430019_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

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Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: �z Arrival Time Departure Time: County: Region:��
Farm Name: 7�3 �a.��S 1-t-c svL�) Owner Email:
Owner Name: "' Fj a T Phone:
Mailing Address:
Physical Address:
Facility Contact: H1 ° lt-4C Title:
1�
Onsite Representative:
Integrator:
Phone:
5' t�'T P-
Certified Operator: V Certification Number: 10c, Z ff C, '(
Back-up Operator:
Location of Farm: Latitude:
Certification Number:
Longitude:
Design
Current
Design Current =_ Design Current
5 ne
Capacity
fop.
Wet lPoultry.,
Capacity�3 Pop. Capacity Pop.
,Cattle,'`
Wean to Finish
La er
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish r
3�7r�'Jr .
�' a
-'
Dai Heifer
Farrow to Wean
aDesign Current
D Cow
I) ``;Poult ,
Cs aci Po
Farrow to Feeder
UC�7�
Non-Dai
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
..
Discharges and Stream Imaacts
1. Is any discharge observed from any part of the operation?
❑ Yes
[�o
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
EQJ h A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
E17NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
❑ Yes
❑ No
[JNA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[3--No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [] Yes L]Ni o [] NA ONE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facili Number: }{ - Date of Inspection:
Was:e Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes EaNU—[] NA ❑ NE
a. If yes, is waste level into the structural fireeboard? ❑ Yes ❑ No �A ❑ 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
E 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
ED o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
'l ]�
❑ 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 [3-No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Ej 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 fWind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): _ ck% 6 IS't 4 ,I L (', 0
13. Soil Type(s): m c 1-
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[3-'Co
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ffCo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
E o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
E3 o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E "o
❑ NA
❑ NE
R uired Records & Documents
"No
"id the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes El
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes �No+
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Other:
21. Does record keeping need improvement? if yes, check the appropriate box below.
❑ Yes No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes [3 No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ETNo
❑ NA
❑ NE
Page 2 of 3 21412015 Continued

Facili Number: 4j - Date of Inspection:
24. Ijid the facility fail to calibrate waste application equipment as required by the permit? [] Yes E3-M° ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes L4o ❑ 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 o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes rq'1 a- ❑ 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)
3 I. 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?
0 Yes
m'No ❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
No ❑ NA
❑ NE
❑ Yes E j ❑ NA ❑ NE
❑ Yes ]Va ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
c omrrn'nts (Teter to.gaestioni0) Explain any Y" answers nafor.any 8dditjonal,recgmmengations or any other comments. } � TW.
Use drawings of factLty to�better, explarn,sitnat�ons�(ase additeoniii,nakes as necessary]
...
a' (t 6 1'4x� 0", --
'51 I
Reviewer/inspector Name:
S
CA lio-
3�}-;�s�
Phone:gl
Reviewer/Inspector Signature: R J U Date: 7�C
Page 3 of 3 21412015

(Type of Visit: QrCompliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: �7Arrival Time: Departure Time: County: VACt�Region: / : `_e
Farm Name: W � S �/x ✓` wi S ( rf t1 Owner Email:
Owner Name: 7;;, yr -t r III Phone:
Mailing Address:
Physical Address:
Facility Contact: fn OL(& J '� -'1 &' 4 Title:
Onsite Representative: t f
Certified Operator:
Back-up Operator:
Location of Farm:
r
Latitude:
Phone: n -
Integrator: ►� tYr GAT
Certification Number:
Certification Number:
Longitude:
Design CurrentBill
Design Cuirren#
Design Current
Swine Capacity Pop.
Wet Poultry
Capacityop.
Cattle
-,Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
}r "
Designy�,Current
Dry Cow
Farrow to Feeder
D , 1Pou1
Ca a t �Po
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Pullets
Turkeys
Beef Feeder
Beef Brood Cow
Boars
Qther
Turkey Poults,_�,.
Other
Other
E
M
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
[] Yes �o ❑ NA ❑ NE
❑ Yes
❑ No
e-NA
❑ NE
❑ Yes
❑ No
Egll�A
❑ NE
d. Does the discharge bypass the waste management system? (I f 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
❑ Yes K� No
❑ Yes �io
[TNA
❑ NE
❑NA
❑NE
❑NA
❑NE
Page I of 3 21412015 Continued

Facili Nunlber: - Date of Ins ection:
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [�r`&o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No R 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
Di io
❑ 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
ffNo
❑ 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
any of the structures need maintenance or improvement?
❑ Yes
[( No
❑ NA
❑ NE
8any of the structures lack adequate markers as required by the permit?
l
(es
❑ 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
❑'11ro'
❑ NA
❑ NE
maintenance or improvement?
Waste Application
No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[V]
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes L1 f�o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN F PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window
0 Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 5 S 6 v . N:Pa
13. Soil Type(s):
14. Do the receiving crops differ from those desigmatedt in the CAWMP7
❑ Yes
Q o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[�o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[Er�4o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[2"F4o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[21�o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes �No ❑ NA ❑ NE
20. Does the facility fail to have al I components of the CAWMP readily available? If yes, check ❑ Yes [ Flo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists [—]Design [—]Maps ❑ Lease Agreements ❑Other:
ODoes record keeping need improvement? If yes, check the appropriate box below. 11es eo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard [�" aste 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 ff"No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment'? ❑ Yes [�No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

FacilityNum er: - Date of Inspection:Inspection:27 liezz
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes EKO
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Err14'o
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 F-?<o
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes E; o
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 [ENo ❑ NA ❑ NE
❑ Yes ,rNo ❑ NA ❑ NE
❑ Yes [j]No ❑ NA ❑ NE
❑ Yes kfNo ❑ NA ❑ NE
❑ Yes �o
❑ Yes [ZrNo
❑ Yes ZNo
&1G vo, fb
6vae L.cc ocj leoe-1 Sc
42-1 rA_A.__ ju, C,1 & e,
Reviewer/Inspector Name:
Reviewer/Inspector Signatut
Page 3 of 3
III _ q(o -3a9-6, Fsr
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
Phone: q3 �—i 3 37
Date:
21412015

r
type of visit tdc7omtianceinspection v operation Keview VStructure Evaluation V Iecnnical Assistance
Reason for Visit: utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: tiOd Departure Time: County:
Farm Name_ CCf'�-f RKf'04,5 '�`� Owner Email:
Owner Name: t i Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: _�.t{ O+3 Title: Phone:
Onsite Representative: � � Integrator:
Certified Operator: Certification Number: !7�
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design
Current MPIDesi
esign Currentapacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
p� ..
Dai Heifer
Farrow to Wean
Design
Current
Cow
Farrow to Feeder
ii[7
0 "'' D : ° P,oWtr.
Ca aci
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Otlfer
Turkey Poults
_
Other
10ther
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
n NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
Q iA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[1Vo
❑ 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 I of 3 21412014 Continued

Facilitv Number: t8 - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Ko-
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.)
❑ NA ❑ NE
p-KA ❑ NE
Structure 5 Structure 6
❑ Yes hTo ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
<o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
;�No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[.]4o
❑ 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
No
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes [ 4o ❑ NA
❑ 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
ab�
12. Crop Type(s): l� 13
,:% c ' 56 C>
13. Soil Type(s): AJ p f,& 61
❑NE
14. Do the receiving crops differ from those designated in tht 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?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design [:]Maps [:]Lease Agreements ❑ Other:
21 _ Does record keeping need improvement? if yes, check the appropriate box below. [:]Yes [:]No ❑ NA ❑ NE
❑ 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 [:]No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: Lf- Date of Inspection-
24. Did the facility fail to calibrate waste application equipment as required by the permit? [—]Yes �o
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �Q
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 0<0
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [; Nu
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[2,M
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
[31To
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
❑' o
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
[]-hTo
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAW W?
❑ Yes
ENo
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
O No
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[�JNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question ft. Explain any YES answers:andlor, any additional recommendations or'any�other comments
Use drawings of facility. to betfer explain situations (use add�hanal pagesas necessary). _ x
5(-Aj--5ce� —
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
�33t 33
V
21412014

Type of Visit: @M7outine
ance Inspection O Operation Review p Structure Evaluation p Technical Assistance
Reason for Visit: O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: wi�lr Arrival Time: F5r7ZZ� Departure Time:1 /y`r County: '%q Region:
Farm Name: 1A61T fefOt tk-&
Owner Name: q
Mailing Address:
Physical Address:
Owner Email:
Phone:
�7 r
Facility Contact: !C_y L2 Title: Phone:
!T t
Onsite Representative: Integrator:
Certified Operator: 2G� f� �C ��� Certification Number: �Z
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design
Swine Capacity
Wean to Finish
Current Design Current
Pup. Wet Poultry Capacity Pop.
I ILayer
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
I lNon-Layer
Dairy Calf
Feeder to Finish
loco
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design CurrentDry
D . Po.ultr Ca aci P,o
Layers
Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
10ther
i
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
[:]Yes
���
EJ Tlo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[-]Yes
❑ No
[3 "'r'
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑ NSA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
ONA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[3No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
FffNo
❑ NA
❑ NE
of the State other than from a discharge?
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 No ❑ NSA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [q'NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes � [] 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
�
❑ 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
❑-3o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
D-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
[ o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
i0. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
FZ-Wo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 0-'N-o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
Loll
13. Soil Type(s): / V E> (,.<t
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Q'1\lo ❑ 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 E],No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑'No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
dNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[ =`o
❑ 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
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [-1�0
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes EJ40
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facili *Number: - Date of lns ection:'
24. Did the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes g3--go— ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes [S"'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 ❑f o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[.]'�
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
[:)Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
L7 "'o
❑ 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
E 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
Q'1�'o
❑ 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
�o
❑ NA
❑ NE
Comments (refer to question 9): 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);.
V.4 X-(L(
r�s 7�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: J ] `� S 3
Date: la 15
2141264

t ype of V IStt: V Compliance inspection V Operation Review V structure Evaluation V l echnical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
- p I 'C 4 �
Date of Visit: Arrival Time: .(1 Departure Time: County: Region
Farm Name: X��V
t'eOwner Email:
Owner Nape: U er- JyA"_� Phone:
Mailing Address:
Physical Address:
Facility Contact: fZ�vu �c Vt1 eS Title: Phone:
Onsite Representative: I Integrator: t I.-IVD
�7Certified Operator: t Certification Number: { z 0
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design ~Current _ li Design Current Design Current
Swine CapacttyPop + Wet Poultry Cap eityP-op. Cattle Capacity P.
Wean to Finish Layer DairyCow
Wean to Feeder
Non -Layer
DairyCalf
Feeder to Finish
S°
DairyHeifer
Farrow to Wean
Farrow to Feeder
DO
Design Current
D . P,oult . Ga acPo
D Caw
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Beef Feeder
Gilts
Non -Layers
Boars
Pullets
Beef Brood Cow
Turkeys
Other -
Turkey Poults
Other I I 10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes [?-N t.J NA ❑ NE
a. Was the conveyance man-made? [:]Yes ❑ No P-9A- ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) [] Yes ❑ No ❑ 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 1A ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [r]'Ro ❑ 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

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
M,?tt - ❑ NA
[] NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No Eg NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): r7
Freeboard
Observed (in): !�•
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
®' ❑ 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
®'K'o� ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
LB5P ❑ 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
[3'No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
T5o ❑ NA
❑ NE
maintenance or improvement?
1 1 _ 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): 9 C'_if-44_ cuY& & riw, _
13, Soil Type(s): !V O LY
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑'1uVo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[TNo
❑ 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
[EN
❑ NA
❑ NE
Reouired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
& o
❑ NA
❑ NE
20_ Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑.Ko—
[] 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
[G.t>16—
❑ 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
Ko
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

Facili Number: tj Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [3 No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes [] No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
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)
❑ Yes
ffr-No
❑ NA
❑ NE
❑ Yes
[Ergo
[ NA
❑ NE
❑ Yes [D-1Qo ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes [! j"Ro ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. [:]Yes do
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? [-]Yes �o
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes LINO
34. Does the facility require a follow-up visit by the same agency? ❑ Yes E3firo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
se drawings_ of:facitify.to.better,explain situations (hse;additional pages as necessary). y ed U.
_Comments referfto uestion Explain an YES answers and/or an addition recommep ations orian .6t er corn
C AV1*0'j
IS"
cx 3
10--
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
l
PhoneAW 3 S '(
Date:
21412011

D f HS UVs q f 111t3
Type of Visit: t8 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 0 Denied Access
Date of Visit: Arrival Time: Departure Time: " ; County: Qr Region:
Farm Name Ww-kS R!(n _
Owner Name: .Weeks „? 11on—
Mailing Address:
Owner Email:
Phone:
Physical Address: 1101 �Ir }� bt1nn
Facility Contact: Rye h/Peki Title: C--olmr, Phone:
— - a
Onsite Representative: Integrator:
Certified Operator:%aAI WIRKS Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
Design Current Design Current
Design Current
Swine Capacity Pop y -Wet�Po.ultry Capacity P,op.
Cat#le Capacity Pop.
DairyCow
Wean to Finish
La er
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
;- _
"
DairyHeifer
Farrow to Wean
= Design Current
D , P_oul Ca aci Po
Cow
X Farrow to Feeder
$Qp
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Pullets
Beef Brood Cow
Boars
Turkeys
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
FK] No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does 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
® No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facifi Number: 3 -___j Date of Inspection:
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:
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.)
[� No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 6
❑ Yes ® No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
® No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
10 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
® No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ® 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): for- -
13. Soil Type(s): Np lk/q , LYhchh 4 SI j&Uj1rj3
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes & No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? Yes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ® No [] NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists []Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. []Yes S No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [a 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

Vacility Number: Ll 3 -
Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? [:3 Yes 2] No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑-No
NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[5j 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
CR No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
® No
❑ NA
C] NE
permit? (i.e_, discharge, freeboard problems, over -application)
31. Do[[s surface tile drains exist at the facility? If yes, check the appropriate box below. ® Yes
[:]No
[DNA
❑ NE
® Application Field ❑ Lagoon/Storage Pond ® Other: ZjA nk;de
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
® No
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
[!R No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
[a No
❑ NA
❑ NE
Comments (refer to, question. t —Explain any YES answers and/or any additional recommendations or any other comments:
Use.drawines of facility to better explain situations (use additional pages as necessary), .r
�, Pl-eNc mew I e�m befas
is. plate I ire. �Ils -t�afi nit ri- , Mtn ore � (� . `rh Is insreut l S&V?j a:r a wire of tic'
C NCD-QM-Fc `r`M 3 t '
Records ors (� 9ood shof?,
FMlowt� -Qvh f h -fteebo4 jn Oft/ , Paie�wark to W Iss ( IVA(� af V101,110,1)
pWA l�+ a ova, down on s 11 ra 104 V'614 � 9 aid_ a Is o good 'o bOY
��� J o�0w•, fvllorr�l� e��-, - -
N�On �v6$ � � # a NielNodh9h -
_.)Dj'
,1►4I3 frx �f�ebaa�,atedl� ►'o, rvri-tt�4r�.
0 IF
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: [phone]?Q f 09�j
Date: S of
4/2011

Facility No. L13 -1 a -. --Farm Name Moll?KS R347 Date !13
Permit ✓ COC —**" OIC ✓ NPDES (Rainbreaker PLAT Annual Cert Daily Pipe )
MAN
Lagoon Name, S forspillway
1
2
3
4
5
6
7
Design Freeboard 1 Last Recorded in
l
Observed freeboard
Sludge Survey Date
I
Sludge Depth ft
Liquid Trt. Zone ft
4. 1`
Ratio Sludge to Treatment Volume if> 0.45
4.
Date out of compliance/ POA?
.
Calibration Date
Actual Flow
i - • i _{®-------
Irj--), M �
Soil Test Date Crop Yield C 4e afjj"14- Transfer Sheets nik
pH Fields Wettable Acres RAIN GAUGE
Lime Needed L'4WUP Dead box or incinerator
Lime Applied Failaol0� Weekly Freeboard Mortality Records
Cu-I ✓Zn I 1 in Inspections Check Lists
Needs S (S-I<25) �_Ali)N�-� 0 120 min Insp. Storm Water
Needs P k Weather Codes Cmv 1a11411a- l 1A 11
all
Pull/Field
Soil
Crop
Acres
PAN
Window
Max Rate
Max Amt
-S
I>+-
P �
030110
*At Al Rh
7
1
avjlr
!AO
'
HMO
I
1
LvffWka,,c( 1110
Verify PHONE NUMIBEREj and affiliations
Date last WUP FRO I I1iQ Qq FRO or Farm Records
Date last WUP at farmf(j�._ Lagoon #
App. Hardware Top Dike SO 17
Stop Pump4S,} S ,9 -
Start Pump 48,3
V% 4q1
Conversion- Cu-I 3000= 108 Ib/ac; Zn-I 3000= 213 Iblac
4.3

Type of Visit: C�Compliance inspection U Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: routine 0 Complaint O Follow-up 0 Referral 0 Emergency O Other Q Denied Access
Date of Visit: Arrival Time: , V Departure Time: County: Region: /) -U
Farm Name: 2IQ,J !� _ /fi r Email:
Owner Name: (�l�s Phone:
Mailing Address:
Physical Address:
Facility Contact: _ Title: CWn 64,R&r
Onsite Representative: r Integrator:
Certified Operator: �i/t � �44 Certificatir
Back-up Operator:
Location of Farm:
Latitude:
Phone:
/ryu 2-
i Number:
Certification Number:
Longitude:
Swine
Wean to Finish
Designam Current
Capacity Pop.
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
C*attle Capacity Pop.
Dairy Cow
Wean to Feeder
Non -La er
I
Design
Ca acity
Current
P.o
Dai Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Feeder to Finish 02
Farrow to Wean
Farrow to Feeder IF66 2woDry
'
Pzoult M
Layers
Non-Laers
Farrow to Finish
Gilts
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure 0 Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
[-]Yes b ❑ NA ❑ NE
[]Yes
❑ No
[PO<A
❑ NE
❑ Yes
❑ No
El-<
❑ NE
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
02 A
❑ NE
❑ Yes
g3 No
❑ NA
❑ NE
❑ Yes
[2'FIo
❑ NA
❑ NE
Page I of 3 21412011 Continued

Facili Number: 113ate of Insp ection:
Waste Collection & reatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ©0110 ❑ NA M NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:,
Spillway?:
Designed Freeboard (in): f
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[20110
❑ 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
rj_j4qo
❑ 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
To
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
�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
[q"54o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
t[ o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[:]Yes
L2<o
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to incorporate
Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):3207u" 2 h-,".'� "
13. Soil Type(s): A1G
14. Do the receiving crops djffer from those designated in the CAWMP?
❑ Yes
o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�To
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
E3<o
❑ NA
❑ NE
acres determination?
17, Does the facility lack adequate acreage for land application?
❑ Yes
Lid'"O
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ID "o
❑ NA
❑ NE
Reuuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [j�<o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EJOKo ❑ 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 o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No �lA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: jDate of Inspection: f
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 024o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes L To ❑ 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 [EloNo ❑ NA NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No A ❑ NE
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes to ❑ 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 Vo ❑ 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
permit? (i_e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes To ❑ NA ❑ NE
❑ Yes E�'< D NA ❑ NE
❑ Yes
[�o
❑ NA
❑ NE
❑ Yes
E o
❑ NA
❑ NE
[]Yes
I_LJ4
❑ NA
❑ NE
U,>e—I',
A-tI
L 0 & SI
K'
1
S Ul L%
Reviewer/Inspector Name:
Reviewer/Inspector Si
Page 3 of 3
Phone:
Date:
4/7o11

5 to 16
ivisioit of Water Quality
Facility Number - ® ® Division of Soil and Water Conservation
s0 Other Agency
Type of Visit: EMmpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 91 routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: ounty:ZL42�_Region:_
Farm Name: (�ee'As ��rMG , Owner Email:
Owner Name. !-{ e Phone:
Mailing Address:
Physical Address:
Facility Contact: _5 Title: r` Phone:
Onsite Representative: [/d„f /'J,.$ Integrator:
Certified Operator: Wjj4AJ [.�-�Crp�G 5 _ Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Design. Current
Design Current
Swine Capacity Pop.
Wet Poultry
Capacity Pap.
Cattle Capacity Pop.
Finish
La er
Non -La er
l F
Dai Cow
Dai Calf
Dai Heifer
o Feeder
to Finish
p
#o Wean
r:
Design .. Current
D Cow
Lo
to Feeder
D . P,oul
La ers
�Ca aci P,o .
Non -Dairy
Beef Stocker
to Finish
Non -La ers
Beef Feeder
Pullets
Beef Brood Cow
Turkeys
Other
-Turkey Poults
Other
L
10ther
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
P -
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
Fg,<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
ff NA
❑ NE
2. 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
No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facili ',Number: IDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes To ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No Ej NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: _ l
Spillway?:
Designed Freeboard (in): Z19
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ,! 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 [ Q No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? [:]Yes io [DNA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 0:1- 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 Vo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes E No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Cg o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13, Soil Type(s):
l4. 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?
Reauired Records & Documents
❑ Yes ®No
[:]Yes H <o
❑ Yes 2<0
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑ Yes 0"No NA ❑ NE
❑ Yes o ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[�io
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
D o
❑ 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
&To
[] 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
To
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No [Erl�4A ❑ NE
Page 2 of 3 21412011 Continued

Facility �Wumber: - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit. [] Yes fo ❑ NA ❑ NE
25. Is 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?
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:
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?
s•(refer to:question #1):. Explain°any YE&answers and/or any additional reconm
das of facility to better expliWsituations (use.'additional pages as necessary
'�5" ,loize V_a44_-' eke.' 61 1 /2CV/ ,
P.A'e"" tee. z.
4 6-
Reviewer/Inspector Name:
Reviewer/Inspector
Page 3 of 3
zo �l .
❑ Yes E31<o ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA L2-119
❑ Yes [a*go ❑ NA ❑ NE
❑ Yes I`_-_f ivo ❑ NA ❑ NE
❑ Yes 2<o ❑ NA ❑ NE
❑ Yes 2 o [DNA ❑ NE
❑ Yes
g:?#<o
[DNA
❑ NE
❑ Yes
1�o
❑ NA
❑ NE
❑ Yes
5'No
❑ NA
❑ NE
Phone: �� '�
Date:
14/2011

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: tO Arrival Time: 42 Departure Time: County: rI � '�%Region:
Farm Name: _ �11� p (P, k s pavj fto 5 ^,E, , Owner Email:
Owner Name: W 042 Phone:
i
Mailing Address:
Physical Address:
Facility Contact: ' ``f a�F-� Title:
tt
Onsite Representative:
ti
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number: Ir i ZS
Back-up Certification Number:
Location of Farm: Latitude: 0 0 = f = Longitude: = ° ❑ 1 ❑ "
Design Current Designnent
ne
!nM6ugent
Capulation
Wet Poultry
Capacity Population Ca#tle Capacity Population
❑ Wean to Finish
❑ La er
❑Dai Cow
❑ Wean to Feeder
❑Non -La er
❑ DairyCalf
Feeder to Finish
a�0
(�
-
❑ DairyHeifer
El Farrow to Wean
Dry<Poultry
❑ D Cow
Farrow to Feeder
QEW
❑ Non -Dairy
❑ Layers
El Farrow to Finish
❑ Non -Layers
❑ Beef Stocker
❑ Ciits
❑ Beef Feeder
El Boars
❑ Pullets
❑ Beef Brood Co
❑ Turkey s
her❑Turke
JEED
Poults
Other
❑Other
mber pf Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d_ Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes P No ❑ NA ❑ NE
El Yes
❑No
®NA
(Q9
❑NE
❑ Yes
El No
NA
❑ NE
❑ Yes
❑ No
99NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
IPNo
❑ NA
❑ NE
12128104 Continued

lFacility Number:
Date of Inspection 5 2
Waste Collection & 'Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Stru ture 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?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No F NA ❑ NE
Structure 5 Structure 6
❑ Yes 9No ❑ NA ❑ NE
❑ Yes [9 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 [nNo ❑ 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 B No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes IN No ❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ONo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside ofAcceptqblaCrop Window [:]Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) 414 '7ro_ �
13.
Soil type(s) 6 Pik L tj,6
--
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
C#No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
[4 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
I] No
❑ NA
❑ NE
18,
Is there a lack of properly operating waste application equipment?
❑ Yes
M No
❑ NA
❑ NE
Comments. (refer to, question ft Explain any YES answers and/or, any recommendations or any other comments. }
Use drawings -'of facility Eo better explain situations. (use additional pages as necessary): s'
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page 2 of 3
Phone: 4]/0- 3 31
Date: 21 �I D
12128104 Continued

r
• Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes gNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes D9 No ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes CR 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
`'P No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�j No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
1p No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
T No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
1P No
❑ 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
V) 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
V) No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 I . Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
NFNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
®No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
El Yes
�No
❑ NA
❑ NE
Page 3 of 3 12128104

)5/H1 a111le0a svJ
Type of Visit aCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit (5�"Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival `rime: Q: Departure Time: County: Region: Fk0
Farm Name:t��'[�, T711_� f' Owner Email:
Owner Name: � n-P _Wee!6 Phone: 89�-3ql) _
Mailing Address: k r p QVn Q833 `>r
Physical Address: [1
Facility Contact: RV an �� Title: Phone No: Soo—r
Onsite Representative: Integrator: Ink -
Certified Operator: i\ wL kr Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = o Longitude:
Swine
-€
Design Current Design Current a 7 . ,
t
Capacrty Populatinnr Wet Poultry • CapYactty I'opulahon, s :Cattle
Design Current
C9pack�yj ulation
-
❑ Wean to Finish
❑ La er ° El Dairy Cow
❑ Wean to Feeder
❑ Non -La er ❑Dai Calf
E=]s
Feeder to Finish
" a, ❑ Dairy Heifer
❑ Farrow to Wean`
rsaa ❑ D Cow
Farrow to Feeder
Dry Poultry'.
' . ❑ Non -Dairy
❑ Farrow to Finish
r= + ❑ El Layers Beef Stocker
❑ Gilts
El Feeder
❑ Boars
❑ Beef Brood Co
Other
°"°
❑ Other
Number of 5truetures:
El Non -Layers
El Pullets
El Turke s
El Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
[I Yes
CRNo
El NA
❑ NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
El Yes
El No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El Yes
El No
El NA
El NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system`? (If yes. notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
CRNo
❑ NA
El NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El yes
RNo
El NA
El NE
other than from a discharge?
12128104
Continued

Facility NumberN3 —' Date of Inspection lfLJ.lI J
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes rRNo ❑ 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?: -my;;:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
j;JNo
❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
RNo
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
P No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
WNo
❑ 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
N No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
NNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
UNo
❑ 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 p p ❑Evidence of Wind Drift ❑Application Outside of Area
12. Crop type(s)
13. Soil type(s)
F--
7 J
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
J�jNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
V[Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
JR No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
RNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
RNo
❑ NA
❑ NE
Reviewer/Inspector Name inr
2
0Ctv�j� Phone: q10 433 3?9 �C�3
Reviewer/inspector Signature: Date:
Page 2 of 3 12128104 Continued

µ
Facility Number: Date of Inspection 11
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 5-No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 5a 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 ERNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ® NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ERNo ❑ NA ❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[RNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
(R No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
[R NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
C? 7No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
PffNo
❑ 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
[�TNo
❑ 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
[tNo
❑ 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
�TNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
0 No
❑ NA
❑ NE
Additional Comments and/or Drawin s::
'PleS e dlo soil . ark �s�, f'a- )009 0)4— 1lrne -0.eVr rvh6P-e n�rt4
1) Well MdlA' _61F}e4 -(v&I q-,36a rt.rords,
de
io V ich a orYNle 31- r►oL
f4atal plats add roe crors, rnot� vsD�� r����;�PG�i«r�o�,
Pt A) .+D lG nt _'l+fl� e ��l s 1 S,¢� l b ✓n1M jP'
Page 3 of 3 12128104

Facility No. Farm Name NAS— %)) ' f Date °)11114
Permit COC ✓arOIC—Z-11" NPDES (Rainbreaker
Pop.Type Design Current
FB Drops
PLAT Annual Cert )
Lagoon
1
2
3
4
5
6
7
Spillway
Design freeboard
I
Observed freeboard in
Sludge Survey Date la, i
Sludge Depth ft& % —IIS
Liquid Trt. Zone ft
L6j1' '
Calibration Date
3
4
5
6
7
8
Design Flow
Actual Flow
p
Design Width
Actual Width
Soil Test Date a li
pH Fields
Lime Needed
Lime Applied-
Cu Zn 56Wh&,e lap
Needs P
1 in Inspections
Crop Yield �� a3� 120 min Inspections
Wettable Acres v Weather Codes
WUP ^`-� Transfer Sheets
Weekly Freeboard RAIN GAUGE^
Rainfall >1"
Pull/Field
Soil
Crop
RYE
PAN
Window
Max Rate
Max Amt
"04
30
Mir-
1.
w_
ar
TO
N —
U
;3
5
r
if
V*Prn►=I -1'1'r so-* t5loq�
Verify PHO NUMBERS and affil tions 11` ��
Date last WUP FRO Date last WUP at farm 1
FRO or Farm Records
Lagoon #
Top Dike
Stop Pump
Start Pump
App. Hardware Ws-f Jwr

V-Division of Water Quality ns
Facility Number O Division of Soil and Water Conservation
0 Other Agency C4
Type of Visit compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit,_*outine O Complaint 0 Follow up 0 Referral O Emergency 0 Other ElDenied Access
Date of Visit: z Arrival Time: ® Departure Time: County: Region: i"�
Farm Name: iKiQKA:.Faj rnS X Inc— _ Owner Email:
Owner Name: LOUAL& f CY1S Inc Phone:
Mailing Address:
Physical Address:
Facility Contact: QY'\
Title: U l,S W_'V' Phone No:
Onsite Representative:
`
Integrator: _ 1 nd 9 &Kj­
Certified Operator: 2
I
e Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o ='
❑ « Longitude: = o = I = "
Swine
❑ Wean to Finish
❑ Wean to Feeder
Fecderto Finish
tJ
-7
❑ Farrow to Wean
arrow to Feeder
0c)
l7D
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La ei
Dry Poultry
❑ La ers
❑ 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?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
Design � Ci�i
Cattle Capacity Popu
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood CoyA
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes KNo ❑ NA ❑ NE
❑ Yes
❑ No
tKNA
❑ NE
❑ Yes
❑ No
P,NA
❑ NE
❑ Yes
❑ No
bkNA
❑ NE
❑ Yes
[ LNo
❑ NA
❑ NE
❑ Yes
F No
❑ NA
❑ NE
12128104
Continued

Fdcility Number: —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes V No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes 1� No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes J 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 01 No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7_ Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes XNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes kNo ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes X No ElNA ❑ NE
ElExcessive Ponding ElHydraulic Overload ElFrozen Ground ElHeavy 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) L:9_ m P C"1 r o S
13. Soil type(s) Wo A , No Lw
14. Do the receiving crops differ from those designated i the CAW117P?
El Yes
o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ANo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
�gNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
'�ZNo
❑ 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):
AL
Reviewer/Inspector Name WL= EitANTbm Phone:
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: 3 — Date of Inspection
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 ali components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes XNo ❑ 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
t%No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
"No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
];?LNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes R No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
'RNA
❑ NE
Other lssues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
91 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
[S 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
RNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
PNo
❑ NA
❑ NE
Comments and/or Drawings:
12128104

Facility No,. ci� Time In (� W Time Out Date ant 1012
Farm Name WLX" o.-vfYls V,C Integrator �P
Owner . ' Site Rep r��
Operator �wl��- _ _ _ No. ! m
Back-up No.
COC
Circle: C84eral r NPDES
Design
Current
Design
Current
Wean - Feed
Farrow - Feed
Farrow - Finish
Feed - Fini
ow - Wean
-]
Gilts oars
hers
FREEBOARD: Design I Observed r P,,,
Sludge Survey L� Calibration/GPMQ�/ 7,j Q
Crop Waste Transfers
Rain Gauge ��� Rain Brea
Soil Test Wettable Acres PLAT
Weekly Freeboard `Daily Rainfall `� 1-in Inspections
Spray/Freeboard Drop
Weather Codes 20 min Inspections
Waste Analysis:
Date Nitrogen (N) Date Nitrogen (N)
I r b a % U ty 3,
f
Pull/Field Soil Crop Pan Window
No- IN Va r - C]
C--, C) 60 Nai - F��

z

Michael F. Easley, Governor
o�oF w A rFRQG
wi'NOO-i
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
July 1, 2007 C
07—
Weeks Farms, Inc. JUL 17 2V
Weeks Farms Inc OBS-FAYEiTEVfLLEREG10NMLOFFICE
163 Ruffin Road
Dunn, NC 28334
Subject: Certificate of Coverage No. AWS430019
Weeks Farms Inc
Animal Waste Management System
Harnett County
Dear Weeks Fauns, Inc.:
In accordance with your application received on Januray 4, 2007, we are hereby forwarding to you this
Certificate of Coverage (COC) issued to Weeks Farms, Inc., authorizing the operation of the subject
animal waste management system in accordance with General Permit AWG 100000.
This approval shall consist of the operation of this system including, but not limited to, the management
and land application of animal waste as specified in the facility's Certified Animal Waste Management
Plan (CAWMP) for the Weeks Farms Inc facility, located in Harnett County, with an animal capacity of
no greater than an annual average of 800 Farrow to Feeder and 2700 Feeder to Finish swine. If this is
a Farrow to Wean or Farrow to Feeder operation, there may be one boar for each IS sows. Where boars
are unnecessary, they may be replaced by an equivalent number of sows. Any of the sows may be
replaced by gilts at a rate of 4 gilts for every 3 sows.
The COC shall be effective from the date of issuance until September 30, 2009 and replaces the NPDES
COC issued to this facility with an expiration date of July 1, 2007. You are required to continue annual
surveys of sludge accumulation in all lagoons at your facility; the one-year extension in Condition 111.19
does not apply.
Pursuant to this COC, you are authorized and required to operate the system in conformity with the
conditions and limitations as specified in the General Permit, the facility's CAWM_ P, and this COC. An
adequate system for collecting and maintaining the required monitoring data and operational information
must be established for this facility. Any increase in waste production greater than the certified design
capacity or increase in number of animals authorized by this COC (as provided above) will require a
modification to the CAWMP and this COC and must be completed prior to actual increase in either
wastewater flow or number of animals.
Please carefully read this COC and the enclosed State General Permit. Enclosed for your convenience is a
package containing the new and revised forms used for record keeping and reporting. Please pay careful
attention to the record keeping and monitoring conditions in this permit.
If your Waste Utilization Plan has been developed based on site -specific information, careful evaluation
of future samples is necessary. Should your records show that the current Waste Utilization Plan is
inaccurate you will need to have a new Waste Utilization Plan developed.
Aquifer Protection Section 1636 Mail Service Center
lntemet: www.ncwaterquality.org Location: 2728 Capital Boulevard
An Equal Opportunity/Affirmative Adion Employer-50% RecyciedtlO% Post Consumer Paper
ttttCamlina
JVatura!!r�
Raleigh, NC 27699-1636 Telephone: [phone]
Raleigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
Customer Service: [phone]

The issuance of this COC does not excuse the Permittee from the obligation to comply with all applicable
laws, rules, standards, and ordinances (local, state, and federal), nor does issuance of a COC to operate
under this permit convey any property rights in either real or personal property.
Upon abandonment or depopulation for a period of four years or more, the Permittee must submit
documentation to the Division demonstrating that all current NRCS standards are met prior to restocking
of the facility. ��-- � LUJ
Per ISX NCAC 2T .0111(c) a compliance boundary is provided for the facility and no new water supply
wells shall be constructed within the compliance boundary. Per MRCS standards a 100-foot separation
shall be maintained between water supply wells and any lagoon, storage pond, or any wetted area of a
spray field.
Please be advised that any violation of the terms and conditions specified in this COC, the General Permit
or the CAWMP may result in the revocation of this COC, or penalties in accordance with NCGS 143-
215.6A through 143-215.6C including civil penalties, criminal penalties, and injunctive relief.
If you wish to continue the activity permitted under the General Permit after the expiration date of the
General Permit, an application for renewal must be filed at least 180 days prior to expiration.
This COC is not automatically transferable. A name/ownership change application must be submitted to
the Division prior to a name change or change in ownership.
If any parts, requirements, or limitations contained in this COC are unacceptable, you have the right to
apply for an .individual permit by contacting the staff member listed below for information on this
process. Unless such a request is made within 30 days, this COC shall be final and binding.
This facility is located in a county covered by our Fayetteville Regional Office. The Regional Office
Aquifer Protection Staff may be reached at [phone]. If you need additional information
concerning this COC or the General Permit, please contact the Animal Feeding Operations Unit staff at
[phone].
Sincerely,
for Coleen H. Sullins
Enclosures (General Permit AWG100000, Record Keeping and Reporting Package)
cc: (Certificate of Coverage only for all cc's)
Harnett County Health Department
Harnett County Soil and Water Conservation District
Fayetteville Regional Office, Aquifer Protection Section
AFO Unit Central Files
Permit File AWS430019

'Division of Water Quality
Facility Number O Q Division of Soil and Water Conservation
In Other Agency
Type of Visit IKCompliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit O Routine NwComplaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: '� Arrival Time: Departure Time: County:
Farm Name: r`a�vnn Owner Email:
Owner Name:
Mailing Address:
Phone:
Region:
Physical Address:ir j l
Facility Contact: Q Title: Phone No: 1 lO i � �'"
1-
Onsite Representative:v%' Integrator: -
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =] o [—]' =] « Longitude: [—] ° =' E=] "
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
_ _ _ ElLayer
^� j ❑ Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkev Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ DaiEZ Calf
❑ Dairy I-Ieifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
FF1'
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
A
❑ NE
.�-
❑ Yes ❑ No
ONA
❑ NE
❑ Yes 510
❑ NA
❑ NE
❑ Yes No
❑ NA
❑ NE
12128104 Continued

.3 o1
Facilitv Number: — Date of Inspection aS
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
❑ Yes Az�o
❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
❑ Yes �Vo ElNA ❑NE
ElYes bNo ❑ 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 ❑ No ❑ NA �NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes ❑ No El NAfE
(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
maintenance or improvement? !!!
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA yNE
maintenance/improvement? V
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes , No El NA El NE
❑ Excessive Ponding El Hydraulic Overload El Frozen Ground El Heavy Metals (Cu, Zn, etc.) /
❑ PAN ❑ PAN > 10% or l0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA ANE
15. Does the receiving crop and/or land application site need improvement?
ElYes
❑ No
ElNA g04E
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
❑ No
❑ NA
rNE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA )TNE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name S7/1Aj'5- Q1-'j Phone: L/33 ;3
Reviewer/Inspector Signature: Date:
121281041 1 Continued

Facilit3(,Number: — Date of Inspection i!
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA 1*E
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [I Yes El No ❑ NA 1 *�E
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA P NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections
22. Did the facility fail to install and maintain a rain gauge?
❑ Monthly and 1" Rain Inspections ❑ Weather Code
❑ Yes �No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Additional Comments and/or Drawings:
112S) rn 5 n`l n f `7 O
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes �eNo
❑ Yes ❑ No
❑ Yes ) jNo
❑ Yes 1%No
❑ Yes -4No
❑ Yes ',1E%No
❑ NA ❑ NE
❑ NA �iE
❑ NA PNE
❑ NA ONE
❑ NA 01 NE
❑ NA_A NE
❑ NA E
❑ NA P3KE
❑ NA ❑ NE
❑ NA ❑ NE
El NA El NE
❑ NA ❑ NE
VA C'1 Icy as- cs w "P- V " 6-Y, U
a 6k4 er
rn LX e%'% tc_" ?07A '4C
+'
MC
1Qss 4hon Z nd3
12128104

Type of Visit 'Q Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint *follow up Q Referral Q Emergency Q Other ❑ Denied Access
Date of Visit: . 3 dl Arrival Time: Departure Time: I� County: Region: rP-+C.�
Farm Name: ,TaA M 1 �n �J Owner Email:
Owner Name: ul)cc,_ eA Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: T-� Ga1SZ.Ir _ Phone No:
Onsite Representative: Integrator: I nQ0.. 0 4 .iNd4
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o ❑ g ❑ « Longitude: ❑ 0 ❑ d =
di
Swine
Design
Capacity
Current
Populatiou
Wet Poultry
Layer
❑ Non -Layer
Design Current
Capacity Population
[E]
Design Current
Cattle Capacity Population
log❑
❑ DairyCow
❑ DairyCalf
_
e""°`°"'
3 r .;n, _,_.
❑ Dai Heifer
Dry PoultWNW-y
❑ D Cow
❑ La
❑ Non -Dairy
'Ls
El Stacker
❑ Non -La ers
El Beef Feeder
❑ Pullets
❑ Beef Brood Co
-
❑ Tulles
Other
❑ Other
❑ Turke Poults
❑ Other
"Number of Structures:
❑ Wean to Finish
Wean to Feeder
eeder to Finish
10 v
❑ Farrow to Wean
arrow to Feeder
�� O
❑ Farrow to Finish
❑ Gilts
❑ Boars
Discharges & Stream Facts
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 front a discharge?
Page 1 of 3
❑ Yes �No ❑ NA ❑ NE
❑ Yes
❑ No )p NA
❑ NE
❑ Yes
❑ No
XNA
❑ NE
IRNA
❑ NE
❑ Yes
❑ No
❑ Yes
ANo
❑ NA
❑ NE
❑ Yes
&No
❑ NA
❑ NE
12128104 Continued

Fai•ility Number: 5 — (�
Date of Inspection O
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in): L
Observed Freeboard (in): Z7
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes %No ❑ NA ❑ NE
❑ Yes ❑ No M NA ❑ NE
Structure 5 Structure 6
❑ Yes )hNo ❑ NA ❑ NE
❑ Yes Wo ❑ 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 AE!�No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ho ❑ 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 44No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes o ❑ 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 Drift [:]Application Outside of Area
12. Croptype(s) rn P {.IJLL L� Y - T0.5 Vy-t-
13. Soil type(s) � a A t
14. Do the receiving crops differ from those designated h1 the CAWMP?
❑ Yes Aj No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ YesJ4 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes ANo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes PQ
No
❑ NA
❑ NE
F:
Comments (refer to question { .Explain any YES answersand/or any recomme_ndatyons or•any other. comments ,
Use: drawings of facility to better explain situations. (use. additional pages as necessary): .t
d
Reviewer/inspector Name gT� I Phone
Reviewer/Inspector Signature: Date: 490) I
Page 2 of 3 ---411 12128104 Continued

Facility Number: � Date of Inspection
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA �' "E
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes El No El NA �" E
the appropriate box. ❑ WUp ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA
❑ 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 ❑ No ❑ NA [� NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA QNE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No ❑ NA t NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ❑ No ❑ NA b3NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No ❑ NA [MNE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No ❑ NA 0 NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes ❑ No ❑ NA NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ❑ No ❑ NA NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes ❑ No ❑ NA [� NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ❑ No ❑ NA ONE
33. Does facility require a follow-up visit by same agency? ❑ Yes ❑ No ❑ NA NE
Additional Comments and/or Drawings ,r "
V1 C4 '► V re U• ' CXw fE ?O.-tf it emcc ds c,-r d Uri ;,np� �O►� Yn�: rl 17vt'2S JL
` V U
1 n � • C0.�e.d. [ �e i a-ss-��he.� -�� �k+� �ctr r,n � I `�,� C'
g �1X0 �R.YI C�.Uri v� Lq4e Nov
r� r kCL U
Ti�l Z r r 0. L& ►�rLr i Csy1 CD `0 2 i�JQ S
r \ 9 11 .
&np-
urn k0.S Cad-brw�'�Ci ' �� .' cl� - C�m CQlGu/a tans
a - , ,ra-�-L -5 taw oVe.rQfe 1 t C J,'6Y1 c)cc u rsed
Page 3 of 3 12128104

Type of Visit 40 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
1tLDate of Visit: XA Arrival Time: Departure Time: County: (_` + Region:
Farm Name: CLV m l h c Owner Email:
Owner Name..U_R" lA;a 1 Phone:
113
Mailing Address:
Physical Address: `,,,,
Facility Contact: Title: ® U1Phone No:
Onsite Representative: ` Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = o = [ = u Longitude: = o = 1 ❑
Design Current Design Current
Design Current
Swine Capacity Population Wet Poultry Capacity Population
Cattle CapacityPopulation
❑ Wean to Finish
❑ La er
❑Dai Cow
to Feeder
❑Non -La er
Dairy Calf
Rean
eederto Finish 00 I / oo
❑ Dairy Heifer
❑ Farrow to Wean Dry Poultry x '
❑ Dry Cow
Farrow to Feeder CAD
❑ Layers
❑ Non -Dairy
❑ Beef Stocker
❑ Farrow to Finish
Gilts Non -La ers
ElBeef Feeder
PE]Boars ❑ Pullets
❑ Beef Brood Co
❑ Turkeys
otl EM1311111MIM ❑ Turkey Poults
Number of Structures:
❑ Other 11 ❑ Other
DischaM" & Stream Facts
1. Is any discharge observed from any part of the operation?
❑ Yes
IQ No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
h NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
[�tNA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑ yes
❑ No
*NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
&No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
�MNo
❑ NA
❑ NE
other than from a discharge?
Page l of 3
12128104
Continued

Facility Number: 3 —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
IN No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No JANA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Cd No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
MNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
t2kNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
-0 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
M o ❑ NA ❑ NE
maintenance or improvement?
Waste Api3lication
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.
tK 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 Area
u
12. Crop type(s) rn 0. r 0.5 V- C . �"i {C�� anr� 15
" Nk
13. Soil type(s)
14. Do the receiving crops differ from those designated in the-�AWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
$1 No ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
10 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
QVNo
❑ NA
❑ NE
Comments (refer' -.to question,#f): Explain any YES answers and/or any recommendations --or any other comments r
Use drawings of facility to better explain situations. (use additional pages as necessary): `s
S Z t y S
b�
PirL d a ,Per ape J' [D : rn P� RA s h ZM (o `Ol 1 r— r�
(
�
-Z1'4 a�cr
b 16 No+t In ra�r a<<+ r,,, Nod Z6�(,p. 4c
mutes fs�t &xqr
s
Reviewer/Inspector Name i
f YC�� j f� � Phone: '— 0
Reviewer/Inspector Signature:
Date:
Page 2 of 3 12128104 Continued

Facility Number: 3 —fig Date of Inspection oZ}*
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �4No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 1jNo ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists El Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �§ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ 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
KNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
tPNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
tA No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
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
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
CXNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
EQ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
`
- 60A0­+mot rn us� 5} � 1 fuZ. 'Z m 5 4� � 0 � CA Q "4:
SQ9.Sor .
Lo CA : (5yx %
'� unL �ane� tpr' r r 1 �r�e
a arr-" .rm 4, a 2ti
Page 3 of 3 12128104

Faciiity No. r r Time In `I Time Out Date X07
Farm Name ft Au Fok-1 sw. _ Integrator I ndQ� M/
Owner Site Reg
Operator G-r C3tr` No.
Back-up
COC
No.
Circle: General or Ne
Design
Current
Design
Current
Wean - Feed
arrow -
Farrow - Finish
Wean - Finish
- Finis
O O
Gilts / Boars
arrow --Wean
Others
FREEBOARD: Design
Sludge Survey E�
Crop Yield
Rain Gauge
Soil Test
Weekly Freeboard
Spray/Freeboard Drop _
Weather Codes /
Observed
Calibration/GPM / 3
Waste Transfers
� ain Breaker
PLAT
Daily Rainfall Y
120 min Inspections""
Waste Analysis:
Date Nitrogen (N)
I n"1 a
Wettable Acres
1-in Inspections L_--1
Date Nitrogen (N)
U I -z 3 .-�
'If In
zl 9. z. 4
Pull/Field Soil Crop Pan Window
vj O R
cD 1
U
on
5�0
a ��
3

/
c
1 �
•ao
O
.J
w
G
✓1
/ S
l
3
J
1
-� = ri
>,
ri
t
,fis
I
1
I �

— -(Division of Water Quality
iFacility Number O Division of Soil and Water Conservation
0 Other gene'
Type
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: O Departure Time: /�,' County: .&I-
Farm Name: f,(ito/<�_ }�ui'm� Lr_ , ___ Owner Email:
Owner Name: ��t ou�r,.e „w��S Phone:
Mailing Address:
Physical Address:
Facilitv Contact: Swntl, Title:
Onsite Representative:. S�r�
Certified Operator: ra
Back-up Operator:
Location of Farm:
Swine
Region: J�
Phone No:
Integrator: r7J1, a .Ytz —
Operator Certification }Number:
Back-up Certification Number:
Latitude: = c = 1 = " Longitude: ❑ ° = 1 = u
Design Current Design Current
Capacity Population Wet Poultry capacity Population
❑ Laver
❑ Non-Layet
❑ Wean to Finish
Date of Visit: Arrival Time: O Departure Time: /�,' County: .&I-
Farm Name: f,(ito/<�_ }�ui'm� Lr_ , ___ Owner Email:
Owner Name: ��t ou�r,.e „w��S Phone:
Mailing Address:
Physical Address:
Facilitv Contact: Swntl, Title:
Onsite Representative:. S�r�
Certified Operator: ra
Back-up Operator:
Location of Farm:
Swine
Region: J�
Phone No:
Integrator: r7J1, a .Ytz —
Operator Certification }Number:
Back-up Certification Number:
Latitude: = c = 1 = " Longitude: ❑ ° = 1 = u
Design Current Design Current
Capacity Population Wet Poultry capacity Population
❑ Laver
❑ Non-Layet
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
] tJD
❑ Farrow to Wean
t& Farrow to Feeder
ffV O
b
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Cattle
Design Current,
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy }leifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stockei
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures:
��.
b. Did the discharge reach waters of the State? (ifves, 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 M No ❑ NA ❑ NE
❑ Yes
[Q No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
No
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
5q No
❑ NA
❑ NE
12128104 Continued

' s
Facility Number: - Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Ycs RNo ❑ 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: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _?`_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
,KNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
® No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
& No ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
ENNo ❑ 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
gNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
93 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 El Application Outside of Area
/Drift
12. Crop type(s) YL'J � 1 dZ-j-Wr paw "- nr-
13. Soil type(s) /VIQ A _/ Z. y / 'U0 J3
14. Do the receiving crops differ from those designated in the CAWM P?
❑ Yes
® No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
5allo
❑ 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
JR No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
O No
❑ NA
❑ NE
Reviewer/inspector Name I ^" -f Y' fay f
Phone: �
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: AAgDate of Inspection G
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Callo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ANo ❑ NA ❑ NE
the approprrate box.
❑ WUP ❑Checklists El Design El Maps ❑Other
21, Does record keeping need improvement? If yes, check the appropriate box below- [SYes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking LOCropYield ❑ 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
g No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
9INo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
f�ill No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
JK No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
CK No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
21 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
® No
❑ NA
❑ 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
LgNo
❑ 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
9LNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
5d No
❑ NA
❑ NE
Addttfooal Comentsand)oirDrawvigs;� '
}.
�'
.� ' l;
12128104

r _
Type of Visit ® Compliance Inspection O Operation Review 0 Lagoon Evaluation !
Reason for Visit ® Routine O Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access !i
Faeilinv Number Date of Visit: Time: �Q
- - — Not O erational 0 Below Threshold
0 Permitted ® Certified 0 Conditionally Certified M Registered Date Last Operated or Above Threshold:
Farm Name: ��G!'i,n1 V%Q. __ _ County: -LcIg '
Owner Name: _ ,4 - W cicep.-S Phone No; � 1�q3 —31-?a
Mailing Address:
Facility- Contact: Phone No:
Onsite Representative: L;� G n 0 aL _ Integrator: ram. a .
Certified Operator: --1 n6 13 e-CM - Operator Certification Number: 3L9 ak
Location of Farm:
IN Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' & ��" Longitude ' •
Design Current
Swine i"anw-eh Pnnnlatinn
❑ Wean to Feeder
® Feeder to Finish
OD
❑ Farrow to «'ean
® Farrow• to Feeder
goo
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Ca acity Po elation
❑ Laver ___d❑ Dairy
❑ Non -Laver ❑ Non-Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains
Holding Ponds I Solid Traps 10 No Liquid Waste 11
Discharges & Stream Impacts
1. Is anv discharge observed from any part of the operation?
Dischame originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the Statc? (if yes, notify DWQ)
c. if discharge is observed. what is the estimated flow in Qal/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?
Area JLJ Spray Field Area
❑ Yes ® No
❑ Yes ❑ No
3. Were there am adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes ® No
Structure 6
Continued

r
a
Facility Number:
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?
❑ Yes [ No
❑ Yes Q3 No
❑ Yes [P No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
51,No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
No
Waste Aoolication
10. Are there any buffers that need maintenance/improvement?
❑ Yes
PNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
29 No
12. Crop type Re.rvw ", 4, S CTV%& 1^ D. -S,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
F�j 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
P No
16. Is there a lack of adequate waste application equipment?
❑ Yes
EjLNo
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
[�No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
W No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
`tom No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
[�g No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
ERNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
W No
23.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
M No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
Wo
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
��„$'n kg ia` �,r i.., W .yXy _ fY: .5-� ��R 'M
Comments�(�efer tq question #) E:platn any YEAS answers, aii&oi dny recommendations or any other comments.�£u
l he drawings ofsicihty to better explain situations (use stidtbonal pages as necessary) ( .' ❑Field Cony ❑Final Notes
�,,..tt�'�"*,
f�►e.t..3 L l am- -U Crnr o `^- Z 4 t� Ycs ^ r c�^ V L.,,, �-
t
®��4, P-01 c.J� l� Qit lc�� ist. 44-• Sf GSf
T
Reviewer/inspector Name
Reviewer/Inspector Signature: Date: 4 a 6
05103101
Continued

Facility Number: /4 3 - I q Date of inspection l
dor 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. Arc there any dead animals not disposed of properly within 24 boors?
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/tcmporary cover?
❑ Yes ❑ No
❑ Yes IV No
❑ Yes W No
❑ Yes M No
❑ Yes [XI No
❑ Yes CU No
❑ Yes ❑ No
Additiona];Camments an or Drawings• ?
05103101
05103101

visiodofVaiWi)i
M
Type of Visit Q Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification O Other
❑ Denied Access
Facility Number 43 19 DatC of Visit: 08-1 l-2003 Time: 1.00
Q Not Operational Q Below Threshold
® Permitted ® Certified [3 Conditionally Certified 13 Registered Date Last Operated or Above Threshold_
Farm Name: 1'N County: tLwmktL---------------------------------- FRQ---------
. ir�ks.l~��ms lac...................................................................
Owner Name: D��a1Ae-- --- -ee --- - - --- - - ---------- Phone No: 4�Q_8422�D - ---- ------ ----- --- ---
Mailing Address: ib.l3uAn0..liRad................................ Ii1�i110...L!1 ............................. 83 .4 .............
...................................................................................
Facility Contact: ........................................................... Title: ............................................... Phone No:
Onsite Representative: -- - - - ----- - - ------------------------ - - - - I;ntegrator:.-------------------- - - - ----- --------
Certified Operator:Rja[1.a).................................. .W.:e4Kks........................................._...... Operator Certification Number: 1.7928 ............................
Location of Farm:
From Raleigh 140 E. to 1-95,1-95 S. to exit 71 across bridge go 1/8 mileto crossroads take right on 1811 go 1/2 mile. Left on +
Ruffin Rd. go 1/4 mile to first left farm entrance.
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 6 Longitude • 1 Du
Design Current Design Crar�ent "Design Current
Swine. Ca aci Po elation Poultry` Capacity Population Cattle ,, Capacity "Popu[apou_
❑ Wean to Feeder
® Feeder to Finish
2700
❑ Farrow to Wean
® Farrow to Feeder
800
❑ Farrow to Finish
❑ Gilts
❑ Boars
i timber of Lagoons 1 , ® Subsurface Drains Present ❑ Lagoon Area JIM Spray Field Area F
Holdtng:Ponds / Solid Traps ❑ No Liquid Waste Management System
�.,
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ ether
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, «•hat is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
El Yes [I No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): .......... _..... _.__............................ .......................... .......................... ........................... ...........................
05/03/01 Continued

Natality Ntamber: 43:79 Date of Inspection 08-11-2003
5. Are there any immediate threats to the integrity of any of the structures observed? (le/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ❑ No
(If any ofquestions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste A onlication
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
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
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
I &
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19,
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ ofemergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
❑ Yes
❑ No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Camrttents (refer to:gnestton #) Explain any YES answers and/or any recommeodat>ions or any other comments
Use drawings of facility to better s�tuati (use�add�tional pages as necessary). `
i.explain _. f ❑ Field Copy ❑ Final Notes j s-
�'
t ter.,-�.rt, r'-,,,,^,:.Yk
Site visited as result of reported freeboard level of 12". Present situation is cause for concern. High waters from the nearby creek are
backed up to the toe of the dam and flowing. Spoke with Mr. Weeks about diverting surface water flow from his house area away from
the lagoon. Lagoon has no set standard marker also. LCB is referring this to SWC for technical assistance.
Reviewerllnspector Name Larry Baxley`; Y Haghic White '
Reviewer/Inspector Signature: Date:

State of North Carolina
Department of Environment,
Health.and Natural Resources • a
Fayetteville Regional Office
&j
James B. Hunt, Jr., Governor ID E H N
Jonathan B. Howes, Secretary
Andrew McCall, Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
August 10, 1995
Mr. Dewayne weeks
Weeks Farms
Rt. 1, Box 66
Dunn, NC 28334
SUBJECT: Compliance Inspection
Harnett County
Dear Mr. Weeks:
On August 8, 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 [phone].
Sincerely,
D. T. Jones
Chemist
DTJ/sc
Enclosure
CC* Facility Compliance Group
Wachovia Building. Suite 714, Fayetteville, North Carolina 28301-5043 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

DewjfyE WOO Ms
wrm s
.2S3 3
DIVISION OF ENVIRONMENTAL MANAGEMENT
1
SUBJECT: Compliance Inspection
County �1�'1��✓��
Dear
rd1�9.�
On 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 [phone].
Sincerely,
'afVjI
mt
eer
Enclosure
cc: Facility Compliance Group

Site Requires Immediate Attention:
Facility No.
DIVISION OF ENVMONMENx'AL MANAGEMEN 7
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
er
DATE: �` , 1995
Time: /O '. 101t�l
Fawn Name/Owner:-
Mailing Address: r -V V Iv-6 2,0
County:
NJ g9.1, 3 93 a
Integrator: Phone:
On Site Representative: R Phone:
Physical Addres_s//Locati{`on: /� ✓t/ e F - 4,,A/
Y
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
I.atitude: ,�riLongitude:
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) CC?or No Actual Freeboard: Ft. Inches
Was any seepage observed from the lagoon(s)? Yes ore Was any erosion observed? Yes o 10
Is adequate land available for spray? a or No Is the cover crop adequate? 'e or No
Crop(s) being utilized:G
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? a or No
100 Feet from Wells? es or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or(9
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line.) Yes os N&
Is animal waste discharged into waters of the state by man-made ditch, flushing systenn, or other
similar man-made devices? Yes o� If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or (go
Additional Comments: _ 1k Al 6' f--.) Oct- 5 _.
- - t a -- _
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.