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260004_INSPECTIONS_20171231
NORTH CAROLINA Department of Environmental Qual j iI grj"3 °}`l '1101�11tf ;Srli53l.ICI�EEI"I7 I IF ' I';I# �II` I I r I:Nr' IIt {il' 3 i I I of'W,itew Resources I Irll��El@ICEE4�.::+11 I 11 tl! . j. { r i�l ! 'F e ! IFaci ty,Number; li il,r kr OfDlr+lslon ofSbilland�Water,Consery oil 1 �li t{€'til .. dill I SI I.I ''IIYI'y..� fJ'1� 1 `.II i. xf7'L: "i3 i I!k �; ,i. It, !i ' �' Il II I ll;. lII I: I 1 ther Ageq n r�..��rh�.l,f�'1uIIINIfiI�I. ',!It .�ll��_..I o,14�� - Type of Visit: (Comp iance inspection O Operation Review O Structure Evaluation O Technical Assistance Reason for Visit: outine O Complaint O Follow-u�O Referral O Emergency O Other O Denied Access - IP.... LIII Date of Visit: ISITUYtt I Arrival Time: Departure Time: Con nty:,C.a4'6_X/Region:FCW � Farm Name: OK c `+ 60e« tivf7 Owner Email: Owner Name: It Phone: r Mailing Address: Physical Address: } 7� Facility Contact: ��1�c Jt/e-5 r Title: Phone: Onsite Representative: < < Integrator: i K f Certified Operator: Certification Number: 77 Back-up Operator: Location of Farm: Certification Number: Latitude: Longitude: r I { ll? ` I '� ` li, ! r 4i 1,- y I P ;IE h ''�I' �i l.'��rl<!i' 1 rl�l I '°I''i,L !i Illrkk - d o 111. l�tl .. II 1r.. ! __ f 1 1 .,k ... .. It'I{`pj !II II rIIr�IIIF[ I, 1t EIAI�'�''iriyl';Desi n`I Ca" nt{1'., 1 I,. i;i.l: 1 q �'.I � ;,�, Dcsl( n Current) I. i, ;� Design i Current 48 ll � f`p , , y k lel i. ul� ill l l,l�,a�,u Il lk' I.: Ifj' 1 I� V,il'. I Il ��l l r. "Ill I I I „ I, I , i i t i,h r +, , -I 1 3 ..I I I b 1 ..E Winelll:' II ' ICa aci �IIPo I� IS11! I,IWet�Poult p',' p ry 1 Capacity I Ik Pap Cattle Capacity Pop E ? ! ;LISIEI:IIIII d I'„ , 1� I'!�� I�'jp!.rl. f'"h'nJ,..'1 JI, ��'.E,I �I N . 1 1 . { 6a' •', Wean to Finish • La er Wean to Feeder �. (� 0- �11,;i� I Non a er Feeder to Finish ' Farrow to Wean III I E 17i1� 1 l� I 1I I I I ail �! i F I l l I al Il ' „ J� i I �i �I I 1"ii?esi n Current Il+,I� i►; � I al lr �' g t d Farrow to Feeder ,� _ 1 i �'I h;.kr,.D ,;Nult �;di;!%iCa acl r,� (Po l,l Farrow to Finish ' "` Layers it Gilts N'� ��i Non -Layers Boars Pullets Dairy Cow Daia Calf Dairy Heifer Cow —Dry Non -Dairy Beef Stocker Beef Feeder Beef Brood Cow ": f IY d a; rPl +rl x! f r r F I h V I g Turke S I .1i' a I Othew,jti l J ..Jli�l�,f Aa . Rll I 411�I ��� . rllpj ; Turkeyl3oultS , Other Other,)-. Discharges and Stream Impacts 1. is any discharge observed from any part of the operation? ❑ Yes Eh"lqo ❑ NA ❑ NE Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? [:]Yes []"N—o ❑ NA [] NE b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes 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 dNo ❑ NA ❑ NE 2. Is there evidence of a past discharge from any part of the operation? ❑ Yes E!f No ❑ NA ❑ NE 3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes F:�No ❑ NA ❑ NE of the State other than from a discharge? Page 1 of 3 21412015 Continued Facility Number: 2 Date of Inspection: Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ®-No---o NA ❑ NE a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No �-[-] NE Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): '3`D� 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes E3 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 [D-Na ❑ 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 B-K—o ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes Vo ❑ 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 ARylication 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ' Q'1So ❑ NA ❑ NE maintenance or improvement? I l . Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes E;P.0 ❑ 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): C'(4'.-[ C 4 13. Soil Type(s): H V LS r'r & D 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [3'1lo ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes [3 o ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable [] Yes [Zj>o ❑ NA ❑ NE acres determination? 17. Does the facility lack adequate acreage for land application? ❑ Yes Q o ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes �o ❑ NA ❑ NE Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Eg-M ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E3-lq0 ❑ 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 F3-110 ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis [] Waste Transfers ❑ Weather Code ❑ Rainfall _]Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑'No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Ej No ❑ NA ❑ NE Page 2 of 3 21412015 Continued Facility Number: - Date of Ins ection: 7 ' d 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ©o ❑ NA ❑ NE 25. !� the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑< ❑ 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 E� o ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No DNA ❑ NE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes E' o ❑ 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 ETNo ❑ 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 EfNo ❑ 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 ff 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 E 'No ❑ NA ❑ NE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? [] Yes 7�rrNo ❑ NA ❑ NE 34. Does the facility require a follow-up visit by the same agency? ❑ Yes JZ' ']`No ❑ NA ❑ NE nr, u•;i `., w, µH. ,�.: -. f .�+:; Jl_.. and/or -any additional.,recommenda,tionsor.any other.commcntg '..,. omments� refer to uestinn # : Ex Isin an YES answers Uscdrayvin s of,;facillty"an better„expla insitiiatians'{use,ad litionaE�paRes us necessary): ,,. l,p--IF #z 6 - �. 3 19 - 3 6 _ 3 s70 Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of 3 Phone: {[0`� �3 Date: 21412015 Elms I F=epL t2 go .,, ivision of Water Resources Facility Number - O Division of Soil and Water Conservation ? O Other Agency Type of Visit: Cam Hance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance Reason for Visit: . 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: Arrival Time: Departure Time: County4 .-e-y6 Region: Farm Name: S OfC%0_CA't '` V Owner Email: Owner Name: t { Phone: Mailing Address: Physical Address: Facility Contact: K'-ev', { Title: Onsite Representative: Certified Operator: Ii Back-up Operator: Location of Farm: Swine Wean to Finish Wean to Feeder Feeder to Finish Farrow to Wean Farrow to Feeder Farrow to Finish Gilts Boars Other Other Latitude: Phone: Integrator: Pr ec Certification Number: 77 Certification Number: Design Current Design Current Capacity Pop. Wet Poultry Capacity Pop. La er I I :::::] Ca Non -Layer pry rouitry Layers Non -Layers Pullets Turkeys Turkey Poults Other Design Current Discharees 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? h. 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: Design Current Cattle Capacity Pop. Dairy Cow Dairy Calf Dairy Heifer Dry Cow Non -Dairy Beef Stocker Beef Feeder Beef Brood Cow ❑ Yes ❑ NA ❑ NE ❑ Yes ❑ No [3-q'A ❑ NE ❑ Yes ❑ No C3 NA ❑ NE ❑ Yes ❑ No ❑ Yes []'No ❑ Yes ['No [3 N A ❑ N E ❑ NA ❑ NE ❑NA ❑NE Page 1 of 3 21412015 Continued Facili Number: - Date of Ins ection: n Waste Collection & 'Treatment 4' is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes Q-VIo ❑ NA ❑ NE a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No RNA ❑ 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 C2 ❑ 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 E;Ko ❑ 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 CNNo ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes E!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 ETNo ❑ NA ❑ NE maintenance or improvement? Waste Ai mlication 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Q'No ❑ NA ❑ NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [ ❑ 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 Drift ❑ Application Outside of Approved Area 12. Crop Type(s): LJ efwt "4& �� 1 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ® No ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes E No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ZNo ❑ 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 2(No ❑ NA ❑ NE Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes eNo ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes EfNo ❑ 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 [!rNo ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall. Inspection s 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ❑ NE ❑ Weather Code ❑ Sludge Survey ❑ NA ❑ NE ❑ NA ❑ NE Page 2 of 3 21412015 Continued Facili Number: - Date of Ins ectio 24..Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes EE 1\ o je 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [.]moo the appropriate box(es) below. ❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels ❑ Non -compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: ❑ NA ❑ NE ❑ NA ❑ NE 26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes �o ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes RNo ❑ 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? 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? 34. Does the facility require a follow-up visit by the same agency? Reviewer/Inspector Name: ❑ Yes ONo] NA ❑ NE ❑ Yes ffNo ❑ NA ❑ NE ❑ Yes [T'No ❑ NA ❑ NE [—]Yes [fNo ❑ NA ❑ NE ❑ Yes [a'No ❑ Yes [�o ❑ Yes ❑No ❑NA ❑NE ❑NA ❑NE ❑NA ❑NE Phone: SE gK Reviewerllnspector Signature: Page 3 of 3 21412015 MI —Vision of Water Resources Fac1lity Number - 0 Division of Soil and Water Conservation 0 Other Agency 1. Type of Visit: Q<ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I Reason for Visit: Wgo'utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: Arrival Time: 1, Departure Time: County: Region:V Farm Name: ak riywts � � /L Owner Email: -+r Owner Name: Phone: Mailing Address: Physical Address: Facility Contact; ►(4 [ { 5 Title: Onsite Representative: I t Certified Operator: Back-up Operator: Location of Farm: Swine Wean to Finish Wean to Feeder Feeder to Finish Farrow to Wean Farrow to Feeder Farrow to Finish Gilts Boars Other Other it Latitude: Phone: Integrator: Net if Certification Number: Certification Number: Design Current Design Current Capacity Pop. Wet Poultry Capacity Pop. Layer Non -La er Foul Pullets Poults Design Current Discharees and Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (if yes, notify DWR) c. What is the estimated volume that reached waters of the State (gallons)? Longitude: Design Current Cattle Capacity Pop. Dairy Cow Daig Calf Dairy Heifer Dry Cow .Non-Dairy Beef Stocker Beef Feeder Beef Brood Cow ❑ Yes!❑ NA ❑ NE [:]Yes [] No [] g—A ❑ NE ❑ Yes ❑ No ❑ ❑ NE 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? [:]Yes ❑ No [21 A ❑ NE []Yes [3-No ❑ NA ❑ NE ❑ Yes [,-.INo ❑ NA FINE Page I of 3 21412014 Continued Facility Number: - Date of Inspection: Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ®.Ate--❑ NA ❑ NE a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ 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 [a•?<6_ ❑ 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 E?4o ❑ 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 ®moo ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes lg-K" ❑ 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;�d6 ❑ NA ❑ NE maintenance or improvement? Waste Aw lieation 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 10 ❑ NA ❑ NE maintenance or improvement? / 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [3'NO ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window. ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area 12. Crop Type(s): qW4 (J UA CT U i✓Gv.0 13. Soil Type(s): V 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes eNo ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes if No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes C No ❑ NA ❑ NE acres determination? 17. Does the facility lack adequate acreage for land application? ❑ Yes [20�o ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes �o ❑ NA ❑ NE Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Vo ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [2 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 [3"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 install and maintain a rain gauge? ❑ Yes WNO o 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes NA ❑ NE Weather Code Sludge Survey NA ❑NE ❑NA ❑NE Page 2 of 3 21412014 Continued I Facili ' Number: - Date of Inspection: 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [�o ❑ NA ❑ NE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [ <o ❑ 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 [3171ro— ❑ NA 0 NE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [5'lqo— ❑ NA ❑ NE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes []qoll�o ❑ 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 [ fo ❑ 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 Z,XK ❑ 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 Q 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 do ❑ NA ❑ NE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ❑0510 ❑ NA ❑ NE 34. Does the facility require a follow-up visit by the same agency? ❑ Yes C2oVo ❑ NA ❑ NE Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. Use drawings of facility to better explain situations (use additional pages as necessary). �(L 1,0 n, 91A e &A") Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of 3 A3-15 _#_! PDA PVY4 C) - A"S Phone: 3 3 Date: 8 l 'G 21412014 vislon of Water Quality Facility Number -f--' 0 Division of Soil and Water Conservation 0 Other Agency Type of Visit: rCI C6mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: tine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: Arrival Time: Departure Time: County:C-41W(-,✓4.OlRegi0n Farm Name: 6k pJw1s e' "1� aaw Owner Email: Owner Name: 61 `✓.S Phone: Mailing Address: Physical Address: Facility Contact: tvul, We-t Title: Phone: Onsite Representative: Integrator: &_e)&%e - Certified Operator: r� Certification Number: zw 77 Back-up Operator: Location of Farm: Design Current Swine Capacity Pop. Wean to Finish Wean to Feeder O Feeder to Finish Farrow to Wean Farrow to Feeder Farrow to Finish Gilts Boars Other Other Certification Number: Latitude: Design Current Wet Poultry Capacity Pop. Layer Non -La er Design Current Dry Poultry Capacity Pop. La ers Non -Layer Pullets Turkeys Turkey Poults Other Longitude: Design Current Cattle Capacity Pop. Dai Cow Dairy Calf Dairy Heifer Dry Cow .Non-Dairy Beef Stocker Beef Feeder Beef Brood Cow Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? ❑ Yes []'No ❑ NA ❑ NE Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? [:]Yes [:]No C!r<A ❑ NE b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No [B'<A�' ❑ 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 ❑ NA ❑ NE 3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes Ej No ❑ NA ❑ NE of the State other than from a discharge? Page I of 3 21412011 Continued i •Facility Number: - Ob Date of inspection: ' 1^ Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes a. If yes, is waste level into the structural freeboard? ❑ Yes Structure I Structure 2 Structure 3 Structure 4 Structure 5 Identifier: ❑ NA ❑ NE ❑ No [3-?d� ❑ NE Structure 6 Spillway?: Designed Freeboard (in): Observed Freeboard (in): LS 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Eg-> r- ❑ 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 ❑,.N1(r_ ❑ 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 [3.bler ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [crier'❑ 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 [modr ❑ 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 ❑ No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area 12. Crop Type(s): 13. Soil Type(s): t4. uo the receiving crops airier trom mose Qes►gnatea In the I;AwMr! IJ Yes M No U NA l__I Nt 15. Does the receiving crop and/or land application site need improvement? ❑ Yes 2'9io ❑ NA [] NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE acres determination? 17. Does the facility lack adequate acreage for land application? ❑ Yes No ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes Io ❑ NA ❑ NE Reauired Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [:]Yes L 3, [DNA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [:I, o ❑ NA ❑ NE the appropriate box. ❑WUP ❑Checklists [3 Design ❑Maps ❑ Lease Agreements ❑Other: 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes D10 ❑ 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 [2No [DNA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ENo ❑ NA ❑ NE Page 2 of 3 2/4/2011 Continued Facility Number: [Date of Inspection: d 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the appropriate box(es) below. ❑ Failure to complete annual sludge survey ailure 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? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Ea] Aim ❑ NA . ❑ NE [3-1go ❑ NA ❑ NE ❑ Yes L-jkK ❑ NA ❑ NE ❑ Yes LB"O ❑ NA ❑ NE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [B o ❑ 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 [;, o ❑ 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 [,-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 [3No ❑ NA ❑ NE ❑ Application Field ❑ Lagoon/Storage Pond ❑ Other: 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes El -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 E No ❑ NA ❑ NE Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of 3 Date: 4Q wjyi 1-5 21412011 Wt - C� �' ry z t Orblvislon of Water Quality Facility Number - O Division of Soil and Water Conservation Q Other Agency Type of Visit: om ance Inspection Operation Review Q Structure Evaluation Q Technical Assistance Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access In Date of Visit: ,, Arrival Time: Departure Time; County: Ii- Regiont- Farm Name: /7 rty(',e 'q Of Owner Email: Owner Name: Kw Le\ 1,J Phone: Mailing Address: Physical Address: Facility Contact: Onsite Representative: Certified Operator: Title: Phone: Integrator: Certification Number: 0 QZZ Back-up Operator: Certification Number: Location of Farm: Swine Wean to Finish Wean to Feeder Feeder to Finish Farrow to Wean Farrow to Feeder Farrow to Finish Boars Other Other Latitude: Design Current Design Current Capacity Pop. Wet Poultry Capacity Pop. La er g E.1 cl-)!3 I Ion -Layer I I El Non-L Pullets Other Poults Design Current Longitude: Design Current Cattle Capacity Pop. Dairy Cow Dairy Calf Dairy Heifer Dry Cow Non-Dai Beef Stocker Beef Feeder Beef Brood Cow Discharges and Stream, Impacts 1. Is any discharge observed from any part of the operation? [:]Yes 0140 ❑ NA ❑ NE Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: �. a. Was the conveyance man-made? ❑ Yes ❑ No 2iA ❑ NE `y b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No E30NA ❑ 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) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? ❑ Yes ❑ No E3,<A ❑ NE [:]Yes No [ErNA ❑ NE ❑ Yes 0-K-o ❑ NA ❑ NE Page 1 of 3 21412011 Continued Facility Number: I XZU -[ jDate of Inspection: 0E_A14k,1 [ I Waite Collection & Treatment �,� 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Zj'NO a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No Structure 1 Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): � — Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? ❑ NA ❑ NE ❑ NE Structure 5 Structure 6 ❑ Yes [gam ❑ NA ❑ NE ❑ Yes io ❑ NA ❑ NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes [ to ❑ NA ❑ NE S. Do any of the structures lack adequate markers as required by the permit? ❑ Yes C24o ❑ NA ❑ NE (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require ❑ Yes M N ❑ NA ❑ NE maintenance or improvement? Waste_Auulication 10. Arc there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Cj'No ❑ NA ❑ NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 2 No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area 12. Crop Type(s): 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropriate box. ❑ Yes (;J'*No ❑ Yes [;J-,No ❑ Yes ENo ❑ NA ❑ NE ❑ NA ❑ NE ❑ NA ❑ NE ❑ Yes EfNo ❑ NA ❑ NE ❑ Yes 21--No ❑ NA ❑ NE ❑ Yes [,]"No ❑ NA ❑ NE ❑ Yes <o ❑ NA ❑ NE ❑ 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 V Rainfall Inspections ❑ Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes o ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes d No ❑ NA ❑ NE Page 2 of 3 21412011 Continued Facility umber: - Date of inspection: KL 24.,, id the facility fail to calibrate waste application equipment as required by the permit? [:]Yes <0 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes To 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 Ca"No 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 2<0 ❑NA ❑NE ❑NA ❑NE ❑ NA ❑ NE ❑NA ❑NE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes Q-o ❑ NA ❑ NE and report mortality rates that were higher than normal? 24. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes G2-lTo ❑ NA ❑ NE If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the [] Yes No ❑ NA ❑ 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 [fNo ❑ NA ❑ NE ❑ Application Field ❑ Lagoon/Storage Pond ❑ Other: 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [2r<o ❑ NA ❑ NE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes E To ❑ NA ❑ NE 34. Does the facility require a follow-up visit by the same agency? [:]Yes No ❑ NA ❑ NE mments (refer to question #): Explain any YES answers and/or any additional recommendations or: any othere r drawings of facility to better explain situations (use additional pages as necessary). <, C1rJ49J_C141L_0-'7 �13 S(ul - e, S,tcy D 3.1 Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of 3 It it 0.-2,s Phone:�C� ~ `U -�33 Dateav 21412011 r } 1Z 1- l Division of Water Quality Facility Numberq�D - O Division of Soil and Water Conservation (] Other Agency Type of Visit: Comm lance Inspection Operation Review Q Structure Evaluation O Technical Assistance Reason for Visit: V70utine O Complaint O Follow-un O Referral O Emereencv, O Other O Denied Access Date of Visit:Arrival Time eparture Time: Farm Name: $ `- Owner Email: Owner Name: Phone: Mailing Address: Physical Address: Facility Contact: _ 1fr::Q(V' (/" �� Title: Onsite Representative: Certified Operator: l Back-up Operator: Location of Farm: Swine Wean to Finish Wean to Feeder Feeder to Finish Farrow to Wean Farrow to Feeder Farrow to Finish Gilts Boars Other Other Latitude: Phone: Integrator: Certification Number: Certification Number: Longitude: Design Current Design Current Capacity Pop. Wet Poultry Capacity Pop. L ayer Design Current Dry Poultry CRPaCitY PO . Layers Non -Layers Pullets Turkeys ,Turkey Poults Other i �' Design Current Cattle Capacity Pop. Dairy Cow Daia Calf Dairy Heifer Dry Cow Non -Dairy Beef Stocker Beef Feeder Beef Brood Cow Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? ❑ Yes No ❑ NA ❑ NE Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? ❑ Yes ❑ No [] NA ❑ NE b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes [3 No [] 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 C No ❑ NA ❑ NE 3. Were there any observable adverse impacts or potential adverse impacts to the waters [—]Yes FI�No ❑ NA ❑ NE of the State other than from a discharge? Page 1 of 3 21412011 Continued Facili Number: - Date of Inspection: Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes io ❑ 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 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 [EKo ❑ 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 ONo ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? [] Yes MXo ❑ NA W. ❑ 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 []]Xo ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [�To ❑ NA ❑ NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes LJ.JXo ❑ 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 ❑f Application Outside off Approved Area 12. Crop Type(s): u'� ,� jGt�j f—. 0`if/I`�'f ��•�'v"Y,L p`{,, -� {/oyc_ L--t 13. Soil Type(s): t3 n ao 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 'bff o ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes Q o ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 42-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? Repuired Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropriate box. ❑WUP ❑Checklists [—]Design ❑ Maps ❑ Lease Agreements ❑ Yes Zl-lqo ❑ NA ❑ NE [] Yes []R<o ❑ NA ❑ NE ❑ Yes ffl�o [DNA ❑ NE ❑ Yes -No ❑ NA ❑ NE ❑ Other: 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ®.I-o ❑ 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 [Z�No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes `p - ❑ NA ❑ NE Page 2 of 3 21417011 Continued Facility Number: Date of Ins ection: 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes the appropriate box(es) below. ❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels ❑ Non -compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail to provide documentation of an actively certified operator in charge? 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over -application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Application Field ❑ Lagoon/Storage Pond ❑ Other: M,Noo ❑ NA ❑ NE E4,110 ❑ NA ❑ NE ❑ Yes ro ❑ NA ❑ NE Yes o ❑ NA ❑ NE ❑ Yes ❑ Yes [ No ❑ NA ❑ NE ❑ NA ❑ NE ❑ Yes M o ❑ NA []NE ❑ Yes [Mo ❑ NA ❑ NE 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [P"�o ❑ NA ❑ NE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [Vo ❑ NA ❑ NE 34. Does the facility require a follow-up visit by the same agency? ❑ Yes j"No ❑ NA ❑ NE Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.' Use drawings of facility to better explain situations (use additional pages as necessary). la -la ii 5L.L Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of 3 Phonb! E) Date: l 214 011 r = 6 a ivision of Water Quality Facility Number ®- 0 0 Division of Soil and Water Conservation 0 Other Agency EType of Visit: (9 70utine ance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: Arrival Time: 1100jSAM I Departure Time: a.! is County: C uv%. P R \0 Region: VRO Farm Name: FAfirn.S n7 N QpiL (3 N)< Owner Email: Owner Name: 0K fidLtnS cR C�aGLk CR.i U4. LLB Phone: Mailing Address: Physical Address: Facility Contact: Title: Own_(" _ Phone: Onsite Representative: I� = rl t-c _ Integrator: et-SAn Q T Certified Operator: S QMe,— Certification Number: '�bn 0-)-1����_� Back-up Operator: Location of Farm: Swine Wean to Finish Wean to Feeder Feeder to Finish Farrow to Wean Farrow to Feeder Farrow to Finish Gilts Boars Other Other Certification Number: Latitude: Design Current Design Current Capacity Pop. Wet Poultry Capacity Pop. Layer 120\4 M E1,510Non-La er Design Current Dry Poultry Capacity Pop. Layers Non -Layers Pullets Turkeys Turkey Poults Other Dischar es and Stream lm acts 1. I* y discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? Longitude: Design Current Cattle Capacity Pop. Dairy Cow Dairy Calf Dairy Heifer Dry Cow Non -Dairy Beef Stocker Beef Feeder Beef Brood Cow ❑ Yes dNo ❑ NA ❑ NE ❑ 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 the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE Z. Is there evidence of a past discharge from any part of the operation? [:]Yes E�No ❑ NA ❑ NE 3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes FZ/No ❑ NA ❑ NE of the State other than from a discharge? Page 1 of 3 21412011 Continued Facill Number: - LA Date of Inspection: JO ! Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [ji"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: j q- a-;t Spillway?: Designed Freeboard (in): Observed Freeboard (in) T tiq 19 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? ❑ Yes �NoE] ❑ NE ❑ Yes ►�No ❑ NA ❑ NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? [:]Yes [R o ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? [:]Yes [ j o ❑ 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 �o ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [3�No ❑ NA ❑ NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [Z/No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN [] PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area 12. Crop Type(s): �bi�� �v� t \'3\tNV_fkT 0 C.oRS:mi PaVk1+RQW% (LAZ_�S 13. Soil Type(s): �Q �- 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [gNo ❑ NA ❑ WE 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 E�No ❑ NA ❑ WE acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropriate box. DWUP El Checklists ❑ Design ❑ Maps ❑ Lease Agreements Yes [yNo ❑ NA ❑ NE ❑ Yes C'No ❑ NA ❑ NE ❑ Yes dNo ❑ NA ❑ NE [:]Yes [?(No ❑ NA ❑ NE ❑ Other: 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes . [yNo ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? [:]Yes [ZNo ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [] Yes (3"No ❑ NA ❑ NE Page 2 of 3 21412011 Continued Facili Number: 1g - LA Date of -Inspection: !U ai 1 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ No 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 2"No the appropriate box(es) below. ❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels ❑ Non -compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [2�No 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [;�No Other Issues ❑ NA ❑ NE ❑NA ❑NE ❑NA ❑NE ❑ NA ❑ NE 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes �o ❑ 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 YNo ❑ 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 Ege�4o ❑ 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 []'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 C]3�No ❑ NA ❑ NE 33. Did the ReviewerlInspector 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 [ j 4o ❑ NA ❑ NE Comments (refer to,',uestions#): Explain any.YES;answers�and/or'any additionalrecomimendati(ins�oriany other comments; ,': Use drawings of facility to better explain:situations (use.additional pages'as;necessary} U_CA_ s w v' l r1Ast� �laa ReviewerlInspector Name: F O V.v. ;o) , t-=-) l \M V_\ ReviewerlInspector Signature: Page 3 of 3 Phone: 9 10-30 %--& Date: d 2 412011 .ti Type of Visit: QXrompliance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance Reason for Visit: 046utine O Complaint 0 Follow-up O Referral O Emergency O Other O Denied Access Date of Visit: Arrival Time: / Departure Time:County: Region:( Farm Name: d Asc�Ji? Owner Email• Owner Name: eq/ d vS dD� al�rt'rri �G Phone: Mailing Address: Physical Address: Facility Contact: r-^ wjf a Title: �fj��j�/ Phone: Onsite Representative: .lisY�-� r�%�'�f Wrs ' Integrator: e Certified Operator: Certification Number: Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Design Current Design Current Design Current Swine Capacity Pop. Wet Poultry C►apacity Pap. Cattle Capacity Pop. Wean to Finish La er Dairy Cow Wean to Feeder 0 INon-Layer Dairy Calf Feeder to Finish Dairy Heifer Farrow to Wean Design Current Dry Cow Farrow to Feeder Ilr, P,oul P. Non -Dairy Farrow to Finish Layers Beef Stocker Gilts Non -Layers Beef Feeder Boars Pullets Beef Brood Cow 11 Turke s U_thcr Turkey Poults Other I L10ther Discharges and Stream Imuacts 1. Is any discharge observed from any part of the operation? ❑ Yes L!jNo ❑ 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 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 C@ 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 1 of 3 21412011 Continued ' Facility Number: jDate of Inspection: Waste Collection & Treatment t� 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes jig -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): Z�? Observed Freeboard (in): 1012 S T 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes W 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 [LNo ❑ 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 ❑ 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 ZLNo ❑ 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 PZ No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop //Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area 12. CropTYpe(s) �'Istytdr !�'J��1'Sr-�/ /M'ZZYZ:I-.Q f[�e�' 13. Soil Type(s): 1jy /.xu '-f /G 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 �g No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ENo ❑ NA ❑ NE acres determination? 17. Dods the facility lack adequate acreage for land application? ❑ Yes [&No ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes [allo ❑ NA ❑ NE Required Records & Documents 19. Did the facility fail to have the 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 [3 Design ❑ Maps ❑ Lease Agreements ❑Other: 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes allo ❑ 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 install and maintain a rain gauge? E] Yes MNo 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE ❑ Weather Code ❑ Sludge Survey ❑NA ❑NE ❑NA ❑NE Page 2 of 3 21412011 Continued Facility Number: - Date of Inspection: 4 24, Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �RNo ❑ NA ❑ NE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 0 No ❑ NA ❑ NE the appropriate box(es) below. ❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels 3Non-compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: /D no`14— /1 26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes M No ❑ NA ❑ NE 1.1 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ® No ❑ NA ❑ NE Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ®. No ❑ NA ❑ NE and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? []Yes [Z 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 RLNo ❑ 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 fZ 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 INo ❑ NA ❑ NE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes jj3Z No ❑ NA ❑ NE 34. Does the facility require a follow-up visit by the same agency? ❑ Yes KNo ❑ NA ❑ NE Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments., Use drawings of facility to better explain situations (use additional pages,as necessary). Reviewer/]nspector Name: Reviewer/[nspector Signature: Page 3 of 3 Phone: �f�j--y��•.j Date: a`cZ��.•i�/�l� 21412011 Type of visit: 9Compliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access Date of Visit: !�1) _ Arrival Time: ' Da Departure Time: �U County: a 624�Region: EY Farm Name: Q a QI c L IX Owner Email: Owner Name: ra,rm pF CGBlc�r C/IIII //G Phone: Mailing Address: Physical Address: Facility Contact: Re V j 9- Title: 00/I ey" Phone: Onsite Representative: er Integrator: T Y'rot'l-el Certified Operator: 4��� __ Certification Number: Back-up Operator: Location of Farm: Latitude: Certification Number: Longitude: Design Current Design Current Design C►urrent 5wlne Capacity Pop. Wet Poultry Capacity Pop. Cattle Capacity Pap. Finish La er DairyCow Feeder Non -La er DairyCalf o Finish Dai Heifer o Wean Design C►►urrent D Cow to Feeder D�, P,oultr, Ca aci P,o .. Non -Dairy to Finish PBoars Layers Beef Stocker Non -Layers Beef Feeder Pullets Beef Brood Cow Turke s Turke Pouets Other _Discharees 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)? d. Does the discharge bypass the waste management system? (if yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? ❑ Yes RNo [] NA ❑ NE [:]Yes ❑ No [:]Yes ❑ No ❑ Yes ❑ No [-]Yes No ❑ Yes O No ❑NA ❑NE ❑ NA ❑ NE ❑NA ❑NE ❑ NA ❑ NE ❑ NA ❑ NE Page 1 of 3 21412011 Continued Facili Number: - Date of Inspection: Waste Collection & Treatment 1 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes a. If yes, is waste level into the structural freeboard? ❑ Yes Structure I Structure 2 Structure 3 Structure 4 Structure 5 Identifier: Spillway?: _ Designed Freeboard (in): Observed Freeboard (in): 4�z 1 5. Are there any immediate threats to the integrity of any of the structures observed? (i.e., large trees, severe erosion, seepage, etc.) 0 No ❑ NA ❑ NE [:]No ❑ NA ❑ NE Structure 6 ❑ Yes IN No ❑ NA ❑ NE 6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes gLNo ❑ 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 ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes RLNo ❑ 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 g No ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need [] Yes allo ❑ NA ❑ NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes ® No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area 12, Crop Type(s): Wj1jr 13. Soil Type(s): 14. Do the receiving crd`ps 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 No ❑ NA ❑ NE acres determination? I7. 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 [g No ❑ NA ❑ NE Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes g 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 0 No ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes ® No ❑ NA ❑ NE ❑ Weather Code ❑ Sludge Survey ❑NA ❑NE ❑ NA ❑ NE Page 2 of 3 21412011 Continued Facility Number: - V I Date of Inspection: 24, Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ELNo 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check []Yes ❑ No the appropriate box(es) below. ❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels ❑ Non -compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes K[ No 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [Et No 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? 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? 34. Does the facility require a follow-up visit by the same agency? ❑ NA ❑ NE ❑ NA ❑ NE ❑ NA ❑ NE ❑ NA ❑ NE ❑ Yes [LNo ❑ NA ❑ NE ❑ Yes E&No ❑ NA ❑ NE [:]Yes 2-No ❑ NA ❑ NE ❑ Yes [KNo ❑ NA ❑ NE [:]Yes [No ❑ Yes RNo ❑ Yes g]No ❑NA ❑NE ❑NA ❑NE ❑ NA ❑ NE Comments (refer to question #1): Explain any. YES answers and/or any additional recommendations or, any other comments:_. ;L lUse.drawings of facility to better explain, situations (use additional pages as necessa6)., j f k ._Sty Reviewer/Inspector Name: Reviewer/Inspector Signature: Page 3 of 3 Phone: Date: 21412011 :1 0 Division of Water Quality �� � Facility Number 0 0 Division of Soil and Water Conservation 0 Other Agency Type of Visit Pd ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit 61fooluune 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access Date of Visit: -- G Arrival Time: ,f3D Departure Time: / : B County: • Region: I� Farm Name: 69/K 62 B� ,I�Ir CF-e-,A � � �- Owner Email: Owner Name: Otr, 60"W 3 o,--- �v�ar ale Phone: Mailing Address: Physical Address: Facility Contact: G ,- 7 ` Title: Phone No: Onsite Representative: 5� Integrator: 42a_ Certified Operator: �°Y'"`�^` Operator Certification Number: ,;�,7 Back-up Operator: Location of Farm: Swine Back-up Certification Number: Latitude: = o = 1 Longitude: = ° = 6 Design Current Design Current Capacity Population Wet Poultry Capacity Population � ElLayer —Ej� - D 3 ❑ Non -Layer ❑ Wean to Finish K Wean to Feeder ElFeederto Finish ❑ Farrow to Wean -J El Farrow to Feeder ❑ Farrow to Finish El Gilts El Boars Other ❑ Other Dry Poultry ❑ Layers ❑ Non -Layers El Pullets ❑ Turke s El Turkey Poults ❑ Other Discharges & Stream Impacts . 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? Design Current Cattle Capacity Population El Dairy Cow ❑ DairyCalf ❑ DairyHeifer El Dry Cow ❑ Non -Dairy El Beef Stocker El Beef Feeder ❑ Beef Brood Cow Number of Structures: 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 I,No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE ❑ Ye's ❑ No ❑ NA ❑ NE ❑ NA ❑ NE ❑ Yes ❑ No ❑ Yes ® No ❑ NA ❑ NE ❑ Yes allo ❑ NA ❑ NE Pale I of 3 12128104 Continued Facility Number: — p Date of Inspection _7 Waste Collection & Treatment 4. Is storage capacity structural plus storm storage plus heavy rainfall less than adequate? Yes g P' Y ( P g P Y ) q ❑ CR Na ❑ NA ❑ NE a. If yes, is waste Ievel 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): �3 7, —D 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ NA ❑ NE (iel large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed []Yes &No ❑ NA ❑ NE through a waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes Q'l 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 E[No ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes R No ❑ NA ❑ NE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes E9,No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence ofWind Drift ❑ Application Outside of/Area 12. CroP tYPe(s) 13. Soil type(s) 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 0 No ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes RNo ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes a No ❑ NA ❑ NE 17. Does the facility lack adequate acreage for land application? ❑ Yes E§-No ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes 0-No ❑ NA ❑ NE x to}qucshon:##) TUpl :m. lei Iltylto liette'r ex"pI wer/Ins ector Name P r €#1k'k " "L' Phone: � T LR'eviewerlinspectorSignature: Date: Page 2 qf.i .�.�o.�y . �"6614h9;" Facility Number: (v — Date of Inspection y 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 2 No ❑ NA ❑ NE the appropriate box. ❑ WUP ❑ Checklists ❑ Design [I Maps ❑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 V Rain inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ®,No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes RNo ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes b� No ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ®.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 ER No ❑ NA ❑ NE Other issues 29. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes RNo ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes allo ❑ 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 ONo ❑ 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 " (g No ❑ NA ❑ NE General Permit? (iel discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes Z No ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes RNo ❑ NA ❑ NE Page 3 of 3 12128104 a 61DIvislon of Water Quality e� Facility Number 0 Division of Soil and Water Conservation 17 U_� ; � r 0 Other Agency Type of Visit Z--CCoompliance Inspection O Operation.Review O Structure Evaluation O Technical Assistance Reason for Visit R' Routine O Complaint O Follow up O Referral O Emergency 0 0ther ❑ Dan led Access Date of Visit: "�i}ltT Arrival Time: Departure Time: ' County Farm Name: 4/ K 6d'm6 OwnerEmail: Owner Name: r r rC/ G C Phone: _ Mailing Address: Physical Address: Facility Contact: 'Ile d.�q_ WGS / Title: Onsite Representative: Certified Operator: Back-up Operator: Location of Farm: Swine Wean to Finish Wean to Feeder Feeder to Finish Farrow to Wean Farrow to Feeder Gilts Boars Other ❑ Other Region: T Ll Phone No: Integrator: l �` Operator Certification Number: Back-up Certification Number: Latitude: = D = 4 = Longitude: = ° = 6 = S, Design Current Design Current Capacity Population Wet Poultry Capacity Population [:]Layer �a /btu ❑ Non -Layer Dry Poultry ❑ Layers ❑ Non -Layers ❑ Pullets ❑ Turkeys ❑ urkey 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? Design Current Cattle Capacity Population ❑ -Dairy Cow ❑ Daia Calf ❑ Dairy Heifer ❑ Dry Cow ❑ Non -Dairy ❑ Beef Stocker ❑ Beef Feeder ❑ Beef Brood Cow Number of Structures: T11 h. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE ❑Yes ❑No ❑NA [I NE ❑ NA ❑ NE ❑ Yes ❑ No ❑ Yes ® No ❑ NA ❑ NE ❑ Yes ® No ❑ NA ❑ NE 12128104 Continued Facility Number: — Date of Inspection It Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [:]Yes B No ❑ NA ❑ NE a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): ^ 3 r 5. Are there any immediate threats to the integrity of any of the structures observed'? []Yes 13No ❑ 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 PRNo ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes JRNo ❑ 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 RNo ❑ 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 C,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 ElEvidence of Wind Drift ❑ Application Outside of Area 12. Crop type(s) /z.1/G� �._. ' (�/• I _ r"/ --- 13. Soil type(s) 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes RNo ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes ZNo ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ER No ❑ NA ❑ NE 17. Does the facility lack adequate acreage for land application? ❑ Yes NNo ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes ®.No ❑ NA ❑ NE 'Comments (refer to question ##): Explain kiy VES,answers and/nr any�recommYendationskor�any�other comments. ain situatl6ns.� (use a'dditibndl pages -as necessary),_�°� Used'rawingsoffacllity�tn-liett�r'expl yy ReviewerlInspector Name phone:/D 33�d ReviewerlInspector Signature: Date: r Facility Number: — Date of Inspection r f Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other ❑ Yes :S No ❑ NA ❑ NE ❑ Yes O No ❑ NA ❑ NE 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ONo ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? 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? ❑ Yes ,�No ❑ NA ❑ NE ❑ Yes MNo ❑ NA ❑ NE ❑ Yes 5..No ❑ NA ❑ NE ❑ Yes JO No ❑ NA ❑ NE ❑ Yes XNo ❑ NA ❑ NE ❑ Yes [RNo ❑ NA ❑ NE ❑ Yes 9No ❑ NA ❑ NE ❑ Yes KNo ❑ NA ❑ NE ❑ Yes F[No ❑ NA ❑ NE ❑ Yes RNo ❑ NA ❑ NE ❑ Yes P.No ❑ NA ❑ NE ❑ Yes filNo ❑ NA ❑ NE AciditionalCominents ancllnD„r�awings: w 12128104 Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit • Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access Date of Visit: /!!3 Arrival Time: ® Departure Time: I1 County: 4"*454A7 Regiion:P12-0 Farm Name: M 0 u. e:� Owner Email: Owner Name: _o_� _�t^ ' _D �K-4 UC.. Phon/eqJ o -eglo Mailing Address: Physical Address: Facility Contact: ''f!� weS_�- Title: Onsite Representative: Pf N Certified Operator: Back-up Operator: Location of Farm: Phone No: Integrator: Operator Certification Number:, Back-up Certification Number: Latitude: = o =1 Longitude: = ° =1 I 0 Design Current Swine C•apacit} Population Design Current Design C«urrent Wet Poultry Capacity Pbpu11tion Cattle Capacity Population ❑ Wean to Finish ❑ Layer El Dairy Cow Wean to Feeder 1 ❑ Non -La er ❑ DaiE Calf Feeder to Finish El Dairy Heifer ❑ Farrow to Wean ❑ Farrow to Feeder ❑ Farrow to Finish Dry Poultry ❑ Layers Non -La ers ❑ Dry Cow ❑ Non -Dairy ❑ Beef Stocker ElPullets Bcef Feeder ❑ Beef Brood Cow Number of - ruetures: Gilts EBoars ❑ Turkeys E)tl}er ❑ Turkey POLIItS ❑ Other ❑ 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) 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 I of 3 ❑ Yes LMJ_jNo ❑ NA ❑ NE ❑ Yes ❑ No 123 NA ❑ NE ❑ Yes ❑ No 2 NA ❑ NE ® NA ❑ NE ❑ Yes ❑ No ❑ Yes Q No ❑ NA ❑ NE ❑ Yes P No ❑ NA ❑ NE 12128104 Continued r Facility Number: oZ — Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus stone storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure l Structure 2 Structure 3 Structure 4 Identifier: ! A Spillway?: Designed Freeboard (in): Observed Freeboard (in); 31 _ 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not property addressed and/or managed through a waste management or closure plan? i ❑ Yes No ❑ NA ❑ NE ❑ Yes ❑ No-J2 NA ❑ NE Structure 5 Structure 6 ❑ Yes 0 No ❑ NA ❑ NE 4 ❑ Yes] No ❑ NA ❑ NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement'? ❑ Yes n No ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 50 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 q No ❑ NA ❑ NE maintenance or improvement`? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes JMNo ❑ NA ❑ NE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window El Evidence of Wind Drift El Application Outside of Area 12. Crop type(s) tYti+� �,Si�tlXWIQ Il 13. Soil type(s) 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes P No ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes U] No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes [P No ❑ NA ❑ NE 17. Does the facility lack adequate acreage for land application'? ❑ Yes 1�3 No ❑ NA ❑ NE 19. Is there a lack of properly operating waste application equipment? ❑ Yes ®No ❑ NA ❑ NE ; Comments (refer, to gttestion #) Explain anyYS answers and/or any recommendations or any othci comments x .. Use drawings of facility to, .' liter explain°situations. (use additional agesasnecessary): a; is b`cx 1t QQC 6.1 k . T Reviewer/Inspector Named-' � Phone: O Reviewer/Inspector Signature: Date: 9 O53 Page 2 of 3 12128104 Continued Facility Number: — Date of Inspection I 3 / 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 No ❑ NA ❑ NE the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other 21. Does record keeping need improvement'? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes F No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 9 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 & No ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes 5�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 1p No ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes X1 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 allo ❑ 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? (iel 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 154 No ❑ NA ❑ NE Additional Comments.and/or Drawings: Page 3 of 3 12128104 e(L XrA--�'J_ 6 -/ ? -J-1ro7 0 W Division of Water Quality Facility Number 0 Division of Soil. and Water Conservation t �. Other Agency.., Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit ® Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access Date of Vi§it: Arrival Time: Z : Z Departure Time: County: Farm Name: — ---- IAJOL► C1 6 v.... r 2_ F_- _ Owner Email: Owner Name: �T_OLAJ1414 O&VII Phone: _ Mailing Address: Physical Address: Region: Facility Contact: 33 0 L wrwr. 1ja0.Vc� Title: Phone No: Onsite Representative: J o L N tJ jq l_3 0, V A Integrator: Lk L, IQ .. � 1'a'i,JAJ Certified Operator: Operator Certification Number: Back-up Operator: Location of Farm: Swine Wean to Finish Wean to Feeder Feeder to Finish Farrow to Wean Farrow to Feedei Farrow to Finish Boars Other ❑ Other Back-up Certification Number: Latitude: 0 e 0 6❑ Longitude: 000 1❑" Design Current Design Current Capacity Population Wet Poultry Capacity Population ❑ La er ❑Nan -La er Dry Poultry ❑ Layers ❑ 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? Cattle Design Current Capacity Population, ❑ Dairy Cow ❑ Dai Calf J- ❑ Dairy Heifer ❑ DEX Cow ❑ Non -Dairy ❑ Beef Stocket ❑ Beef Feeder ❑ Beef Brood Cow Number of Structures: b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No ❑ NA ❑ NE ❑ Yes [2 No ❑ NA ❑ NE ❑ Yes ® No ❑ NA ❑ NE ❑ NA ❑ NE ❑ Yes PNo []Yes [A No ❑ NA ❑ NE ❑ Yes R No ❑ NA ❑ NE 11/28104 Continued w Facility Number: -7 — a Date of Inspection t. Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [?No ❑ NA ❑ NE a. If yes, is waste level into the structural freeboard? ❑ Yes P 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 �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 El NE through a waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Dritl ❑ Application Outside of Area 12. Crop types) Cp v b, p 6&t 6 tc,v S 13. Soil type(s) cc , GoA Lu 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [X No ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes W No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes ® No ❑ NA ❑ NE 17. Does the facility lack adequate acreage for land application? ❑ Yes [,-A No ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes [3No ❑ NA ❑ NE Comments (refer to question ##): Explain any YES answers and/or any recommendations or any other comments. I Use drawings of facility to better explain situations. (use additional pages as necessary): Reviewer/inspector Name '�C. RQ �i S Phone: 91e - $133 3"' 0 Reviewer/Inspector Signature: P- Date: _ '�3 .7100 7- 12128/04 Continued Facility Number: -7 — Z Date of Inspection 1y Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [P No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 0 No ❑ NA ❑ NE the appropriate box. ❑ WUP ❑ Checklists ❑ Design [I Maps El Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes V9 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 [I NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No T ❑ 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 I® El NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? El Yes No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes No ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document [3 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 PNo ❑ 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 �XNo ❑ 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 [I NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes PFNo ❑ NA ❑ NE Additional Comments and/or Drawings: Page 3 of 3 12128104 r J Facility. Number ® Division of Water: Quality O Division of Soil and Water Conservation 0 Other Agency . Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance i Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access I Date of Visit: �Q Arrival Time: : r0 Departure Time: , 00 Qlh County: Region: i Farm Name: MS D:e C t Owner Email: _sue Owner Name: , :7K.- �� 0� Cf.✓ I Phone: -011)) q8 "gam jo Mailing Address: Physical Address: I 1 Facility Contact: Keyl o S r Title: Phone No: 61()qeq jo Onsite Representative: 11 Integrator: lf,sWe_ Certified Operator: j) Operator Certification Number: Aa01.1 Back-up Operator: Back-up Certification Number: Location of Farm: Latitude: F--]' =' = Longitude: = ° 0 ` = if I Swine Wean to Finish Wean to Feeder Feeder to Finish Farrow to Wean Farrow to Feeder Farrow to Finish Gilts Boars Other. ❑ Other Design Current Design Current Capacity Population Wet Poultry Capacity Population ❑ Layer ❑ Non-Layet. Dry Poultry Non-L Pullets Poults 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 ❑ Daia Cow ❑ Dairy Calf ❑ Dairy Heifei ❑ Dry Cow ❑ Non -Dairy ❑ Beef Stocker ❑ Beef Feeder ❑ Beef Brood Cow c. What is the estimated volume that reached waters of the State (gallons)? Number of Structures: �I d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes �No El NA El NE ❑ Yes ❑ No NA ❑ NE ❑ Yes ❑ No NA ❑ NE ❑ Yes ❑ No "a NA ❑ NE ❑ Yes [! ,No ❑ NA ❑ NE ❑ Yes [�No ❑ NA ❑ NE 12128104 Continued Facility Number: ,�6 Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [:]Yes [PNo ❑ 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: f Spillway?. Designed Freeboard (in): 36 Observed Freeboard (in): �r « 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes E.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 E.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 1)�No ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit'? ❑ Yes No ElNA ❑ 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 J,No ❑ NA [I NE maintenance or improvement? l Waste Application 10, Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes qjNo ❑ NA ❑ NE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes T No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Ac� Window El Evidence of Wind Drifl ❑Application Outside of Area 13. Soil type(s) 8%1 % 8 ' , 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes A No ❑ NA ❑ NE 15, Does the receiving crop and/or land application site need improvement? ❑ Yes 1P No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes riNo ❑ NA ❑ NE 17. Does the facility lack adequate acreage for land application? ❑ Yes Q9No ❑ 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): A. Reviewer/Inspector Namea 6P Phone: m),43?-3100 JE[Date: Reviewer/Inspector Signature: q1MLoi 12128104 Continued Facility Number: — Date of Inspection I "'�I� 1 Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes KNo ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 0No ❑ NA ❑ NE the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes f� 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 �10 iRNo [I NA El NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �SW0 ❑ 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 'EANo ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes �ANo ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes KNo ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes W 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 IF El NA El 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 [PNo ❑ 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 EpNo ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes qlNo ❑ NA ❑ NE Comments and/or Drawings: 12128104 1. A Type of Visit ® Compliance Inspection C) Operation Review Q Lagoon Evaluation Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access Bate of Visit: d Time: Facility !umber ® Permitted ® Certified E3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: Farm Name: County: LA 1-^ G.,, Cf Owner Name: Phone No: l T_4 Mailing Address:[,%,. �,4 3+af Facility Contact: C, V L Do►�s�+: .f Title: lg1.t e_1— _ Phone No: Onsite Representative: ^ �•� _ 7 t, n ; n c_ Integrator: Certified Operator: 11 v Operator Certification Number: l Location of Farm: J1 swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• ��� Design Current Design Current Design Current Swine Capacity Population Poultry Capacity Population Cattle Capacity Population Wean to Feeder 10 Laver ❑ Dairy ❑erFnish Non -Layer ❑ Non -Dairy ❑ Farrow to Wean El Farrow to Feeder ❑ Other ❑ Farrow to Finish Total Design Capacity ❑ Gilts ❑ Boars Total SSLW r,. Number of Lagoons '��,pa;';;� ❑ Subsurface Drains Present ❑ Lagoon Area S re► Field Area ;_Holding Ponds /Solid Traps 0 „:;, r ` ❑ No Liquid Waste Management System F; Discharges 8 Stream acts I . Is any discharge observed from any part of the operation? ❑ Yes [� No Discharge originated at: ❑ Lagoon ❑ Sprav Field ❑ Other a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No b. If discharge is obsmed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No c. If discharge is observed, what is the estimated flow in gaUmin? 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 M No 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No Was Collection & Treatment 4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes El No Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: 13 Freeboard (inches): 31 05103101 Continued Facility Number: A(,, — 4, Date of Inspection 5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion, ❑ Yes No seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? (If any of questions 4-6 was answered yes, and the situation poses an ❑ Yes No Immediate public health or environmental threat, notify DWQ) 7. Do any of the structures need maintenance/improvement? ❑ Yes No 8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes &No 9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level elevation markings? ❑ Yes [R No Waste Application 10. Are there any buffers that need maintenance/improvement? ❑ Yes No 11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes No 12. Crop type Re -j&—. PCpSCW A- 13. Do the receiving crops differ with those"designated in the Certified 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? 0 Waste Management Plan (CAWMP)? 16. Is there a lack of adequate waste application equipment? Beguired Records & Dociglijents 17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? 18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? (ie/ WUP, checklists, design, maps, etc.) 19. Does record keeping need improvement? (icl irrigation, freeboard, waste analysis & soil sample reports) 20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 21. Did the facility fail to have a actively certified operator in charge? 22, Fail to notify regional DWQ of emergency situations as required by General Permit? (iel discharge, Freeboard problems, over application) 23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? 24. Does facility require a follow-up visit by same agency? 25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes [RNo ❑ Yes +] No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes J} No ❑ Yes VS No ❑ Yes [53 No ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ® No ® No No ® No © No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit. Comments (refer to question #). ExplaIA atiy YES answers;ond/be any recommettdati6Rsr'or any�other comments'.: .:... ' . ,, Use drawings of facil.i t6aietter explain s" pages es necessary):: . g ty ituations �(usE.itdditional ❑Feld Copv ❑ Final Note - b c" d' c'm y Lj eA- tl e k-S 1: t'/i"sS-1^ c�„-� s: -%� lie c�'� rN S • t^'��- _0o wr+1' 45 k' S QkrT L'_1/ FGJ' t (k VC Co r dso U oLr- Reviewer/Inspector Name '` ' ' 3 Reviewer/Inspector Signature: Date: o 05103101 a Continued Facility Number: j� — t4, I Date of Inspection r U Odor Issues 26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below liquid level of lagoon or storage pond with no agitation? 27. Are there any dead animals not disposed of properly within 24 hours? 28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, roads, building structure, and/or public property) 29. Is the land application spray system intake not located near the liquid surface of the lagoon? 30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or or broken fan blade(s), inoperable shutters, etc.) 31. Do the animals feed storage bins fail to have appropriate cover? 32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? 05103101 ❑ Yes ❑ No ❑ Yes [a No ❑ Yes [$ No ❑ Yes N,No ❑ Yes �R No ❑ Yes DINo ❑ Yes 0 No aN. Type of Visit O Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance Reason for Visit OlRoutine O Complaint O Fallow up O Referral O Emergency O Other ❑ Denied Access Date of Visit: 3— fo Dai Arrival Time: / Departure Time.. ! D County: Region: /05U) Farm Name: (19 fry _50-�`r— l,�(gr!_4f6r-ri� - Z .�— Owner Email: Owner Name: rL t"5 Phone: Mailing Address: Physical Address: Facility Contact: A -v i U1i~�?r Title: Onsite Representative: Certified Operator: ��4•-.�J -_ Back-up Operator: Location of Farm: Swine nish Wean to Feeder Feeder to Finish Farrow to Wean Farrow to Feeder Farrow to Finish Gilts Boars Other ❑ Other Phone No: integrator: Operator Certification Number: �0 07 7 Back-up Certification Number: Latitude: 0 c ❑ 4 =1 Longitude: = ° =1 = Design Current Design Current Capacity Population Wet Poultry Capacity Population ❑ Layer 4�11 L.D Itp 70k- 10 Non -La et Dry Poultry ❑ Layers ❑ 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? Design Current Cattle Capacity Population ❑ Dairy Cow ❑ Dairy Calf ❑ Dairy Heifei ❑ Dry Cow ❑ Non -Dairy ❑ Beef Stocker ❑ Beef Feeder ❑ Beef Brood Cow Number of Structures: b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes � No ❑ NA ❑ NE ❑ Yes � No El NA El NE ❑ Yes RNo ❑ NA ❑ NE ❑ NA ❑ NE ❑ Yes Cj�No ❑ Yes RNo ❑ NA ❑ NE ❑ Yes Q 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 ONo ❑ NA ❑ NE a. If yes, is waste level into the structural freeboard? ❑ Yes 9No ❑ NA ❑ NE Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: .1 2 Spillway?: Designed Freeboard (in): - f� Observed Freeboard (in): 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ NA ❑ NE (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes [Q 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 allo ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [2 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 R No ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0 No ❑ NA ❑ NE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area 12. Crop type(s) 13. Soil type(s) '��j�y¢ l �d 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? 9 Yes ❑ No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑ Yes PNo ❑ NA ❑ NE 17. Does the facility lack adequate acreage for land application? ❑ Yes RNo ❑ NA ❑ NE IS. Is there a lack of properly operating waste application equipment? ❑ Yes KNo ❑ NA ❑ NE 4to�qu`esti6ir,#} E,Olai any fafacility to better.7explaln4f a Reviewer/ins ector Name s 4 h,i* ^ E� '^ �� i Phone: p ,� Reviewer/Inspector Signature: Date: ,J =2-b ng 12128104 Continued Facility Number: — Date of Inspection Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 5� No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 0No ❑ NA ❑ NE the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other 21. Does record keeping need improvement? If yes, check the appropriate box below. [RYes ❑ No ❑ NA ❑ NE JO 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 R No ❑ 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 �RNo ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes Z No ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes t4 No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes {d,No . ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes JZ 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 4 No ❑ NA ❑ NE If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes 5f 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 EZNo ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes ® No ❑ NA ❑ NE Additional Camments,and/or Drawings 3 `` �© .� /+4.f !J L+�n ft' •v� i' %'i_. �/� 1 � 1 vY+'rt- �j�Gc�.l� (/-/y"el,� f .S �I�r �v► J 12128104 Date of Visit. Timc: Facility Number 9--Not O erational Belom Threshold ® Permitted ® Certified 0 Conditionalip Certified ©Registered Date Last Operated or Above Threshold: Farm Name: County: C1. 4" t'.9'P ern /� 10, Owner ?dame: e �_ „_ G . V De Phone No: __� 1 0 49e_ J? a is Mailin- Address: '.3 4 3 „jl..�La e - -- Facility Contact: Title: __- rs Phone No: Onsite Representative: Integrator: Certified Operator: C ht, L.%., ;n 4, Operator Certification Number: f rf � iti S Location of Farm: ® Swine ❑ Poultry ❑ cattle ❑ Norse Latitude 0� �° �" Longitude �• �• �" Design Current Swine ranarity Pnnulntinn Wean to Feeder D ❑ Feeder to Finish El Farrow Farrow to Wean, ❑ Farrow to Feeder ❑ Farrow to Finish ❑ Gilts ❑ Boars Design Current Design Current Poultry Capacity Population Cattle Ca acW Po ulation ❑ Laver ❑ Dai 10 Non -Laver I ILI Non -Dairy ❑ Other Total Design Capacity Number of Lagoons j 1LJ Subsurfac :Holding Ponds / Solid Traps '` ❑ No Li uid QischarQes 8 Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at-. ❑ LaQoon ❑ Sprav Field ❑ Other a. If discharge is observed, was the conveyance man-made? Total SSLW b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) c. If discharge is observed, what is the estimated flow in gal/min? d. Does discharge bypass a lagoon system? (If yes, notify DWQ) 2. Is there evidence of past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? A= Collection & Treatment 4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillwav Structure I Structure ? Structure 3 Structure 4 Structure 5 Identifier: Freeboard (inches): 05103101 ❑ Yes JMNo ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes �ij No ❑ Yes M No ❑ Yes E No Structure 6 Continued Facility Number: 21-4 Date of Inspection 5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ 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 maintenance/improvement? 8. Does any part of the waste management system other than waste structures require maintenance/improvement? 9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level elevation markings? Waste Application 10, Are there any buffers that need maintenance/improvement? 11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload 12. Crop type OD 13. Do the receiving crops differ with those designate 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? Reeguired Records & Documents 17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? 18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? (ic/ WUP, checklists, design, snaps, etc.) 19, Does record keeping need improvement? (ic/ irrigation, freeboard, waste analysis & soil sample reports) 20. [s facility not in compliance with any applicable setback criteria in effect at the time of design? 21, Did the facility fail to have a actively certified operator in charge? 22. Fail to notify regional DWQ of emergency situations as required by General Permit? ❑ Yes P No ❑ Yes [ i, No ❑ Yes No ❑ Yes No ❑ Yes " No ❑ Yes P�No ❑ Yes [�INo ❑ Yes [&NO ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes [A No ❑ Yes M No ❑ Yes MNo ❑ Yes ® No ❑ Yes No ❑ Yes] No ❑ Yes No (ic/ discharge, freeboard problems, over application) ❑ Yes No 23. Did Reviewerllnspector fail to discuss review/inspection with on -site representative? ❑ Yes No 24. Does facility require a follow-up visit by same agency? ❑ Yes No 25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes No 0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit. Comments refer to uestloir # Vip"Nldiimy YES answers and/or an recom'mendotions or any other c'ammerifs,' Ilse drawings of facilitytto'`tietter explain situations.,(use;udditiana pages as necessary), y. ❑Field Copy ❑Final Notes y - �� Lj6l .. ��tn l v�'o3 r 4,h der ►S Q .( 6e dZ, q. ,Ld L �,4- C, s PIE L"P-f- e-e- �! e1" -- ,r1rCnrr� ) diett� Reviewer/Inspector Name Reviewer/Inspector Signature: 05103101 Date: Continued Facility lumber: — 4 Date of Inspection Qdff Issues 26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below liquid level of lagoon or storage pond with no agitation? 27. Are there any dead animals not disposed of properly within 24 hours? 28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, roads, building structure, and/or public property) 29. Is the land application spray system intake not located near the liquid surface of the lagoon? 30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or or broken fan blade(s), inoperable shutters, etc.) 31. Do the animals feed storage bins fail to have appropriate cover? 32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? 05103101 ❑ Yes ❑ No ❑ Yes No ❑ Yes] No ❑ Yes ,® No ❑ Yes 81 No ❑ Yes J� No ❑ Yes ❑ No Facility Number Date of Visit: ©Time: e I fl O Not O erational O Below Threshold 0 Permitted 0 Certified 17 Conditionally Certified ❑ Registered Farm Name: OwnerName: _. _... »»».»....»......_........»».»...._» _.........» » ».» »_» ........... MailingAddress:.._..»...».».........................»........._............................................... FacilityContact: ........» ... ........ ........... .......................... ...w»»__...Title:... ................... OnsiteRepresentative:....._ ....... ..... ......__..._. _....... »» ......»......»...» .»....»... Certified Location of Farm: Date, Last Operated or Above Threshold: -. .... ».».». County: --- ��» 0 »��... Phone No: Phone No: Integrator: ..»........ __ .... .......... Operator Certification Number: ❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 " Longitude ' 9 " Discbaraes & Stream Impacts 1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) [❑ Yes ❑ No c. If discharge is observed, what is the estimated flow in gal/min? d. Does discharge bypass a lagoon system? (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 l Structure 2 toteStructure 3 Structure 4 Structure S Structure 6 Identifier: ................ wr. »... ..._....... _.» w.. _ ..�....».............._..... ......... .. ......_»».».».........» . _ .»...___._. Freeboard (inches): 7 37 12112103 Continued Facllit Number: Jy Date of Inspection yr 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ❑ No closure plan? (If any of questions 4.6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No 8. Does any part of the waste management system other than waste structures require maintenancerimprovement? ❑ 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 maintenance/improvement? ❑ 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 I7. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No liquid level of lagoon or storage pond with no agitation? 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. :CkWU a ni, r+ r inn m u z x� . yH;su..n omments (refer tgquestaon #} .Ezplai�n arey;YES answers snd/orNany re omQMA ons or,eny, other�aemmeata: Y]se dra afGfacilt Fief be r v lain tuatio ,�asc additsana! as�aecessa j1� Copy Co Final Notes ( 'u.�`81L:.��:=gY ,iatfh`"'�'��`.:SA �h ���.�4�s���'���E:.�i�l.�ru`.�.ad.ti��..•.��� �..7.;.E, .; �Y�.�'? � t.d� J�.... V,t fl._._.�. _F.Uo..,�i .. ... »`r�r�a........ . _�_ T � ... .._�..._....._ .._ra ..�_ �...�.k..�._ 5 polr er w `-tk betrz&.ry i1't e7Z'g-7`G1e__ -o 1KA7r„_ her- of W ka'� d o g- b; 4 e, Ate, - x S w �-k4�- '4' D 6 w v�. "I 40 y r e.16J t o vcr*'� S �ii� •r C i i Gu Reviewer/Inspector Name Ig Reviewer/Inspector Signature: Date: 12112103 / Conienued State of North Carolina Department of Environment, Health and Natural Resources • • Fayetteville Regional Office James B. Hunt, Jr., Governor ID E H N R Jonathan B. Howes, Secretary Andrew McCall, Regional Manager DIVISION OF ENVIRONMENTAL MANAGEMENT July 19, 1995 Mr. Glenn Clifton Prestige Farms, Inc. P. 0. box 438 Clinton, NC 28328 SUBJECT: Compliance Inspection C. V. Downing & Sons Cumberland County Dear Mr. Clifton: On July 11, 1995, an inspection of your animal operation was performed by the Fayetteville Regional Office (FRO). Please find enclosed a copy of our Compliance Inspection Report for your information. It is the opinion of this office that this facility is in compliance with 15A NCAC 2H, Part .0217, and that Animal Waste Management is being properly performed. Should you have any questions regarding this matter, feel free to contact me at (910) 486-1541. Sincerely, ed-J. go", D. T. Jones Chemist Enclosure CC: Facility Compliance Group Wachovia Building, Suite 714, Fayetteville, North Carolina 28301-5043 Telephone 910-486-1541 FAX 910-486-0707 An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper NORTH CAROLINA DEPARTMENT OF ENVIRONMENT, HEALTH & NATURAL RESOURCES DIVISION OF ENVIRONMENTAL MANAGEMENT Fayetteville Regional Office Animal Operation Compliance Inspection Form All questions answered negatively will be discussed in sufficient detail in the Comments Section to enable the deemed Permittee to perform the appropriate corrections: SECTION I Animal Operation Tyne: Horses, cattle, swine, poultry, or sheep SECTION II I. Does the number and type of animal meet or exceed the (.0217) criteria? [Cattle (100 head), horses (75), swine (250), sheep (1,000), and poultry (30,000 birds with liquid waste system)] 2. Does this facility meet criteria for Animal Operation REGISTRATION? 3. Are animals confined fed or maintained in this facility for a 12-month period? 4. Does this facility have a CERTIFIED ANIMAL WASTE MANAGEMENT PLAN? 5. Does this facility maintain waste management records (Volumes of manure, land applied, spray irrigated on specific acreage with specific cover crop)? 6. Does this facility meet the SCS minimum setback criteria for neighboring houses, wells, etc? Y N COMMENTS x x NA not until 1997 x x x x r 9RCTION III Field Site Management 1. Is animal waste stockpiled or lagoon construction within 100 ft. of a USGS Map Blue Line Stream? 2. Is animal waste land applied or spray irrigated within 25 ft. of a USGS Map Blue Line Stream? 3. Does this facility have adequate acreage on which to apply the waste? 4. Does the land application site have a cover crop in accordance with the CERTIFICATION PLAN? 5. Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other similar man-made devices? 6. Does the animal waste management at this farm adhere to Best Management Practices (BMP) of the approved CERTIFICATION? 7. Does animal waste lagoon have sufficient freeboard? How much? (Approximately 7 ft) 8. Is the general condition of this CAFO facility, including management and operation, satisfactory? SECTION IV Comments NOTES: 1. Wean to feeder pigs 2. 6,000 animals 3. Lagoon size - 2 acres 4. Directions NC53 and SR 2024. Take SR 2014 2 miles north, Farm on right. �4. State of North Carolina Department of Environment, Health and Natural Resources Fayetteville Regional Office James B, Hunt, Jr„ Governor Jonathan B. Howes, Secretary Andrew McCall, Regional Manager Mr. Glenn Clifton Prestige Farms, Inc. P. 0. box 438 Clinton, NC 28328 Dear Mr. Clifton: & I I XA � IT 1.9; WA � C)EHNR DIVISION OF ENVIRONMENTAL MANAGEMENT July 19, 1995 SUBJECT: Compliance Inspection C. V. Downing & Sons Cumberland County On July 11, 1995, an inspection of your animal operation was performed by the Fayetteville Regional Office (FRO). Please find enclosed a copy of our Compliance Inspection Report for your information. It is the opinion of this office that this facility is in compliance with 15A NCAC 2H, Part .0217, and that Animal Waste Management is being properly performed. Should you have any questions regarding this matter, feel free to contact me at (910) 486-1541. Sincerely, , 0, J, 54� D. T. Jones Chemist Enclosure cc: Facility Compliance Group Wachovia Building, Suite 714, Fayetteville, North Carolina 28301-5043 Telephone 910-486-1541 FAX 910-486-0707 An Equal Opportunity Affirmative Action Employer 50% recycled/ 1096 post -consumer paper ii NORTH CAROLINA DEPARTMENT OF ENVIRONMENT, HEALTH & NATURAL RESOURCES DIVISION OF ENVIRONMENTAL MANAGEMENT Fayetteville Regional Office Animal Operation Compliance Inspection Form All questions answered negatively will be discussed in sufficient detail in the Comments Section to enable the deemed Permittee to perform the appropriate corrections: SECTION I Animal Operation Tyne: Horses, cattle, swine, poultry, or sheep SECTION II 1. Does the number and type of animal meet or exceed the (.0217) criteria? [Cattle (100 head), horses (75), swine (250), sheep (1,000), and poultry (30,000 birds with liquid waste system)] 2. Does this facility meet criteria for Animal Operation REGISTRATION? 3. Are animals confined fed or maintained in this facility for a 12-month period? 4. Does this facility have a CERTIFIED ANIMAL WASTE MANAGEMENT PLAN? 5. Does this facility maintain waste management records (Volumes of manure, land applied, spray irrigated on specific acreage with specific cover crop)? 5. Does this facility meet the SCS minimum setback criteria for neighboring houses; wells, etc?. Y N COMMENTS x x NA not until 1997 x x x x' i SECTION III Field Site Management 1. Is animal waste stockpiled or lagoon construction within 100 ft. of a USGS Map B1ue,Line Stream? 2. Is animal waste land applied or spray irrigated within 25 ft. of a USGS Map Blue Line Stream? 3. Does this facility have adequate acreage on which to apply the waste? 4. Does the land application site have a cover crop in accordance with the CERTIFICATION.- ? 5. Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other similar man-made devices? 6. Does the animal waste management at this farm adhere to Best Management Practices (BMP) of the approved CERTIFICATION? 7. Does animal waste lagoon have sufficient freeboard? How much? (Approximately 7 ft) S. Is the general condition of this CAFO facility, including management and operation, satisfactory? SECTION IV Comments NOTES: 1. wean to feeder pigs 2. 6,000 animals 3. Lagoon size - 2 acres 4. Directions NC53 and SR 2024. Take SR 2014 2 miles north, Farm on right. nnl� 11M OEM 11=� MR • Cat �r..� C-L. Ct;,, DIVISION OF ENVIRONMENTAL MANAGEMENT P� F57 P� i30Y Li g 94 J'i3 C.L. % NtdN ' N 4 Z83 -z SUBJECT: Compliance inspection .saw County C'4of Dear DOW/1V I'Ny; 00;1J-`I� inspection of your animal operation was performed by the Fayetteville Regional Office (FRO). Please find enclosed a copy of our Compliance Inspection Report for your information. It is the opinion of this office that this facility is in compliance with 15A NCAC 2H, Part .0217, and that Animal Waste Management is being properly performed. Should you have any questions regarding this matter, feel free to contact me at (910) 486-1541. Sincerely, Enclosure cc: Facility Compliance Group NORTH CAROLINA DEPARTMENT OF EN IROKKENT, HEALTH'& NATURAL RESOURCES DIVISION OF ENVIRONMENTAL MANAGEMENT Fayetteville Regional Office 4 Animal Operation Compliance Inspection Form ,ti; }:L>:i• ti�.W ..l' - t i;S ).. A,:;uy. 4; ;' ".. 4..E?ACILITY '1'LEPHONS I+ifJI�RR °>< ..,, ::....'....:l1II.TNGLDDRESS:.. ... >:.„>.. All questions answered negatively will be discussed in sufficient detail in the. -Comments Section to enable the deemed Permittee to perform the appropriate corrections: ECTION •I Animal O eration Horses, cattle swine poultry, or sheep UGTION II 1. Does the number and type of animal meet or exceed the (.0217) criteria? [Cattle (100 head), horses (75), swine (250), sheep f1,000), and poultry (30,000 birds with liquid waste system)) . 2. Does this facility meet criteria for Animal Operation REGISTRATION? 3. Are animals confined fed or maintained in this facility for a 12-month period? 4. Does this facility have a CERTIFIED ANIMAL WASTE MANAGEMENT PLAN? 5. Does this facility maintain waste management records (Volumes of manure, land applied, spray irrigated on specific acreage with specific cover crop)? 5. Does this facility meet the SCS minimum setback criteria for neighboring houses, wells, etc? EcrlaN III Y N COIrIIMTS Meld Site Management 1. Is animal waste stockpiled or lagoon construction within 100 ft. of a USGS Map Blue Line Stream? 2. Is animal waste land applied or spray irrigated within 25 ft. of a USGS Map Blue Line Stream? 3. Does this facility have adequate acreage on which to apply the waste? 4. Does the land application'site have a cover crop in accordance'with the CERTIFICATION PLAN? S. Is animal waste dischargedinto waters of the state by man-made ditch, flushing system, or other similar man-made devices? 6. Does the animal waste management at this farm adhere to Best Management Practices - - (BMP) of the approved CERTIFICATION? 7. Does animal waste lagoon have sufficient freeboard? How much? (Approximately 7 f T } S. is the general condition of this CAFO facility, including management and operation, satisfactory? SECTION IV Comments No4L- 5: t /- Ne- :512 'Jz,29c . VWC see a lVorfti. =�rtM o.A✓ R,S1 L' ;�0l5/