page: 2

Permit: AWS090037 Owner - Facility : Golden Fars Inc Facility Number: 090037
Inspection Date: 09/20/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Discha es & Stream Impacts
Yes
No Na No
1. Is any discharge observed from any part of the operation?
❑
MCI
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
0 ❑
❑
b. Did discharge reach Waters of the State? (if yes, nofify DWQ)
❑
0 ❑
❑
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?
❑
M ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
❑
❑
State other than from a discharge?
Waste Collection. Storage & Treatment
Yes
No Na Me
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
M. ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ■ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 100/6/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

Permit: AWS090037 Owner - Facility : Golden Farms Inc Facility Number: 090037
Inspection Date: 09120/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
yes No Na No
Crop Type 1
Coastal Bermuda Grass
(Hay)
Crop Type 2
Coastal Bermuda Grass wJ
Rye Overreed
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Lynn Haven and Torhunta
soils
Soil Type 2
Centenary
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
❑ M ❑
❑
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?
❑ ❑
❑
18. Is there a lack of property operating waste application equipment?
❑ M ❑
❑
Records and Documents
yes No Na Ne
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
M ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
M ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑
0 ❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
page: 4

Permit: AWS090037 Owner - Facility : Golden Farms Inc Facility Number. 090037
Inspection Date: 09/20/17 Inssection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na Nt
Rainfall?
❑
Stocking?
❑
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
E ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
E ❑
❑
(NPDES only)?
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑
N ❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
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?
❑
0 ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
yes No Na No
28. laid 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,
1101111
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility?
❑
0 ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWM P?
33. Did the Reviewertinspector fail to discuss review/inspection with on -site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
E ❑
❑
page: 5

— (I kYlks �� l
Division of Water Resources _
facility Number - ©Division of Soil and Water Conservation
® Qther Agency
Type of visit: Compliance Inspection Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: 8 Routine O Complaint O Follow-up Q Referral 0 Emergency Q Other 0 Denied Access
Date of Visit: Arrival Time: kID Departure Time: County: �Ieul�H Region: [!
Farm Name: S ► `A —<;;w Owner Email:
Owner Name: C, jo&t kr,44 S ' 41 Phone:
Mailing Address:
Physical Address:
Facility Contact: I mu., - v j Title:
�T
Onsite Representative:
Certified Operator: i
Back-up Operator:
Location of Farm:
Latitude:
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?
Integrator:
Phone:
VU &S
A" 1E;01
Certification Number: C j
Certification Number:
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
[] Yes ❑'qo ❑ NA ❑ NE
❑ Yes
❑ No
[;'NA
❑ NE
❑ Yes
❑ No
❑NA
❑ NE
❑ Yes ❑ No
❑ Yes [?f No
[:]Yes PTNo
E31A ❑NE
[]NA ❑NE
❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Facili Ntimber: - Date of inspection: 3 0 P Ll
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ YesNA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No E3-11K ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 O
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes ONo ❑ 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 �o ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
[:]Yes El -No ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes []] N ❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[]Yes Q No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[—]Yes �o ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes Q o ❑ 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
A,
12. Crop Type(s): st
13. Soil Type(s): �� 1
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑-lqo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes r7rf4o' ❑ 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?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑'N�o
❑ NA
❑ NE
❑ Yes
[2"No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes2-'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 E2 N ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes cll o ❑ 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 21412015 Continued

lFacility Number: Of- 3 Date of Inspect -ion: (' p
24. bid the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Ug-No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
0 Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes L No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes To ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [D,? " ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? [:]Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes LJ Ko ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
8lLk, djC '�" V,� boy Rj
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
V,i
Dn'o
❑NA
❑NE
}o
❑ NA
❑ NE
fo
❑ NA
❑ NE
D'No
❑ NA
❑ NE
c'.c U-30&-W1
Phone: M
Date: 300 U
21412015

.S ty' "
Type of Visit: QrCom fiance Inspection O 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: UZ" Arrival Time:L _J Departure Time: / Z7 County: Region:
T?
Farm Name:-r".S�{ ��r u� �j o 4� T_"e� Owner Email:
�V1T-i
Owner Name: C� .. �eL a v Z►-; Phone:
Ur
Mailing Address:
Physical Address:
Facility Contact: DO
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator: _ H d
Certification Number: J �S 7
Certification Number:
Longitude:
I S"
Design Current
Design Cnrrent Design Gnrrent
Swine Capacity Pop.
Wet Poultry @opacity Pop. Cattle Capacity Pop.
Wean to Finish
La er Dairy Cow
Wean to Feeder
iJD
o p
Non -Layer
Dai Calf
Feeder to Finish
Dairy Heifer
.Design
Farrow to Wean
3 g
S
Current D Cow
Farrow to Feeder
D . P■oui Ca aci P,o P. Non -Dairy
Farrow to Finish
La ers Beef Stocker
Gilts
jBeef Feeder
Boars
Pullets
Beef Brood Cow
oil -III._ .._
Turkeys
11
Other
TurkeyPoults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[T;No
❑ NA
❑ NE
Discharge originated at: ❑ Structure Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[3lA
❑ NE
b. Did the discharge reach waters of the S te? (If yes, notify DWR)
❑ Yes
❑ No
dNA
❑ NE
c. What is the estimated volume that reach d waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
ff NA
❑ NE
2_ Is there evidence of a past discharge from any part of the operation?
❑ Yes
C] NA
❑ NE
3. Were there any observable adverse impacts or tential adverse impacts to the waters
❑ Yes
FNo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3
21412014 Continued

Facility Number: - Date of —Inspection: lgf k C
Waste Collection &Treatment ❑ ❑
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes NA NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier;
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ILd'' o ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
2<o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
dNo
❑ 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
DNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
6g Ko
❑ 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 Overlo ❑ Frozen Ground Leavy 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
l n/�
12. Crop Type(s): } n kcd-01 s �
13. Soil Type(s); AA G _ ca-t,
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ffNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
FNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[� No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
dNo
0 NA
[] NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes [la/No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes Q 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 ffNo
❑ 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 No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes ?/No
❑ NA
❑ NE
Page 2 of 3 21412014 Continued

w F acili ty Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check es ❑ 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 ErNo ❑ 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 CAWMP? ❑ Yes Q No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site, representative? ❑ Yes UNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes [�fNo ❑ NA ❑ NE
Comments (refer. to question #):;:Explain any YES answers. and/or any -additional recommendations or:.:any"other. comments ��t � °x,
Use drawines of facility`to better. explain situations (use additiona .` _ " _ " l pages as'necessary).
D Yes
oNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[T No
❑ NA
❑ NE
❑ Yes
ffN0
❑ NA
❑ NE
N ,It Il�a�, ��� zn ���� N�Sk
Reviewer/Inspector Name: Phone:
C p
Reviewer/Inspector Signature: Date: ,]
Page 3 of 3 21412014

11"15 0� u 1516
Type of Visit: Q Kompliance Inspection U Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: Grikoutine O Complaint_ O Follow-up Q Referral Q Emergency Q Other O Denied Access
I PI
Date of Visit: Arrival Time: CJ Departure Time: ! OJ County: R I 11� Region:r o
Farm Name: s�tQ_ Owner Email:
Owner Name: �j O� Q�'-�r�J{Nl- 1�}/11(� Phone:
Mailing Address:
Physical Address:
Facility Contact: 2 : +� Title: Phone:
Onsite Representative: Integrator: !l&fT _
Certified Operator: Certification Number: Cy
Back-up Operator:
Location of Farm:
go
Latitude:
Certification Number:
Longitude:
Design Current
Design
Current
Design Current
Swine '
C•apacity Pop.
VF'et�Poultry
Capacity
Pop.
Cattle
Capacity Pop.
Wean to Finish
[70
La er
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
160V
Dairy Heifer
A;'
Farrow to Wean
jSbV ?SOO
Design
Current
Dry Cow
Farrow to Feeder
D . P,oul
Ca ac
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
T ey Poults
Other
I
L
Other
Discharges and 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
[] A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
[2*NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
dNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
ETiVo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412014 Continued

Facili Number: n 47 jDate of Inspection:
4aste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No C ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?. -
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes I!J-M ❑ 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 ❑-#tom ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes a"" ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes gpfT ❑ 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 EJ-NU-- ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes ❑-IQo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Ejrl�_o ❑ 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): G -t-jk4 c)4 S (0-0
13. Soil Type(s): L
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E3-vo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[:]'I o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Ea '`'o
[] NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
LJ J1O
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
fo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
0 Yes
[] o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
ff No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis 0 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 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes L o ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

lFactity Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes ELNjL__❑ 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 C34iv-D NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑-I+Fa- ❑ NA ❑ NE
Outer Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes EjJbIo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below,
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes p..� ❑ NA ❑ NE
[:]Yes [-No ❑ NA ❑ NE
❑ Yes E3-No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the pernvt or CAWMP? ❑ Yes ❑r'Ko ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes EE'go ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? [::]Yes Lallo ❑ NA ❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
21412014

7
t ype of visit.. y %.ompuance inspection v vperauun Keview V structure jr vamanon l J i ecnmcat .pLssisrance
Reason for Visit: Q Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: 11 jg I I Arrival Time: Departure Time: p9; County:13L4bE,4 % Region: ��
Farm Name: - �j S17M le��4 501j � Owner Email:
Owner Name: &lj-en l'Yl �-,C Phone:
Mailing Address:
Physical Address:
Facility Contact: T?p Title:
u
Onsite Representative:
Certified Operator:
H
Phone: Q
Integrator:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
Design Current;
�u Design
Current
Design Current
Swine
Capacity Pop.
Wet Poultry Capacity
Pop.
Cattle
Capacity Pop.
Wean to Finish
La er
iry Cow
Wean to Feeder
Non -La er
iry Calf
Feeder to Finish
Design
CurrentWry
airy Heifer
Farrow to Wean
55eO
Cow
Farrow to Feeder
lNon-Dairy
Farrow to Finish
La ers
-Layers
Beef Stocker
Beef Feeder
Gilts
Boars
Pullets
Beef Brood Cow
_ M
Turkeys
h
Other _
Turkey Poults
Other
Other
Discharees and Stream Imnacts
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
LF
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
rR NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
® NA
❑ NE
2_ Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
T❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
§0 No
[DNA
❑ NE
of the State other than from a discharge?
�
Page 1 of 3 21412011 Continued

Fatility Number: - Date of Ins ection: 11
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes V� No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [] No 29 NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): a
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
❑ Yes M No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
M 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
1p No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[� No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
T
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[P No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
4 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
0 Outside of Acceptable Crop Window ❑ Evidence of Wind Drift Application Outside of Approved Area
12. Crop Type(s): �---tnb`in,l 8wau d a � &Zf-h f / l.[�Yo
13. Soil Type(s): 1--L4 Yj t L.-
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
❑ Yes
EP No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[B No
[] NA
[] NE
Re uired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
© No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements []Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking [] Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to instal I and maintain a rain gauge? [—]Yes q No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes If No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
[DNA ❑NE
Page 2 of 3 21412011 Continued

Facili Number: q-_3r7 Date of Inspection: I t
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes] No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box(es) below. T
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28_ Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes
® No
[] NA
❑ NE
❑ Yes
Zj No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑Yes [�]No ❑NA ❑NE
❑ Yes ®No [DNA ❑ NE
❑ Yes [�] No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes T No ❑ NA ❑ NE
Comments. (refer to question #): Explain any YES answers and/or, any additional. recommendatmns,or any_;other cornments';1- l
Use.drawrngs of facility to better explainn situations ;(use 'additional pages as necessary).
Reviewer/Inspector Name-
Reviewer/Inspector Signature:
Page 3 of 3
Phone: qlv__ (33-3300
Date: 1 f 13 1 Z
21412011

w `Division of Water Quality
Faciiltty,Number ®Division of Soit and Water Conservation
"�� � � *Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review p Structure Evaluation p Technical Assistance
Reason for Visit: 0 Routine o Complaint o Follow-up o Referral o Emergency o Other o Denied Access
Date of Visit: fl Arrival Time: ,00 Departure Time: rLt7 County:
c
Farm Name ��''^^I4t►� Owner Email:
QOwner Name: Evs_, Phone:
Mailing Address:
Physical Address:
Facility Contact:
`ns Title:
Il
Onsite Representative:
Certified Operator: 0
Phone:
Integrator: MaAp
Certification Number: 8
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Region: FPO
Swine
Design Current
Capacity Pop.
Wet Poultry
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity op.
Wean to Finish
I 11-ayer
I INon-Layer
I
Dairy Cow
Dairy Calf
Dairy Heifer
Wean to Feeder
Feeder to Finish
Q7
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
ether
Other
^
D , Poult .
ILayers
Non -Layers
Pullets
Turkey Poults
Other
Design
C_a aci
Current
P,o ,
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharses 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 No [] NA ❑ NE
❑ Yes ❑ No
[:]Yes ❑ No
` 3NA ❑NE
l NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No [9 NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: 9 - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
1p No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
[:]Yes
❑ No
1P NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
rp 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
Qg No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[�,No
7�
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
]p 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 EP No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN 7 10% or I0 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind D,riftft r❑ Application Outside of Approved Area
12. Crop Type(s): L.C.1'.C7-w &—ml
13. Soil TYpe(s): _L-i/� I Le— _ _
L&-(-VL
« I
14. Do the receiving crops differ from those designated in the CAWMP?
C] Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
tfm No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
fpNo
❑ 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
1P No
[DNA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
D NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available'? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box_
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit'_ ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ 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 provide documentation of an actively certified operator in charge? ❑ Yes T No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes IV No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes EP No ❑ NA ❑ NE
and report mortality rates that were higher than normal? TT
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately. 1P
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes T No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes T No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes rp No ❑ NA ❑ NE
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
: ql ! ✓ � ~ -
2/4/Z01

r
Type of Visit compliance Inspection O Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit 0-F outine 0 Complaint Q Follow up O Referral Q Emergency O Other ❑ Denied Access
Date of Visit: — % 10 Arrival Time: ' O Departure Time: ® County:` Region:`
Farm Name: .SQL4J ins Owner Email:
Owner Name: F' a_rN_S _ _77A c Phone:
Mailing Address:
Physical Address:
Facility Contact: /4 ���v _ Title: Phone No:
Onsite Representative: li-77k; ,1 S Integrator: /A Le 4
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 e = 10" Longitude: = ° = = "
Design Current
Design Current Design Current
Swine Capacity Population
Wet Poultry
Capacity Population Cattle Capacity Population
❑ Wean to Finish
10 Layer 1
❑ Dairy Cow
© Wean to Feeder
10 Non -Layer 1 11
❑ Dairy Calf
gL Feeder to Finish o
ov
❑Dai Heifer
R.Farrow to Wean
pry Poultry
❑ Layers
❑Non -La Layers
El Pullets
❑ Turke s
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Da
El Beef Stocker
El Beef Feeder
ElBeef Brood Cowl
❑ Farrow to Finish
❑Gilts
❑ Boars
loll It
❑ Other
ID Turkev Poults
I IEJ Other INumber
of Structures:
Discharees & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a_ Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes R[No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
Rlo
❑ NA
❑ NE
❑ Yes
Sio
❑ NA
❑ NE
Page I of 3
12128104 Continued

Facility Number: Date of Inspection — L
t Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 95 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): j S
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
'A 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
k No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
,5No
❑ 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
WNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
ERNo
❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
RLNo
❑ 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)
Jr z ,
13.
Soil type(s) rh 1-fzee .- ! r'�
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
DLNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
r-"' No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
[K No
❑ NA
❑ NE
17_
Does the facility lack adequate acreage for land application?
❑ Yes
MNo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
5ZNo
❑ NA
❑ NE
-Comments refer to, uestron Explain anYE$answersand/or any recotnmendah,k
- _g � ty. explain (user ital pages as necessary)ns or anv other comments..`,
( q )• P y addrtto
F e.
Use drawrn+is offacttt to better a lain sttuahons x
Lao ic, a_7t-'�a a►----
Reviewer/Inspector Name r r ':: h ^'� ,4"_ Phone: !J -333 n
Reviewer/Inspector Signature: Date: /-- G :- i
Page 2 of 3 !'i«vs "nunueu

' Facility Number: ' — Date of Inspection f-16 -y
g
r Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes RNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E[ No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes RNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers 0 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
LgNo
[DNA
❑ 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
[gNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
K No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
KNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
KNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
allo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[A 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
[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
%LNo
❑ 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
C&No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
W No
❑ NA
❑ NE
Page 3 of 3 12128104

03/31/2010 13:38 9104232212
GALLBERRY CON
PAGE 01
Memo,
i
To: Fnetteville Regional Office, Division of Water Quality, AP
From Kathy Darker, C-W berry Consulting Services
Datw
RE: Lagoon status report
�#3 Pvies+ 41Y
Pleas be advised that the lagoon one _pry G 3 Farm, number
-3 that was reported "in the red" on A 2.-t,-10 (date) is now back
in. com fiance at a reading of
At 3 _ ;L3
--M-h-
px � �vnFardf
�&J� ReucJs
qia- a�f-ba9�

r
Coey ,pages -),3 moll
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Dented Access
Date of Visit: Arrival Time: Departure Time: County: Region:_
Farm Name: I S
�t rO, W 1r+ Owner Email:
Owner Name: mt P �71/M S 1_�z r_� - Phone:
Mailing Address:
Physical Address:
n
Facility Contact: , 47 L In Title: Phone No:
Onsite Representative: ��L1 KIDS Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [= n =' = « Longitude: = ° = I 0
Desigtt Current
Design Cuurrent` ` Design Current
Swine
Capacity Population
Wet Poultry
Capacity Eopulat�oei gattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
Wean to Feeder
9no
❑ Non -Layer
[] Dai Calf
Feeder to Finish
orm I Im
❑ Daint Heifer
Farrow to Wean
Dry Poultry
El Dry Cow
El Farrow to Feeder
='" `` [] Non-Dai
El Farrow to Finish
❑ La ers
❑ Beef Stocker
El Gilts
❑Non -La Non -Layers
❑Beef Feeder
" El Boars
El Pullets
❑ Beef Brood Co
❑ Turkeys
Other
❑ Other
❑ Turkey Poults
❑ Other
t
Number, of Structures:
-
�'� 1 %x=;'_'�'�
,.7 ,,�,s
-�ir'rr.'�=fir p *�
-.« _.,. ,;.
� .air• . � �^f�.-'„Y
Discharses & Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
IR 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
NJ 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?
Page 1 of 3
12128104
Continued

3
Facility Number:eq j Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 15� No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
19 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
S[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
1P 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
® No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
ERNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
[2kNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[__1 PAN ❑ PAN > 10% or ] 0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drifl ElApplication Outside of Area
12. Crop type(s) Lvnri 4-hi*,n _ Ce—Sx `-/+u'n -S 1Qq,_ ' &4A%n da aWIP H; I
` SCo Q1
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
allo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
EYNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
determination?[:] yes
RNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
SNo
❑ 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 explain situations. (use additional pages as necessary):
Reviewer/inspector Name S' �/� Phone:
Reviewer/Inspector Signature: Date:
12128/ 4 Continued

Facility Number: p q pp Date of Inspection �lr!
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes RNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ®'No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes S"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
No
9NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
ERNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
U No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
RNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
I No
19NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
E[No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[!TNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
E[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?
❑ Yes
© No
❑ NA
❑ NE
AdditionalComini=iuts and/or Drawutgs t � r t'z i +a s" " �"s+f �' 4 1C
15t1ti►-o ���� AT
haoC ` i� ifit ZiAcldex of ov$, Iwo hlQybedve-+tp
ps5fble his -icy of F&A Wer , S+;vlV� 00 L470-i KLeI a 10 OX
rem
Co(n 9�Iaje was o�d iS_ked 14en
Na)e. - iNo— cha15e- e 0 1 C -061m
Page 3 of 3 12128104

4
Facility No. Cq-n Farm Name
Permit --"*' COC
F-7-,3N
pvi /V# =Gold+ S' SOW Date sOI�C�-p� � , bije 1j
'
tf�si a� �7iA-OQOj
OIC r N D S (Ry�inbreaker PLAT Ann}�al Cert
FB Drops
Lagoon
1
2
3
4
5
6
7
Spillway
Design freeboard
Observed freeboard (in)
Sludge Survey Date
Sludge Depth ft & %
_Liquid Trl. Zone (ft)
Z1 1 r �Jt , 1 . &
Calibration Date
D - .
IPA
.G��------
�w•$qo
✓
Soil Test Date LS-
Wettable Acres
Weather Codes
pH Fields
WUP /
Transfer Sheets
Lime Needed
Weekly Freeboard
GE
Lime Applied [} Q, w/k
Rainfall >1"
r incinerator
55a
Cu Znb� �tQo�
1 in Inspections
lityRecords
Needs P
J20 min Inspections
I kk
Crop Yield
Waste Analysis Date
L4z/
- 60 Da
+ 60 Da
11,-t
N Amt (Ib11000 Gal)
V&
I
i.,kr
I.t
•.;pp
,
1 2
�•
1 ,�
■�i7f1:1�
Eric I- �Ars.
■i'�����■-
�: � .`
�
I� � Y�lli�■�IM
M,
=10005,11,07=3
Verify PHONE NUMBERS and affiliations
Date last WUP FROI)ICS-10{ A�t_ Hbb7Date last WUP at farm
FRO or Farm Records f�iffll [) -V f 6' -.'(�
Lagoon # j- � �, Wed moo-"
Top Dike /
Stop Pump 3irlo8
Start Pump
Approx. Conversion- Cu-1 3000= 108 lb/ac; Zn-I 300D= 213 lblac
°�f
AD . Hardware �f
s�f.�
6X I I ! . C

0 I HS -)-vt /0b/09 - --- -1
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 0 Emergency Q Other ❑ Denied Access
Date of Visit: Q Arrival Time: r3OtW Departure Time: k)j',D0 ptf I County:y1 fd-er? Region:
Farm Name: S IZU Owner Email:
Owner Name: Phone:
Mailing Address: PO $Dx I13 _ ova l I0r a$y
Physical Address:
Facility Contact: 1`iTitle: Phone No:
Onsite Representative: Integrator:
Certified Operator: M/1?cl I Operator Certification Number: 7
Back-up Operator: -kBnda Back-up Certification Number: AhA 11afl?
Location of Farm:
Latitude: = = =" Longitude: 0 ° [= g Q u
jjjffDestgn
Current
Design Current
`' Design CurrenS.
11,
ap ty
Pnpulatto1.n,
Wet Poultry Capacity Populahoa t ca, -. Capacity Population
❑ La er
El Dairy Cow
❑ Non -Layer
El Dairy Calf
Dry Poultry
❑ La ers
ElDai Heifer
❑ D Cow
El Non -Dairy
El Beef Stocker
❑ Non -La ers
❑ Beef Feeder
l
I
El Pullets
❑ Turkeys
El Beef Brood Co
Other
..
F4 ❑Turke Pouets
❑ Other
Other
Number of Structures:
❑Wean to Finish
Wean to Feeder
OD
4iO4
Feeder to Finish
��D
OD'�
Farrow to Wean
Q
El Farrow to Feeder
R
❑Farrow to Finish
" ❑Gilts
❑ Boars
Discharges &Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at; El Structure El Application Field El Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes R9Vo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
[RNo
❑ NA
❑ NE
❑Yes
&No
❑ NA
❑ NE
Page 1 of 3 I2/28/04 Continued

Facility Number: --003 Date of Inspection o d�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [KNo ❑ NA ❑ NE
a. If yes, is waste level into the structural Freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure S Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): l Qr S
Observed Freeboard (in):
S. 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
MNo ❑ 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? 8 Yes
*No ❑ 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
C,No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
Wo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
I�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 ofWind Drift ❑ Application Outside of Area
12. Crop type(s) - 'h 1
nLd 44
P) , 11,Yi'f JI 10�}p -, 5G OS
13. Soil type(s) �fT1`
y Sf Lynn }Tone, s %-Tp1 hn a_ i*- SL — -
14. Do the receiving crops dl`ffer from those designated in the CAWMP?
❑ Yes
RNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
PRyes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
CRTfo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
IN No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
5�No
❑ NA
❑ NE
Reviewer/Inspector Name r"S CR ✓U Phone: 1 14 33— 209k3M
Reviewer/Inspector Signature: Date: G 1 aQD
Page 2 of 3 12/28/04 Continued

I
Facility Number: Date of Inspection ORE]
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [RNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes EBNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 5�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 ONo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ® NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
t'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
®TTo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
RNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ERNo
❑ 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
®"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
�YNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
ONo
❑ NA
❑ NE
�Hoodj 0 h" �X C°1l
One 0n n ed S" herese44 ar s 1
Pr P �,-
IT, S t Aelh (!e cof(o<<
� `� Pd� OUP n se>r1o�J net � ��
C� OCk re(0A �'A _
Page 3 of 3 12128104

I
I
r
�1
7'
®
o
r-
1

Division of Water Quality &Ms
IFacility Number b3� 0 Division of Soil and Water Conservation
O Other Agency
4',Z5
IType of Visit (A Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit M Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: �k I Arrival Time: Departure Time: fl ' County:
Farm Name:y►, n�w Owner Email:
Owner Name: ir4fYyt, Phone:
Mailing Address:
Physical Address:
--T I
F'arility rantnet. � ..] ` 1lr Title- Fn V sif- phnne Nn-
Region:
Onsite Representative: s-�v Integra
Certified Operator: V�.� —�1 l.2 or Mqr,%, Operator Certification Number:
Back-up Operator: SS-?—L Back-up Certification Number:
Location of Farm: Latitude: = o = I 0 11 Longitude: = e = I = u
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
7 ❑ Non -La et
❑ Wean to Finish
Wean to Feeder
l?
Feeder to Finish
1 o Q 0
OWv
arrow to Wean
3 j<
3�)
ElFarrow to Feeder
ElFarrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
ElNon-Layers
ElPullets
❑ Turke s
❑ Turkey Pouets
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ElStructure ❑ Application Field ElOther
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Curreni
Cattle Capacity Population.:,
❑ Dairy Cow
El Dairy Calf
El Dairy Heifei
El Dry Cow
ElNon-Dairy
ElBeef Stocker
ElBeef Feeder
ElBeef Brood Cowl
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 Z No ❑ NA ❑ NE
❑ Yes
❑ No
FM NA
❑ NE
❑ Yes
❑ No A NA
❑ NE
❑ Yes
[--]No
IN NA
❑ NE
❑ Yes
[k No
❑ NA
❑ NE
❑ Yes
❑ No
XNA
❑ NE
CA
12128104 Continued

FacilityiVumber -03-7 1Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate'?
❑ Yes ANo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes XNo
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): Z�
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No
17
ElNA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes ;4 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 JQ 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 Aoolication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ZNo ❑ NA ❑ NE
maintenance/improvement? f
It. 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 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)
C
14. Do the receiving crops differ from those designated in thL9CAWMP? ❑ Yes
I,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
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
RINo
❑ NA
❑ NE
❑ Yes
J)g No
❑ NA
❑ NE
Comments (refer to question ft 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 IC) Phone:
Reviewer/Inspector Signature: Date: oil 1p %
12128104 Continued

Facility Number: -401-11 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes IP No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes �LNo ElNA ❑ NE
the appropirate box.
El ❑Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Additional Comments and/or Drawings:
❑ Yes
EINo
❑ NA
❑ NE
❑ Yes
❑ No
P NA
❑ NE
❑ Yes
�KNo
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
�+No
❑ NA
❑ NE
❑ Yes
❑ No
03 NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
XNo
!�`No
El NA
❑ NE
El Yes
❑ NA
❑ NE
❑ Yes D?No ❑ NA ❑ NE
❑ Yes OeNo ❑ NA ❑ NE
❑ Yes R No ❑ NA ❑ NE
12128104

Facilit} No.
farm Name
Owner
Operator
Back-up
COC
C==� Time In
Time Out Date It to v
Integrator
Site Rep
No. ��9cbt
No.
NPDES
Design
Current
Design
Current
can — Fee
On
Farrow — Feed
Wean — Finish
Farrow — Finish
—
[ D00
Gilts / Boars
F — can
Others
FREEBOARD: Design
Sludge Survey
Crop Yield
Rain Gauge
Soil Test
Wettable Acres
Weekly Freeboard `-
Daily Rainfall ti
Spray/Freeboard Drop
Weather Codes
120 min Inspections
Waste Analysis:
Date
Nitrogen (N)
Observed
Calibration/GPM
Waste Transfers
Rain Breaker SIT
PLAT -4r'
1-in Inspections
Date Nitrogen (N)
2 ►.
-I1
Pull/Field
Soil
Crop
Pan
Window
nn V�hCoy
Y\ s
d
rnar - u,
Vlr C r00.Z
1 i
f • 1- S DY is Yam-
V
S r- C'
"]
�. r T u ►.►
Cam.

IType of Visit Compliance Inspection 0 operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 4 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: � Departure Time: County:
Farm Name:VA- l T-CL Owner Email:
Owner Name: n m 1 I(�C Phone: _
Mailing Address:
Physical Address:
Region:
Facility Contact: WIT U h� Title: V I r 1 Qrlr' Phone No:
Onsite Representative: .. .- t Y1 e§21 + Integrator:
' 1 O
Certified Operata S Operator Certification Number: f l�
Back-up Operator: 4n-d99 - 0lt�� Back-up Certification Number: [6 1
Location of Farm: Latitude: 0 0 ='
= Longitude: = ° = 0 "
Design "- Current
Design Current
Design Current
Swine
Capacity& Popes lation
Wet Poultry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑Dai Cow
ea.n to Feeder
00
i?
❑ Non -Layer
❑Dai Calf
ceder to Finish
p � Ud V
❑Dai Heifer
rrow to Wean
00
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑ Non -La ers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cowl
Other,
µ
❑ Turkeys
❑Turkey Poults
❑ Other
El Other
Numiter of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes tpNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes ❑ No
�DNA
❑ 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)?
--r-
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes ❑ No
9 NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes AtNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes MNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Faglity Number Date of Inspection I 0
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 2 Structure 3 Structure 4
Identifier I
Spillway?:
Designed Freeboard (in): Zn
Observed Freeboard (in): Z
❑ Yes lzvo ❑ NA ❑ NE
❑ Yes ❑ No A ElNE
Structure 5 /////Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
PoNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
Wo
❑ 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
NINo
ElNA ElNE
(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
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
�No
❑ NA [INE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
r1No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
II'__
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP'j
❑ Yes
Wo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ESNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
ja 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
RNo
❑ NA
❑ NE
Comments (refer to'question #): Explain any YES,answers andlor any recommendations or.ady<othergeomments�
Use drawings of facility to better explain situations. (use additional pages as necessary):
. iry
�.
AL
'-7•--Vc�.� ax IO s
CYO
N4.&s the cL_ Lnz -ems warted
Reviewer/Inspector Name I Phone: U 4J
Reviewer/Inspector Signature: Date:I SEE
rage -1 of -i I-WIVU4 uonnnuea

)Facility Number: —O3 Date of inspection UiLIZJ
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes M No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 1$jNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections Xmonthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes XNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ANo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
XNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
;To
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
)kNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA '$NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ZNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ZNo
❑ 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
RVo
ElNA
❑ 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
ONo
❑ 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
P9No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
o
❑ NA
❑ NE
Additional Comments andlor Drawings: `
A,
d 4 nj I ,n d I c��e' 0'.V m Q,r,- h i o r i" 2�n ► nS�ec�nS
�t A becn 4me _ `rh: � 11aS eh ' UJ`
l'1'� SS n -�' i'nbr � � Yl
r
?_ � fs .
Page 3 of 3 12128104

F;eciKy No. � l Time In Time Out ate
Faun Name Integrator fky1�6
Owner o n OS f Vn Site Re
Operator No. !
Back-up No. [
COC Circle: General
Desi n
Current
Design
Current
Wean - Feed
Farrow - Feed
Wean - Finish
Farrow - Finish
Feed - Finish
Oo
Gilts / Boars
Farrow -Wean
SCAR
Others
FREEBOARD: Design . Observed �l
Sludge Survey _ I�b ` 7 Calibration/GPM I
Crop Yield
Rain Gauge
Soil Test
Waste Transfers
Rain Breaker
PLAT Wettable Acres
Weekly Freeboard j� Daily Rainfall &—.,/_
Spray/Freeboard Drop
Weather Codes 120 min Inspections
Waste Analysis:
Date Nitrogen (N)
10
(0I1g l $
�= nspec#ions /� AJZ
Date Nitrogen (N)
�S -a
1 ZZ?o
Pull/Field
Soil
Crop
Pan
Window
y Y.\
9qu
1q0
1
Q
�-Sie
-
a y
Vh
-
o

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: ,'ZO County: Region:
Farm Name: xie—&Raq _ixz Owner Email:
Owner Name: �1901�cLd/�"
Mailing Address:
Phone:
Physical Address:
Facility Contact: CAfD eWw ve A Title: �"I`44 • .5�I Phone No:
Onsite Representative: Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: E=] e E=] ' =] " Longitude: 0 o = t =66
Swine
❑ an to Finish
❑ an to Feeder
Design Current
Capacity Population
�;-. Design Current
Wet Poultry C►apacity Population
❑ La er
❑Non -La er
Design C*urrent
Cattle Capacity Population
❑Dai Cow
❑Dai Calf
❑ Feeder to Finish
❑ Dairy Heifer
Farrow to Wean
OOD°
-
Dry P.oulfry.,
❑ Dry Cow
[.� Farrow to Feeder.
`' `'"""'"
❑ Non-Dai
El Farrow to Finish
❑ La ers
❑Beef Stocker
❑ Gilts
❑Non -La ers
❑Beef Feeder
❑ Boars
Pullets
❑Beef Brood Coyl
6❑
❑ Turkeys
Other
❑ Other
Turkey Poults
❑Other
Numberof Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes P(No ❑ NA ❑ NE
❑ Yes
�9No
❑ NA
❑ NE
❑ Yes
[f No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
CZNo
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
Eallo
❑ NA
❑ NE
72128104 Continued

a
I
Facility Number: 4 Q — Date of Inspection _D$—
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes � No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 00 No ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists [I Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [P No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 ° Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [6 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes (� No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes �1No ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes [;9 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[RNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
(�
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[$ No
❑ NA
[I 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
V] 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
P
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[RNo
❑ NA
❑ NE
Additionai`.Comments and/or Drawings
Page 3 of 3 12128104

I
Facility Number: j917— a4d Date of Inspection g O8'O
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 IN No ❑ NA ❑ NE
Structurev Structure Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
r
Observed Freeboard (in): S' S/_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes N 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 Fo ❑ 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 [PNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes �Na El 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 oNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 1KNo ❑ 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 l 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Wind/ow El Evidence of Wind Drift El Application Outside of Area
12. Crop type(s) RetwaZG. 4o✓�/ . S13 /,/1,[,,, t Silr�6�t/�o J.✓/d(/Gi's �
13. Soil type(s) l Gx4
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
M No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
[I 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
(rlo
❑ NA
Cl NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
KNo
❑ NA
❑ NE
Comments (refer to ,question #): Explain any YES:,answers and/or any recommenda#ions or any other<commen#s
13se. drawings of facility to better explain situations. (use additional pug as necessary):
Reviewer/Inspector Name �` j �?�[ K e✓ Phone:
Reviewer/I n Spector Signature: Date: ZtTC
Page 2 of 3 12128104 Continued

r
Type of Visit 9;Co—mpliance 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: Arrival Time: i7t% Departure "Time: ,�C7b County: « Region: ER!
Farm Name: uv Jr w✓ Owner Email:
Owner Name r �Q✓Yr9� Phone:
Mailing Address: P1). 1-3VX
Physical Address: NC- , 124 ;z
Facility Contact: V Ldi7 / O/L _ Title: Phone No:
Onsite Representative: Integrator: /W Lc�/A/,Vw h�
Certified Operator: aW:n4c U4S r_- /, Operator Certification Number: 1AZ
Back-up Operator:
Location of Farm:
Swine
Back-up Certification Number:
Latitude: = o = d = Longitude: = o ❑ 4 0 [1
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
i
❑ Non -La et
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Q
❑ Farrow to Wean
rV a
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity' Population,
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
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?
1= .
I I.
❑ Yes Z.No ❑ NA ❑ NE
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
EINo
❑ NA
❑ NE
❑ Yes
%No
❑ NA
❑ NE
❑ Yes
®No
❑ NA
❑ NE
❑ Yes
[2 No
❑ NA
❑ NE
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
R No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
®No
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Q!
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
P 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
9 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?
W Yes
❑ No
❑ NA ❑ NE
S. 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)
4. 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
® No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
J4 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. CroPtYPe(s) �os' n ,SiLfWr /h'l�d��ra�F2_L,,�itz�nJr"0�L`/�'�'
/ f
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 impro n� n
H ti��
'DDu� t 5
1K Yes
El No
El NA [I NE
16. Did the facility fail to secure and/or operate per the irrigation de
U Yes
®, No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? Ca, j ej ! 1 ` q— 05
❑ Yes
'KNo
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipmen 19i -PC YL�g b ,�
❑ Yes
5Q No
❑ NA ❑ NE
Comments (refer to question #} Egpiaut�any4YES,answers}andoo i 7��C 5'-
er. comments.
Use drawings of facility to beaat�tFeF`r e s t iatlons (ase addtttoa
,� P o ke.ti �+.� C `�� /�; �z' �",� � tfvv,5� �� rt 5 i d� �a�gr
f��l ��ar7•-4
/��'��f
%dP F; X S�¢}�. Ga G1 "7 e- 4t)"Z
09&1-
,�e, �d�
IUD- Jan �Dv�t•
pi U) ve ID141 o
Reviewer/Ins ector Name f:. ; t` * �` `
P �� ('' � �; � Phone:
Reviewer/Inspector Signature: Date:
12128104
Continued

Facility Number: 02 —�_32 Date of inspectionIs
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes RNo ❑ 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 El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ® Yes ❑ No ❑ NA ❑ NE
C9 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
C9No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
'JELNo
❑ 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
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
(K No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
1,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
RNo
❑ 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
[ffNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
29 No
❑ NA
❑ NE
(�J►1 A'41 ��/dF?C� 1 /L GlC j � iU`l�! ►'t_ �L f�L�s� 1�lJI" �_'%���e�i ill�
12128104

Type of Visit ® 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
Date of Visit: �/ 03 Tune: � K'w• SO Pr+
Facility Number _ 3 `]
,_ O Not Operational O Below Threshold
® Permitted ® Certified © Conditionally Certified p Registered Date -Last Operated or Above Threshold:
Farm Name: Sir.-�„�_ �+� d w �.�. ►^ m County: dlae&_--------�--
Owner Name: Y►'l r i3 r aw fa _ _ Phone No:
Mailing Address: _ �• V • S r Nose fi. % f LY . C . a8�ly
s
Facility Contact: % r ea r r _ .- --- Title:. ,• `. Yn Q h r Phone No:
Onsite Representative: /V Zo4 Integrator. _�— {.4 r �� o c �J _ , _ • ,
Certified Operator. ,• _.mil p1,j j . C a i e.c _ S r:. _ _ • Operator Certification Number: 3 5 ? P
Location of Farm:
r-1
❑ Swine ❑ Poultry ❑ Cattle ❑ Norse Latitude 0& 4 44 Longitude 00 Ou
Disebaraes & Stream Impa m
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 galimin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
12112103 Continued

Facility,1Qumber: F — .37 1 Date of bupectiion
5. Are there any immediate threats to the integrity of any of the structures observed? Cie/ trees, severe erosion,
❑ yes
❑ No
seepage, etc_)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ yes
❑ No
closure plan? an 4-6 was answered (if any of questions 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&aprovement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
❑ No
elevation markings?
Waste Application
10. Are there any buffers that need maintenanoerunprovement?
❑ Yes
❑ No
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
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
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge agar below ❑ yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? Yes ❑ No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑ No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ❑ No
Air Quality representative immediately.
Field Copy ❑ Final Notes
QN ////6,Q /av r, `j7vG� _C.e- k, G,`rV_ =/
! ►'N d 1�C I y !1 ,' L`1 U Q�/�N/7 � �'GC///C� r f C�J� eQ �(� Q h 1 s+� ca i1 W C: �' C �d s.t +. dG �C7 i/7 � i 1`1 •f' %�C
�4dpPjJ, L d�hCcK <`T , may "t i�IY�bJCL+� LJr li] 4e_ qPT hY, R�jC,%0_ +[f� QS
C
tctlLi'vc-A 7 re,`�"vnt� (( o�� /t%D3i4>q o'/7,'oI:) < -r-- u,. ,Q- -4 -
Q r 1 t.. c) I -c �J r: r c 5 l` ,1( -1r ,. - a c t- - � 0 ca
r�-4�.Yr.caQ c,,a;.. ch� 4�� -fk,n- Pigs wGFc sell �►�Yet. `!
J C��{a�� t0�,, innH� f G�C]rG sG.�I tUc Carcr� Carr c�r.a� �►^c►.3 C 'A
A -co t�+4•.:r+ ��n,a V��lt�
A', dkT {'k^ r cl Ca s Cl .+� o t S �X 4 oz b c c ►� + c W� O ,! tc+i .
Reviewer/Insper-tor Name
Reviewer/inspector Signature:
Date:
Y2/I2N3
condnued

Facility Number Date of �vwt: �% �02 Tune: I�
0 Not 2perational Q Below Threshold
Permitted to Certified © Conditionally Cerdfied 13 Registered Date, Last Operated or Above Threshold:
Farm Name: ...� x� �� s ak:� „ . _. Es r �_ County: „ '64 oi�th
Owner Name: . _ .. _ _.. „• _ _ . .. Phone No:
Mailing Address:
Facility Contact: Title: Phone No:
Onsite Representative: r Integrator. rn t^ ` r wO
Certified Operator: L11 -i C Operator Certification Number: # o? 3S7v
Location of Farm:
l i
dSwine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• �� Du
Swine C-A—"2rity `Pw6n&tiAi
Wean to Feeder
4100
Feeder to Finish
/ 00 O
Farrow to Wean
So
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Ni��er of Lagooffi ,�,� ,°°
Current, - tiCuhvn!
PopulatiiotR, <Cattde tq'4Pbp�steon
Discharges & Streamimpacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance than -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)
❑ Yes M No
❑ Yes [:]No
❑ Yes ❑ No
N//, 14
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes E�No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes qNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 6 No
Structure 1 Structure 2 Structure 3 Structure 4 Structure S Structure 6
Identifier:
Freeboard (inches): 3 0 =,
121121U3 Continued

Facility Number: — 3 7
Date of Inspection �v
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement?
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 Aeration
10. Are there any buffers that need maintenancefimprovement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type 1 o.C.v 60 . 6e r.� s. �� a a •
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?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
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
Air Quality representative immediately.
❑ Yes 0 No
❑ Yes It No
M Yes ❑ No
❑ Yes [P No
❑ Yes R No
❑ Yes Qdi No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ❑INo
❑ Yes dNo
❑ Yes b No
❑ Yes dNo
❑ Yes 0 No
❑ Yes It No
Eg Yes ❑ No
❑ Yes 1:4 No
❑ Yes [5a No
Field Covv ❑ Final Notes
1 t W o n•+ a 1 j c ad2 ip i " { +. a c o u , r G r+._ � t � +... � �s-�.: �. � L(
?� La-1GbCi Oar{ S G�� ►nt d� +' 62 go�OtvCSsC
RO�C�k la C S ` C��2Sti d� 1i�lrlCto `Q100 1J�11^.� �!7 SG�ro�iaQ G
wLGaa�. rs O ��^pl yGSS ar� ���4 �uYarb�J i Kq �e��,� 1t cj. �.� pCs'S�CioCtS
a-c u�c� �oL�ow cx 11 aVn Q�IIVGcA-` aiJ 5
Reviewer/hupector Name 't
Reviewer/Inspector Signature:
Date: l//0.7 / 0
12112/03 Continued

` I Facility Number: — 3 7 1 Date of Inspection 1 c�
Required 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?
(iel WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
M Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
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/inspection 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 Fatalities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
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
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes 5] No
❑ Yes M No
EM Yes ❑ No
❑ Yes ( No
❑ Yes ® No
❑ Yes [P No
❑ Yes No
Ip Yes ❑ No
P Yes ❑ No
[� Yes ❑ No
❑ Yes P No
❑ Yes P No
❑ Yes [R No
❑ Yes ® No
❑ Yes M No
1 ❑ No violations or deficiencies were noted during this visit. You wM receive no further correspondence about this visit. 1
a3 PIi-e- l�sue- o -i-� ,- m`,11--�- -mop. W V P Zr\c��GtS�s
e..--:vc o '� 01PtV''LA�'\nr` allow .`p V—towc
A-e 6e.
19 k aV c �v p , c�-� o r�� + d ►ram to b t o q
0 — "%- C] N t C. P�� 1� Qk \ G +\ (�,) 1 ►.. �o W s.
ai�f .SeC `#c C-1�J6ve-- ,
rio -Nr \h V.r V.—
r "—'f-4>rcS23 PIZc�� ScGu G Gt CGp� �Oit �arti.,
12/12103

State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. Andy Adams
Murphy Family Farms
P.O. Box 759
Rose I ll, NC 29459
V�
E3EE:HNF:Z
DIVISION OF WATER QUALITY
June 5, 1997
SUBJECT: NOTICE OF DEFICIENCY
Murphy Family Farms
Blades County Company Farms
Blades County
On May 28, 1997, June 1, 1997, and June 2, 1997, staff from the Fayetteville Regional Office
of the Division of Water Quality inspected the following company swine facilities: Edge Sow
Farm, Singletary Fame, Squires Farm, Edge Farm, Evergreen Farm, Fox Dire Farms, 242 Sow
Farm, Bladen Sow Farm, Cain Complex, and French's Creek Farms. It was observed that the
record keeping of the waste applications was either inaccurate or incomplete due to an out of
date waste analysis sample. The most recent sample. collection date at the time of the inspections
was January 3, 1997.
Please be aware that waste analysis samples must be collected within 60 days either before or
after waste application to comply with the certified animal waste management plan and the
General Permit.
Nothing in this letter should be taken as absolving this facility of the responsNi ity and liability
of any violations that have or may result from these deficiencies.
Wachovia Building, Suite 714, Fayetteville FAX 911-d86-0707
North Carolina 28301-5043 N4fC An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 5096 recycled/10% post -consumer paper

If you have any questions concerning this matter, please call Bob Heath or John Hasty at (91 U)
486-1541.
Sincerely,
,
Robert F. Heath
Environmental Specialist
Operations Branch
Central Files
Audrey Oxendine - FRO DSW
Sam Warren - Bladen Co. NRCS
Dr. Garth Boyd - Murphy Family Farms