470013_INSPECTIONS_20171231

NORTH CAROLINA ..�
Department of Environmental Qua

Type of Visit: 10 Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency 0 Other O Denied Access
Date of Visit: ? Arrival Time: d9?p04a. Departure Time: : oo County: �Q-
Farm Name: Andri'x _)i'c, Owner Email:
Owner Name:r �y-j�C Phone:
Mailing Address:
Physical Address:
Facility Contact: 1 &4 1 Title:
t1
Onsite Representative:
Certified Operator: rt.
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Region: 1=u0
Integrator: n_P 5 r" 1 S
Certification Number: 19 310
Certification Number:
Longitude:
Design
Swine' Capacity
RWean to Finish
Current Design Current
La er
Pop. Wet Poultry Capacity Pop.roDairy
Cow
Design Current
in Pop.
Wean to Feeder
p
-Layer
FFa'
Calf
Feeder to Finish
Farrow to Wean
�l�� ''�'
1 I' Design Currentw
1)r, P,�ultr, Ca aci P,o P.
Layers
Heifer
Farrow to Feeder
Non-Dal
Farrow to Finish
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Other
Other
pullets
Beef Brood Cow
Turkeys
Turkey Poults
10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes io No
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
�NA ❑ NE
NA ❑ NE
NA ❑ NE
NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

Facility Number: 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
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure I Structure 2 Structure 3 Structure 4 Structure 5
1
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
LT1"No ❑ NA ❑ NE
❑ No E� NA ❑ NE
Structure 6
❑ Yes 0 No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes �D No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? D Yes 1� No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes T® No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) TT
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 q—KbNo ❑ 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 DEvidence of Wind Drift ❑� Application Outside of Approved Area
l 2. Crop Type(s); �yt I t� ��, S614P J-1- . Ca TTV�! G%1 �'1.7 f�V .40 uQ r
13. Soil Type(s): ��, oat�mt.%
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes X No ❑ NA [] NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ®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
r
❑ NA
❑ NE
Required Records & Documents Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility tail to have all components of the CAWMP readily available? Ifyes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP El Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes T No
❑ Waste Application ❑ Weekly Freeboard [3 Waste Analysis ❑ Soil Analysis ❑ Waste Tr a sfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. 1f selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: qZ 6 Date of Inspection: 21161)7
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?
❑ Yes No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes ( No
❑ NA ❑ NE
Other Issues
r
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
r
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?'
❑ Yes {vim, No
`�'
❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No
❑ NA [] NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional naves as necessarv).
SI e s Co "I� 2-Mil L' z. W�% _ CO
[jr-P 1,4j 61311-7 Pvlo�
!uD D
� 5
4,i1 D ✓1 ,° S C o n+ ,v4e) 4, ta7 S
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
Phone: 9 i O-y33- 33D0
Date: g /,(
21412015

Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number:
470013 Facility Status:
Active Permit: AWS470013
❑ Denied Access
Inppection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for visit:
Routine
County: Hoke Region:
Fayetteville
Date of Visit:
08/14/2017 Entry Time: 11:45 am
Exit Time: 12:45 pm Incident 0
Farm Name:
Hendrix Livestock Inc.
Owner gMall,
Owner:
Earl B Hendrix
Phone:
910-875-0229
Mailing Address:
500 Chishlom Rd
Raeford NC 283769753
Physical Address:
500 Chrisholm Rd
Raeford NC 28376
Facility Status:
Compliant ❑ Not Compliant
Integrator: Ernest Smith Farm Inc
Location of Farm:
Latitude: 34' 56' 53" Longitude:
79' 16' 20"
3.5 miles South of Raeford on 401 to Bethel Church and left on JohnRussell Rd. to Chisholm Rd. and the farm is visible from
the
front of the church.
Question Areas:
Dischrge & Stream Impacts Waste Cal, Stor, & Treat Waste Application
Records and Documents . Other Issues
Certified Operator: Earl B Hendrix Operator Certification Number: 18310
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Earl Hendrix Phone:
On -site representative Earl Hendrix Phone:
Primary Inspector: Bill Dunlap Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
No hogs in several years, Sludge Survey and calibraion, other records maintained.
page: 1

Permit: AWS470013 Owner - Facility : Earl B Hendrix Facility Number: 470013
Inspection Date: 08/14/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Feeder to Finish 5,000 0
Total Design Capacity: 5,000
Total SSLW: 675,000
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.00 26.00
page: 2

ti
u
Permit: -AWS470013 Owner - Facility : Earl B Hendrix Facility Number: 470013
Inspection Date: 08/14/17 Inppection Type: Compliance Inspection Reason for Visit: Routine
Discharnas & Stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑
❑
b. Did 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)
Cl
■ ❑
Cl
2. Is there evidence of a past discharge from any part of the operation?
❑
E ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waete Collection. Storage & Treatment
Yes
No_Ne_Ne
4. Is storage capacity less than adequate?
❑
M ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Led large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
M ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0 ❑
❑
maintenance or improvement?
Waste Application
Yes No Na No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
f
page: 3

r
Permit: AWS470013 Owner - Facility : Earl B Hendrix Facility Number:
470013
Inspection Date: 08/14/17 Inpsection Type: Compliance Inspection Reason for Visit:
Routine
Waste Application
Yes No Na No
Crop Type 1
Corn, Wheat, Soybeans
Crop Type 2
Cotton
Crop Type 3
Other
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Wagram
Soil Type 2
Centenary
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑ 0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑ 0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑ E ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
❑ 0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
1101111
Records and Documents
Yes
No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
E ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
E ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑N
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

A
Permit: AWS470013 Owner - Facility: Earl B Hendrix Facility Number: 470013
Inspection Date: 08/14/17 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Reco oc men
Yea_ -No
Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1"Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
■ ❑ ❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
❑ ❑
(NPDES only)?
24. Did the facility fall to calibrate waste application equipment as required by the permit?
❑M
❑ ❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
❑ ❑
appropriate box(es) below:
Failure to complete annual sludge survey
❑
Failure to develop a POA for sludge levels
❑
Non -compliant sludge levels in any lagoon
❑
List structure(s) and date of first survey indicating non-compliance:
26, Did the facility fail to provide documentation of an actively certified operator in charge?
❑
❑ ❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
M ❑ ❑
Other Issues
Yen—No-Na
No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
■ ❑
❑
(!,a., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility?
❑
M ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
■ ❑
❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
■ ❑
❑
page: 5

I ks r L(
I %v prvjsion or waxer Kesources
11 Facility Number - 0 Division of Soil and Water Conservation
? 0 Other Agency
Type of Visit: C�ommpliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Wco
Farm Name: flex �L Owner Email:
Owner Name: -(ivL f Ck Gr,/' i. Phone:
Mailing Address:
Physical Address:
c
Facility Contact: �� i°r dL� Title:
Onsite Representative:
r�
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Region:
Certification Number: / b 3 / D
Certification Number:
Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Layer
on -Layer
pry roultry
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
Design Current
Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non-Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [2-fd ❑ NA ❑ NE
❑ Yes ❑ No D-ITA_ ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ 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 DWR) ❑ Yes ❑ No 21 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 effNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facility Number: q 7 jDate of Inspection:
L
Waste Collection & Treatment
4. 4 storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[ o
0 NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
Q.JNW
❑ 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
Q-Ko"
❑ 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
10
❑ 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
E2 "'o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[;?<0
❑ 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
�10
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
,�,
[✓]'o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Ld <0 ❑ 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
sn ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): C46K CC, -g, k Gd-^-!
❑ NE
13. Soil Type(s): (d )VI NO _
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ffNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes rR"N-o ❑ 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
dNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[ N' o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[3/No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
C�rNo
❑ 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 ONo
❑ 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 [I'No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E! No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412015 Continued

Facility Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [io ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 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 provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Lam° ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes E2<o ❑ NA ❑ NE
❑ Yes <0 ❑ NA ❑ NE
❑ Yes Zwo
❑ Yes ZNo
❑ NA ❑ NE
❑NA ❑NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes YNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes Cg'No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ❑ No ❑ NA ❑ NE
1Comments (refer to'guestion #) Explain any,YES answers and/or any,additionaiFrecommendations or any other-cotnments .;
11J'Wdeawings,of facility to better explainsituatiot si(useaadditiona[pagw as;necessary) >.., :.
C - b V"+" .1 -
'J ( I/ - d _f �
ee�L r Co� p�-6gS�
ReviewerlInspector Name: 1 vY1 Phone:
ReviewerlInspector Signature: ( 1/ LJ _ W1 Date:
Page 3 of 3 21412015

IV J()
v slon of Water Resources
Facility Number - 0 Division of Sol] and Water Conservation
Q Other Agency
type of visit: om fiance Inspection Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint 0 Follow-up O Referral O Emergency O Other 0 Denied Access
Date of Visit: ® Arrival Time: i is►. Departure Time: County: Region:
Farm Name: �v�tij Owner Email:
Owner Name: ���, �y,►I��e Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: I { Integrator:
Phone:
10
Certified Operator: j ( Certification Number: 4$140
Back-up Operator:
Location of Farm:
Swine
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
]Non -Layer
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
You
Non-L
Pullets
Other
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
Longitude:
Design Current
Cattle Capacity Pop.
Daily Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [jj-K ❑ NA ❑ NE
[:]Yes [:]No NA ❑ NE
❑ Yes ❑ No [D,�K ❑ NE
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 ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes o ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes R�-W ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No Z>A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes E3<o ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[ Io
❑ 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
[; <o
❑ 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
25 No
❑ NA
❑ NE
maintenance or improvement?
Waste A1212lication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Efo
❑ NA
❑ NE
maintenance or improvement?
1-1. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes Yo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[![ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�'..
0 NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
�o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[j ,W
❑ 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
�nNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
5No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 2!rNo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes
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 21412014 Continued

FacUity Number: - Date of Inspection: d
,,24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Z�- o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [!rV-o_ ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a PDA for sludge levels
❑ Nan -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes [;j Ncr, ❑ NA ❑ NE
❑ Yes QLNa_❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes Lg-Nu ❑ NA ❑ NE
❑ Yes � ❑ NA ❑ NE
❑ Yes [2-415-- ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes r:;�o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes E f rNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes J:j_No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional, recommendations or any other comments.
Use drawings of facility to better explain;situations1use additional paf;es'asgnecessary)
Reviewer/Inspector Name: �3 I u e uy r1 p Phone: ��� �33
Reviewer/inspector Signature: V Date:- s
Page 3 of 3 21412014

i
13 4)
Division of Water Resources
Facility Number - O Division of Soil and Water Conservation
O Other Agency
Type of Visit: Com ance Inspection Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Com laint OFollow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: i Region:
Farm Name: �*Joy'
Owner Email:
Owner Name: E,� it. dt'/ Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator -
Back -up Operator:
Location of Farm:
✓ w Title:
Phone:
Integrator:
Certification Number: 't1 31,c>
Certification Number:
Latitude: Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop, Cattle
Wean to Finish
Wean to Feeder
Feeder to Finish Flo a
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Layer
Non -Layer
lit
Other
Poults
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Design Current
Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Caw
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
[]Yes If �"� II NA ❑ NE
[]Yes ❑ No
[:]Yes ❑ No
[:]Yes [:]No
[:]Yes ©510
❑ Yes Eno
[a-N-A ❑ NE
NA ❑ NE
NA
❑ NE
❑ NA
❑ NE
❑NA
❑NE
Page I of 3 21412014 Continued

>Facili Number: - Date of Inspection: ks
i
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [d]-Nfr' ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Io ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not property addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
[20 o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[2 J1e
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
0"No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
,__,,�
rG �°
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [ZNo ❑ 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): IV
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[ONo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
QXo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
�1a
❑ 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
G3 o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes 10
❑ 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 6 No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
0 Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[3 NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes VNo
❑ NA
❑ NE
Page 2 of 3 21412014 Continued

Facilik Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
g qTo ❑ 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 to provide documentation of an actively certified operator in charge?
❑ Yes
if ❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[:]Yes
Rio ❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[:]Yes
�o
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[�� "�io
[DNA ❑ 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
Er 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
ffNo
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
O No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
rN
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better.explaln situations (use additional pages as necessary). ..
Sfw[ges�w 1•!V'IY
e
Reviewer/Inspector Name:
s � 3. s3 - ��• 6 P
Phone: q33- 33
Reviewer/Inspector Signature:
Page 3 of 3
Date:
21412014

o �-f� I(� Z o l 3 I3
VDIvision of Water Quality
Facility Number - 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: om Hance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name: .�,�J�. h cylr� Owner Email:
Owner Name: �et,✓-i���`�y/� Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: I
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Phone:
Integrator:
Region:I
Certification Number: 1 e 3C d
Certification Number:
Latitude: Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop,
F;LayerNon-Layer
ury rouitry
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
Design Current
Cattle Capacity Pop,
Cow -
—Dairy
Dairy Calf
Dairy Heifer
DIX Cow
.Non-Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
[:]Yes [l ]Vo ❑ NA ❑ NE
[]Yes [:]No [g1A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
[—]Yes
❑ No
[TA
❑ 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
5Z�14o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
Ej(No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 21412011 Continued

Facili Number: Date of Inspection: 3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes gNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes Lilo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?: _
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
Structure 5 Structure 6
❑ Yes [ fo ❑ NA ❑ NE
❑ Yes ETNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or ❑ environmental t reat, notify DWQ
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 [3 Heavy Metals (Cu, Zn, etc.)
PAN ❑ PAN > 10% or 10 lbs. Total Phosphorus [3 Failure to incorporate Manure/Sludge into Bare Soil
Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
❑
❑ ❑
❑
7. Do any of the structures need maintenance or improvement?
❑Yes
o ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the pen -nit?
❑Yes
611(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
I �f""' NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑Yes
No ❑ NA
❑ NE
12. Crop TYPe(s): [ lJmi.j e.wa
13. Soil Type(s): IV 60_uC
14. Do the receiving crops differ from those designated in the CAWMP? [] Yes eNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [!�<o ❑ 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 [�Io ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? [] Yes [j;KNo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
CY 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 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
VNo
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

r
Facility Number; - Date of Ins ection;
24. Did the facility fail to calibrate waste application equipment as required by the permit?
[] Yes
To
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
[&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
�10
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
CaXo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to property dispose of dead animals with 24 hours and/or document
❑ Yes
[lk*f10
❑ 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
[&Ko
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[ Dflo
❑ NA
[] NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[�fo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?]
Yes
[TNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
F!rNo
❑ NA
❑ NE
Comments (refer to question ft 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).
.51 k_�
� *) '( {r t � fo Cj�;s s
Reviewer/Inspector Name: iR l 1LI1 Phonejlo
Reviewer/Inspector Signature: �.. Date:
Page 3 of 3 21417011

Division of Water Quality
Facility Number L - © 0 Division of Soil and Water Conservation
0 Other Agency
(Type of Visit: ('Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance j
Reason for Visit: (kooutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access II
Date of Visit: Arrival Time: 1 '. Departure Time: �S M County: �Region:
Farm Name: 1A tVk ''T -A �_ s \1 QS4Cx_k 1VC' _, Owner Email:
Owner Name: '�, AR KEN U N1%A Phone:
Mailing Address:
Physical Address:
Facility Contact: pR Q , tkt tAAiJX Title: Phone:
Onsite Representative:
Integrator: KWI P-S-T S M_T'L h
Certified Operator: t ARC Q. _'k-no lI u Certification Number: k 83 , Q
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Certification Number:
Latitude:
Design. Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
ury F,
Layers
Non-L
Pullets
Other
Poults
Design Current
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Daiu Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non-Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes E(N o ❑ NA ❑ NE
[:]Yes [:]No
❑ Yes [:]No
[:]Yes [-]No
❑ Yes [3'No
❑ Yes [D"'No
[-f A ❑ NE
[5AA ❑ NE
?<A
❑ NE
❑NA
❑NE
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

r 'C
Facility Number: - 3 Date of Inspection:
Waste Collection & Treatment
YNo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
[gINA
❑ 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
[�2eIVo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
b. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[ 3'*No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[�No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
[2�No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[jeNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[ffNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
[[*No
[DNA
❑ 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): Q(>�-1�+�j�r&k %CW kLm,S
13. Soil Type(s):�jCCO lk !�Ras'6
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 EZNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes E2/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 02'No ❑ NA ❑ NE
❑ Yes D"No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [2"No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Q No ❑ NA ❑ NE
the appropriate box.
❑WUP []Checklists []Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 02'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 Q�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

Facili Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes h No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes do ❑ 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
[ rNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
Q<o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[D4 ❑ 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
[]J<o ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
Io ❑ 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.
M/Yes
;fo ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other: U;%Lv$ IMAWMI
32. Were any additional problems noted which cause non-compliance of the permit cVVAM?OA ObYes [//No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [Dll�o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes El"No ❑ NA ❑ NE
Reviewer/Inspector Signature: Date: a51 f & h r0a,
Page 3 of 3 21412011

t `225 Green St, Fayetteville, NC 28301 to Blue Springs Rd - Google Maps
Page 1 of 1
Directions to Blue Springs Rd
Gooste maps 26.6 mi — about 35 mins
225 Green St, Fayetteville, NC 28301
1, Head south on Green St toward Old St
2. At the traffic circle, take the 1st exit onto Hay St
About 1 min
41 3. Turn left onto Robeson St
About 5 mins
461. 4. Turn left onto Raeford Rd
About 12 mins
Save trees. Go greens
Download Google Maps on your
phone at googte.comlgmm
go 0.1 mi
30� total 0.1 mi
go 0.5 mi
• � total 0.6 mi
1
4Q1 5. Continue onto US-401 S/Fayettevitle Rd " C&
Continue to follow US-401 S L fAr nG
About 15 mins C.�
6. Turn left onto State Rd 1207
/~
About 1 min
41 7, Turn left onto Chisolm Rd ..
About 1 min
8. Slight right onto Blue Springs Rd
Blue Springs Rd
go 2.6 mi
total 3.2 mi
go 9.6 mi
total 12.9 mi
go 13.1 mi
total 26.0 mi
go 0.1 mi
total26.1 mi'
go 0.2 mi
total 26.4 mi
go 0.1 mi'
total 26.5 mi
These directions are for planning purposes only. You may find that construction projects, traffic, weather, or other events may cause
conditions to differ from the map results, and you should plan your route accordingly. You must obey all signs or notices regarding your
route.
Map data Q2011 Google
I Directions weren't right? Please find your route on ma s. oo le.com and click "Report a problem" at the bottom left.
http:l/maps.google.com/maps?f=d&source=s_d&saddr=225+Green+Street,+Fayetteville,+... 7/19/2011

�irO-S , /90/9011 1�4
Division of Water Quality
Facility Number ©- © 0 Division of Soil and Water Conservation
0 Other Agency
Type of visit: ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: d Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 7 d10 Edot Arrival Time: Departure Time: /1 ! 30 0 County: Hob Region: Fko
Farm Name: kt'n1DRUUac�'. 1 nIC` Owner Email:
Owner Name: L AR/ I& M-E d iMitil Phone:
Mailing Address: 500 C hX5/1Q/M l� uA 1O RAP' rOQo � aS3 a�
Physical Address:
Facility Contact: Title: Phone: 410.
Onsite Representative: r— fARt Alt t IpILT x -- -_ _ Integrator: /Z
Certified Operator: A R. i H L.et-t;�g t). . Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
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 Pop. Wet Poultry Capacity Pop.
La er
Non -La er
ury rounry
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
Discharces and Stream Impacts
l . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
—Dry
Cow
Non-Dai
Beef Stocker
Beef Feeder
Beef Brood Cow
[3 Yes 52 o ❑NA ❑NE
❑ Yes ❑ No
❑ Yes [:]No
rU" iA ❑ NE
["VA ❑ NE
[]Yes
[]No
YNA
❑ NE
[]Yes
[ No
❑ NA
❑ NE
[:]Yes
52No
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

Facility Number: '{ - 01,4) Date of Inspection: -7o a dZ0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
eNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
VNA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier; 4a
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): kA!,
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
O 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
[glVo
❑ 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
QrNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[] Yes
FFf/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
[g 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 [2'No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Qo R P.LJ h F A r Smi_A eA tis__, no?IwLA
13. Soil Type(s): NnA rM l lC i 8 A.tNS
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 [allo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [-]Yes ff 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 [g�`No ❑ NA ❑ NE
❑ Yes [fNo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [1�'No [] NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check []Yes ]f 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 [SINo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [�
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? My
�No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
&NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: % - 013 jDate of Inspection: 7 5O aU1
24. Did the facility fail to calibrate waste application equipment as required by the permit?
[v7Yes
❑ No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
D'Yes
❑ No
❑ NA ❑ NE
- the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?.
❑ Yes
[�Vo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[�JNo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[ "No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[TNo
[DNA ❑ 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
2rNo
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Yes
❑ No
❑ NA ❑ NE
[YApplication Field ❑ Lagoon/Storage Pond Other: VA%xc,,* keC,b&,"S
onto. 1 0m.4ON
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[ZTo
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[D,*No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[�rNo
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or. any other comments -4 '
Use drawings of facility to better explain situations (use additional pages as necessary).
Nip +0 ��p jE4E A 5kuc suRv�.�
e,e.PA.TbRot
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
�S)nt_A05
Phone: Q lo._g3. 35 2
Date: ?!po tI
21412011

Division of Water Quality
Facility Number ®- 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ..0 Routine Q Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
�
Date of Visit: I(Ol(6� Arrival Time: _� 1 Departure Time: p.' Q County: �4
Farm Name: HeVI6.1`34 1a��e5 i -P"Gr Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative; if
V1
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Region: f:P-0
integrator; pies"
Certification Number: 10310
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Discharees and Stream Imuacts
Nan-L
Pullets
Other
Poults
Design Current
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
on -Dairy
I
Beef Stocker
Beef Feeder
Beef Brood Cow
1. Is any discharge observed from any part of the operation? ❑ Yes MM 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 M 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)
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 [ No
❑ Yes No
NA
❑ NE
❑ NA
[] NE
❑ NA
❑ NE
Page I of 3 21412011 Continued

S
Faclli Number: - Date of Inspection: o /
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 1 Structure 2
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 3 Structure 4 Structure 5
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
[PNo ❑NA ONE
❑ No RNA ❑ NE
Structure 6
❑ Yes [a No ❑ NA ❑ NE
[:]Yes P No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public stealth or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ® No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ® No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) T
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 '0 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 lWJIin_dow ❑ Evidence of Wind Drift 0 Application Outside of Approved Area
12. Crop Type(s): Carr} , W kagQ . ��s D-t'h. I
13. Soil Type(s): n%9'I�f of lLQr�'tS
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes R 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?
Required Records & Documents
❑ Yes `tom' No ❑ NA ❑ NE
❑ Yes ®No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
EP No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
M No
LPP
❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[2 No
❑ NA 0 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
Qg No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
i,#"No
❑ NA ❑ NE
Page 2 `of 3
21412011 Continued

i
Facility Number: 7 - 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
LNon-compliant
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
'E� 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
P No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
'Yes
fl No
❑ NA
❑ NE
Application Field ❑ Lagoon/Storage Pond El Other: av,-`att54or_ bhi
32. Were any additional problems noted which cause non-compliance of the p�t MMP?
❑ Yes
[V No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
jP No
TZ
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments :y.a %.
Userdtawings of facility to better explain situations (use additional. pages as°necessary)��r.
1jeej 4 C o ►gyp l4_ 16t e
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: gk3y.-33m
Date: to('(
21412011

BLS 5-04-20/0
sion of Water Quality
Facility Number O Division of Sail and Water Conservation
-- O Other Agency
Type of Visit ompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: -14 - /D 1 Arrival Time: �O •��fU Departure Time: : / S' County:
Farm Name: f1e.101rt%.e L1•yCs:AC_& Owner Email:
Owner Name: ��� #a'vdri1 Phone: _
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: 6'9 ✓/ 4L&r /P+` 'e
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Title:
ow r/ w-
Integrator:
Phone No:
Operator Certification Number:
Back-up Certification Number:
Region: 00=�eV
Latitude: = a = ` 0 `4 Longitude: = ° = 4 0 11
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
I _ _ ❑ Non -Layer
Other
❑ Other —
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pousts
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dai Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters ofthe State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No [ <
❑ NE
,
El Yes ❑ No L<NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes B oo ❑ NA
❑ NE
❑ Yes r7No ❑ NA
❑ NE
Page / of 3 12128104 Continued

Facility Number: -13 Date of Inspection IA / - /O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ffNo ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes 3<o ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z q
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed El 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 2<o ❑ NA ❑ NE
8. Do'any of the stuctures lack adequate markers as required by the permit?
❑ Yes
2-15-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
NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No ❑ NA ❑ NE
maintenance/ i m provement?
l l . Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
ETNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of
Area
12. Crop type(s) C +'y�! - w L-< ct, - So y Gt4,vs r atlo /dL,
13. Soil type(s) Q Lys f v (ram
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No [INA ElNE
17. Does the facility lack adequate acreage for land application?
[IYes
No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ YesEl"No
❑ NA ❑ NE
�g rr fus5 �Aer.c
.Comments(referto:question#) .,ExpiainanyYESanswers andlorany reammendationsort any omentUse,drawings of facility to better,explamsttuatians.`{useadditioniil pagesasnecessary,}F,.
Reviewer/Inspector Name k �* ,• Phone: 910, y�33, 33eO
Reviewer/Inspector Signature: Date: -51 — ,/t'p -ZO 1O
Page 2 of 3 12128104 continuea

r: . . .
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 all components of the CAWMP readily available? If yes, check ❑ Yes 03 o ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
L 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
[o
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
L.�o
El NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
o
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
D o
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
ETONo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
,
L7No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Q'No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
B"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
LENo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
io
❑ NA
❑ NE
Page 3 of 3 12128104

Type of Visit ()'Compliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit utine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: ��� %.J - County: D lec-
Farm Name: ���ivde- ! e 't/e..5l�,+ - - _ Owner Email:
Owner Nome cl�r'f' �.�i✓Gir-f��iPhone!
Mailing Address:
Region:
Physical Address:
Facility Contact: Ealrl r7 c ^��rt i� Title: 6✓L,'JA/ P e- Phone No:
f s
Onsite Representative: Integrator: F,lj�:, S
Certified Operator: d!ZL Vr- flrAAd �'��� Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = o N Longitude: 0 ° = 4
Design C*urrent
Design C►uMen t
Design Current
Swine Capacity Population
Wet Poultry
Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ DairyCow
❑ Dai Calf
❑ Wean to Feeder
❑ Non -Layer
Feeder to Finish
QQ0
❑ Dai Heifer
❑ Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Beef Feeder
Gilts Non -La ers
PCBoars
❑ Puliets
El Beef Brood Cow
❑ Turkeys
Other
❑ TurkeyPoults
❑ Other11
El Other
Number of Structures:
DischaMes & 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?
❑Yes B o ❑NA ❑NE
❑ Yes
❑ No D<A ❑ NE
❑ Yes
❑ No [�'l A� ❑ NE
NoB'IQA ❑ NE
❑ Yes
❑ Yes
,❑
NA ❑ NE
❑ Yes
[l Ntf ❑ NA ❑ NE
Page 1 of 3 12128104 Continued

Facility Number: %
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
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?
(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 2<0 ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes t_Ttvo ❑ NA ❑ NE
❑ Yes ❑'1�❑ 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 ,2"� ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? [IL1 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 ❑-Pdir❑ NA ❑ NE
maintenance or improvement?
Waste Application��
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes O No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Dlq'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 Driti ❑ Application Outside of Area
12. Croptype(s) Y/l/� (.Jln,c .�7�'�i✓S
13. Soil type(s) A'a%�'/S gild Kh /
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
BNo ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ErNo ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
Q<[:1 NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ NE
18. Is there a lack of properly o . erating waste application equipment?
P
❑ Yes
gzg-'�[NA
o LI NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/]nspector Name G� G(Je_� Phone:
Reviewer/Inspector Signature: Date:
12128104 Continued

lFacility Number: %- %3 Date of Inspection13-31-'471
Re wired Records & Documents ,�
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes E 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 approprrate box. ❑ WUP ❑ Checklists ❑ Design [I Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [ -55 - ❑ 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
S} NT
❑ NA
❑ NE
23,
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
El NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
,0�
I SNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
0-1q`o`
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
0-N-o-
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
C3'
❑ 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
[-1 a��❑ 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
D lqo ~❑ 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
EN-6-
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
0-rqo-_E3
NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[-}lo
_❑ NA
❑ NE
Additional Comments and/or Drawings:
12/2&104

Facility Number I q -1
rrvision of Water Quality
Division of Soil and Water Conservation
O Other Agency
Type of Visit ACompllance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit (PRoutine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: S am Arrival Time: ® Departure Time: � Q County: ��`�_h� Region: LK'0
Farm Name: _CL.J'1 � j x U m4ackG_ Owner Email:
Owner Name: ( 9L V' I q. ,.(LC`tiY i _)G Phone:
Mailing Address:
Physical Address:
Facility Contact: G.y I c1kJVl.OfA.I./tiG Title: n co ► ttC.f' _ __ _ Phone No:
Onsite Representative: Integrator:
Certified Operator: ` Operator Certi ication Number: W t to
Back-up Operator: Back-up Certification Number:
Location of Farm:
Swine
Latitude: = = f Longitude: = ° ='
=
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
❑
Wean to Finish
El
-Wean to Feeder
EgT-eederto
Finish
16660
1 3 0
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non-Dai
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
I
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: FTi
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 14 No ❑ NA ❑ NE
❑ Yes
❑ No N NA
❑ NE
El Yes
❑No jj�NA
El NE
❑ Yes
❑ No .Z'Q4NA
❑ NE
[]Yes
,KNo ❑ NA
❑ NE
❑ Yes
)ONo ❑ NA
❑ NE
12128104 Continued

Facility Number: Ll Date of Inspection Z. 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 I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed freeboard (in): 1�1
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 0 No ❑ NA ❑ NE
[]Yes UNo ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes I'No ❑ NA ❑ NE
❑ Yes E9 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 BNo ❑ NA LINE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes E� 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 [�j No ❑ NA ❑ NE
maintenance or improvement?
Waste ApRlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes '10 ❑ NA ❑ NE
maintenance/improvement?
11, Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes ❑ NA ❑ NE
❑ Excessive Ponding ElHydraulic Overload ElFrozen Ground ❑ Heavy Metals (Cu, Zn, etc.)�No
❑ PAN ❑ PAN > 10% or 10 lbs [:]Total Phosphorus ❑ failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window 0 Evidencet of Wind D_rifl El Application Outside of Area
12. Crop type(s) ��( h — V YAP — 5
13. Soil type(s)
14. Do the receiving crops differ from those designatesin the CAWMP?
❑ Yes o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes .R No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes -'jig No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes IR�Io
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes MNo
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
a
Reviewer/Inspector Name T jUr-1-1Phone:
Reviewer/inspector Signature:L1446"Date: z
12/28/04C { Continued'-'

Facility Number: — Date of lnspeetion
Required Records & Documents
19. Did the facility fail to have 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 J&No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ANo ❑ 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
)6,No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
(9NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
V No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ElYes QNo ❑ 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
3 I. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
RNo
❑ 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 -tip visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings:
7Suhz l S - 0 CJ 3 0s KUJA , �Y10,k� hoof_ j4
�C ,R- t.o r
O W t`4.f Yv`0.CR� Y-10 I
C kzw �1 D n, �f q��k 0. ` 0 C�Y►'QQ.VrCa1. b{a►ov-� 1V+""
zoCZA
Corn 13S -Za 1 S
43 1P id z L0 (03
CDVn 111w2-0z: q1 V_1d Z- So� 13-1
12128104

Facility No'"T l —. 1
Time In r
Farm Name
Owner
Operator
Back-up
COC
Circle: General or
Time Out
Integratoi
Site Rep
No. R
No.
NPDES
Design
Current
Design
Current
Wean — Feed
Farrow — Feed
— Ttwb,
Farrow — Finish
Feed — Finish
Gilts / Boars
— can
Others
FREEBOARD: Design
Observe alibrationl 1
C wl
Crop Yield Waste Transfers �� u
Rain Gauge �� Rain Breaker'
Soil Test Wettable Acres PLAl`�
Weekly Freeboard Daily Rainfall 1-in Inspections
Spray/Freeboard Drop 1(cz
Weather Codes 120 min inspections
Waste Analysis:
Date Nitrogen (N) Date Nitrogen (N)
S I u t I Z-
Z I to 5 �a z 1, k-
� I-z..� I • I
Pull/Field
Soil
Crop
Pan
Window
3 -3

48 Division of Water Quality,
Facility Number 0 Division of Soil and Water Conservation \
Q Other Agency I `
Type of VisitCompliance Inspection 0 Operation Review 0 Structure Evaivation 0 Technical Assistance
Reason for Visit * Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 5 i 1 0" 1 Arrival Time: i a Departure Time: County:
Farm Name: H P nCl rl y, Owner Email:
Owner Name: &�_r 44Y.,!& l �c Phone: _
Mailing Address:
Physical Address: Facility Contact: �Y1Qf
,1' i Title: O i k)1 X Phone No:
Onsite Representative: Integrator: E—YrIe-
Certified Operator: �Q tf lQ�.���_ Operator Certification Number:
Back-up Operator: Q QL_ M L-]'��l�l'� Back-up Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
eeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Region: 1=&
Latitude: 0 0= 1 Longitude: 0° 0=
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
ElLa er
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Puults
❑ Other
Dischar>fes & 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 I..
❑ Daia Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:EEI
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?
w�
❑ Yes �Wo ❑ NA ❑ NE
❑ Yes
❑ No PNA
❑ NE
❑ Yes
❑ No L')SKA
❑ NE
❑ Yes
❑ No ,;KNA
❑ NE
❑ Yes
Mo ❑ NA
❑ NE
❑ Yes �'No ❑ NA ❑ NE
12128104 Continued

y Facility Number: Date of Inspection S !
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes %No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No RNA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 21\4
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
�qNo
❑ NA ❑ NE
Oe/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
'ANo
❑ 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
5 No
❑ NA ❑ NE
8, Do any of the stuctures lack adequate markers as required by the pen -nit? ❑ 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
r% o
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
;R No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) KQv
14. Do the receiving crops differ from those designated �in the CAWMP?
❑ Yes
[ANo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
CINo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
D jNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
211�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�J No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
a
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date:
12128104 J Continued

Facility Number: 7 —c7[ 3 Date of Inspection
Required
Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
;a No
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
O%No
❑ NA
❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
$2 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
M No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
(�bNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
RNo
❑ 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
�] No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus toss assessment (PLAT) certification?
❑ Yes
ONo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
MNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
bava, C4 ent ea C.) C-rT
S�SDri
_ 4b r 0,5 S 1rn� d mroxr• c[ b u; l d �� ✓
inn
�O�v1� CION�'CYD I
k e. e p 6a-_M�n C-r
12128104

Facility No. l ' Time In9 j 5 Time Out Date 16 �� 07
Farm Name `4es41x,&Integrator
Owner EMAJ Site Rep
Operator &�� _ &-&K No. 1 g 3 t�
Back-up No.
COC —AZ-- Circle: General o
Design
Current
Design
Current
Wean -'Feed
Farrow - Feed
W
Farrow - Finish
eed.-
t o
Gilts / Boars
Farrow --Wean
Others
FREEBOARD: Dn
Sludge surrey
Crop Yield
Rain Gauge
Soil Test PLAT
Weekly Freeboard
Spray/Freeboard Drop C3c_:
Weather Codes
Observed
Calibration/GPM I '`Pd3
Waste Transfers
Rain Breaker
Wettable Acres
Daily Rainfall 1-in Inspections
N Ov r:SCLY, , 4 ' r
120 min Inspections
Waste Analysis:
Date Nitrogen (N)
d o, g
_74-
01
Date Nitrogen (N)
}
-rM
.. ■ - . .
■�■ ■ IM-04MUTM
r

6
Facile Number ' v�
Division of Water Quality 4 `:
Division of Soil and Water Conservationkr' k r
�Other,Agency`'�
Lof Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
n for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: g.w Arrival Time: �; Departure Time: 8 9County: t7k6 Region:
Farm Name: 1'' C br`r' ��V'h1 Owner Email:
Owner Name: 1`t oyiq-4ci FA,r Als Phone:
Mailing Address:
Physical Address: ��ff
Facility Contact: JT erfN1 TlGtC1 rns Title: Phone No:
rr I
Onsite Representative: Integrator: u't`Da
i
Certified Operator: I Operator Certification Number: -- PA 73
Operator:
Location of Farm:
Design
Swine Capacity P
❑ Wean to Finish
Wean to Feeder jin
El Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
'r LJ Gilts
❑ Boars
Back-up Certification Number:
Latitude: = o Longitude:
Current Design. Current2.7
Design }Corr
opulation. Wet Poultry Capacity Population Cattle Eapact`y Popiila
❑ Layer
❑ Non -Layer
Dry Poultry .
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
ODry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes P No ❑ NA ❑ NE
❑ Yes
❑ No
P NA
❑ NE
❑ Yes
❑ No
FNA
❑ NE
❑ Yes
❑ No
[ANA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
PNo
❑ NA
❑ NE
.12128104 Continued

Facility Number: — Date of Inspection :700
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
9 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
N NA
❑ NE
Structure i Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3X"
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[9 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
nNo
❑ 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 13 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [� No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ® No ❑ NA ❑ NE
maintenance or improvement?
Waste _Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ® No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 9 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 0 Evidence of Wind Drift+❑ Application Outside of Area
12. Crop type(s)XIM l9't'�5 r`t�-rtl�P�7 Sty lN, OVP.+�S� 64n
13. Soil type(s) Ah r-Q 1 k. o1 rCo! l
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
JR No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
19 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
[9 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
r�No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
V§ No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations o.r any ether comments
Use drawings of facility to better explain situations. (use additional pages as.necessary): a,
a
Reviewer/inspector Name i I Phone: 3
Reviewer/Inspector Signature: Date:
Page 2 of 3 1 /2 /04 Continued

Facility Number: — j Date of inspection
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WDp ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Lu 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 1P No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes VINo ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
M No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
R1 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
Q;No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
JA 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
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
P No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
0 No
El NA
❑ NE
Additional Comments and/or Drawings:
W,
Page 3 of 3 12128104

® Division of Water. Quality
.0-cili M Number Division of Soil and ater Conservation
Q Other Agency
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: j'27�—I�% Arrival Time: JZ: z 1 Departure 'rime: County: T�-�Q � Region: E9_0_
Farm Name: J7en��l r i Liyp�_fnc_k Zty- _ Owner Email:
Owner Name: �Eor.v- Phone: (910) 975- DZZ 9
Mailing Address: 500 C Lr i S h b/wl Rae-pov-cf N C- z g3 7
Physical Address:
Facility Contact: Ea y- _�-� e PIS Title: _12A&!IsLe to4)4l &K- Phone No: (9i19) 975 -D z Z 9
Onsite Representative: _ ,r �, ►.: K Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gills
Boars
Other
❑ Other
Back-up Certification Number:
Latitude: = c ='
= Longitude: = ° =' 0
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
on -Layer
Dry Poultry
❑
Layers
❑
Non -Layers
❑
Pullets
❑
Turkeys
❑
Turkey Poults
❑
Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ® Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dai F{eifei
❑ Dry Cow
❑ Non-Daity
❑ Beef Stocker
❑ Beef Feeder
ElBeef Brood Cow
Number of Structures: 711
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
® Yes ❑ No ❑ NA ❑ NE
® Yes
❑ No
❑ NA
❑ NE
ZYes
❑ No
❑ NA
❑ NE
13gg 000 --Y000 0
® Yes
❑ No
❑ NA
❑ NE
Yes
❑ No
❑ NA
❑ NE
❑ Yes
9 No
❑ NA
❑ NE
12128104 Continued

Facility Number: 447- /3
Date of inspection O/-2%-0G
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
Identifier:
Spillway?:
Designed Freeboard (in): 2#
Observed Freeboard (in):
Structure 2 Structure 3 Structure 4
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 arc not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes [XNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes EZ No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ® No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
IN No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ® Yes
❑ No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
❑ No
❑ NA ® NE
maintenance/improvement?
l 1. Is there evidence of incorrect application? If yes, check the appropriate box below. ® Yes
❑ No
❑ NA ❑ NE
® Excessive Ponding Z Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
PAN S FAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
IN Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ® Application Outside of Area
12. Crop type(s) _ t.a. C.oNr t� So•., +02GN S
13. Soil type(s) Ra5. I `� n tPo 1 K
; N
14. Do the receiving crops differ from those designated in the CAWMP? ® Yes
❑ No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
❑ No
® NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination;19 Yes
❑ No
❑ NA ❑ NE
IT Does the facility lack adequate acreage for land application? ❑ Yes
09No
❑ NA ❑ NE
IS. Is there a lack of properly operating waste application equipment? ❑ Yes
IN No
❑ NA ❑ NE
w4S o65evvc-.d. Viu­INS ►-$ S.�v4dcerwr�,+c,S , '5­pi -►v es+ h,w a-
2. Pou��d. w•�s#e_w�ev- w�-s o6,srvut..�-/Pko�oyr�L.*.� o..��'4tcjs ,
5 +0 11�au: l�t�.s s rf ae.d r��a'i-�1rin�/� �1 {� L ll 1 1
tt. GYU 1titi� to c.GN ta,J aS I-'l& k' �M LAWVIAP+ /tO81Tofuwl ,5'r4'h�SIJ C. 7i[+{d 4J4f NOT
apPwvcd�o-v urvvuroc.d C�ZMP.
146 No +re.c.e.i'v%ti Cvra %3c-,5 v"e.-4 )'4rveoovo Aia be -,a cAolie_ el.
ReviewerlIns actor Name' �..
P %Qi : lC'e.vs. S%'-�� Phone: C9/0)5�8e- /SSz/
Reviewer/Inspector Signature: Date: 'f —2 5--2006
12128104 Continued

-11
Facility Number: 47 — /3 Date of Inspection 01-2770
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 9 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 appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
® Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ® 120 Minute Inspections ❑ Monthly and 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
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Z 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
❑ No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
® No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
® Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings
21.
PrtSGn�+
Af ,L(� •�.c o�
%kS�tG�oN.
Z�. y .ski �YC�.�C.lr U,?ce S N4 O�G✓Q.'Y i�O l�f L� Ci.`I-�--�`N0.. C.. O1c 1 NSp 1-CY1_0 A/
f . 1=ccGi i�Ly •Fa7I �� No+t �,7 ��- rC3;on.al a Ff'i'c c� of drsal,d�L I� 0Vr'V,
33. (0-4—t_ D 1t4C_.w.tot✓311 200 6 .
12128104

'1 r .,.r%.
1",h1;, F'�^ End _�^7'r 4 'r� „ ..fq «t.�V�uwtstoa'at Water truattry a,.q., j..:gy:a.
� 'i' �E. 'lo�T��,',.�+1", �.�{'%` y,S s raw. !`'�4 r ' k+,.q �s"�i'� ,1€l#' �+F�.� �rf �'�. � �«w� � � «•`.-CF; ne «' <',
Cansetrr+ation
^f'[`4 O .x.4' ;.�y iV
i �. Otber AAgeacy�..n> ,y�., '� ael.yj'ff .4. ����p� x, h . u q. , -�i';• h.i�,,. , rX�"ar lr¢ �.
y�ryn; ,�.+G � I-...,-. �-,eLw„�t '; Y •€:F. � r. �e " . ti.. _ _�._ _
Type of Visit 0) Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit (PRoutine O Complaint O Follow up 0 Emergency Notification 0 Other © Denied Access
Facility Number Date of Visit: A3 Time: I==
Not Operational 9 Below Threshold
Permitted 13 Certified [3 Conditionally Certified 13 Registered )bate Last Operated or Above Threshold:
Farm name: S County: �J^4 O�c�¢
Owner Name: F_6A ]4c.,.,Ar,,s' Phone No: jll9
Mailing Address: SIB D C k Lc kZ4,11 60) Q GE A n'E'!�y jai �tf G. -1$ 3 .7 .
Facility Contact: __ __F_W,'�_, ca�'(kr-f 4^. Title: Phone No:
Onsite Representative: I <x1 6 tm� P'`r !A' Integrator: DO 4 1 Lj e D
Certified Operator: r &r PC", I, k Operator Certification Number: 183 ID
Location of harm:
swine ❑ Poultry ❑ Cattle ❑ Worse Latitude �' �° �" Longitude
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Ca acity Po ulation
❑ Wean to Feeder IEJ Laver 1 ❑ Dairy
Feeder to Finish JE1 Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ] l :` 10 Subsurface Drains Present ]]❑ Lagoon Area ]❑ Spray Field Area j
e ;-Holding Ponds / Solid Traps r', ❑ N o Liquid Waste Mana emetit System '
Discharges 8: Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Sprav Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from,any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Timatment
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):
05IV3101
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes 51 No
❑ Yes P No
Structure 6
Continued

4
Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes No
(If any of questions 4-6 was answered yes, and the situation poses an
Immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes [] No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes O No
Wgstg Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes (D No
It. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes I j No
12. Crop type 1.3 Iyx 5.I�iJx�ra --
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 [j No
Reauired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes O 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 ® No
19. Does record keeping need improvement? (icl irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes ® No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ® No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ® No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(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 [A No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes P No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
.I— [ 6_8,-w, (%;:� o"J
Reviewer/inspector Name 1
ReviewerAnspector Signature: f1�
Field Copy ❑ Final Notes
Date:
05103101
Continued

Facility Number: — 13 1 Date of inspection 3 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. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes No
❑ Yes � No
❑ Yes F&I No
❑ Yes K No
❑ Yes ❑ No
�Fi�(�it101i�lGoI11[!Il'Iit�7t��i1TDC$111�$ 1 sr.�E ��
05103101

State of North Carolina
Department of Environment,
Health tnd Natural Resources 4 • �
Fayetteville Regional Office
James B. Hunt, Jr., Governor 1DEiHNF;Z
Jonathan B. Howes, Secretary
DIVISION OF ENVIRONMENTAL MANAGEMENT
April 8, 1996
Mr. Earl Hendrix
Hendrix Livestock, Inc.
496 Chisholm Road
Raeford, NC 28376
SUBJECT: Compliance Inspection
Hoke County
Dear Mr. Hendrix:
On April 2, 1996, an inspection of your animal operation was performed by the
Fayetteville Regional Office (FRO). Please find enclosed a copy of our Compliance
Inspection Report for your Information. It is the opinion of this office that this facility is
in compliance with 15A NCAC 2H, Part .0217, and that Animal Waste Management is being
properly performed.
Should you have any questions regarding this matter, feel free to contact me at (910)
486-1541.
Sincerely,
Ricky Revels
Environmental Technician IV
RR/bs
Enclosure
cc: Facility Compliance Group
F'R o
Wachovia Building, Suite 714, Fayetteville . FAX [phone]
North Carolina 28301-5043 NO'C An Equal Opportunity Affirmative Actlon Employer
Volce 910-486-1541 50a6 recycled/10% post -consumer paper

Facility Number:_±Z- / 3
Division of Environmental Management
Animal Feedlot Operations Site Visitation Record
Date:
Time: /5 4
General Information:
Farm Name: #e N d r; x Liye._5-A0 < --,6 M ► J c . _ _ _ County: -
Owner Name: EoLv tAc" � t Phone No: C /0 9'75-- 3 ► SO
On"Site Representative: GO-- l to NdY x Integrator: WA
Mailing Address: LA9& C G,i s h o p Rd
Physical Address/Location: ' a v e.1 3.5 o-f Racal o N 0. +4
3`e-N.��l Ci, k yCA.
tw,-,Q 1 � .,� P,,-s se I Kal -i-> CL i s i� n! �.,,
T�(�dM w. ; ,-T'r
Latitude:_) 1 Lon 'tude:J /
Qoeration Description: (based on design characteristics)
Type of Swine No. of Animals Type of Poultry No. of Animals Type of Cattle No. of Animals
O Sow 5_c77 _T O Layer © Dairy
❑ Nursery 0 Non -Layer a Beef
0 Feeder
OtherType of Livestock- Number of Animals:
Nl,mber of Lagoons: (include in the Drawings and Observations the freeboard of each lagoon)
Facility Inspectlem
Lagoon
Is lagoon(s) freeboard less than I foot + 25 year 24 hour storm storage?: Yes ❑ No
Is seepage observed from the lagoon?: Yes 0 No a/
Is erosion observed?: Yes ❑ No G(
Is any discharge observed? Yes ❑ No C(
❑ Man-made ❑ Not Man-made
Cover Crop
Does the facility need more acreage for spraying?: Yes 0 No,U
Does the cover crop need improvement?: Yes 0 . Nod
list the crops which need improvement)
Crop type: l,Jktaf Cprr� . So ti e.aas Acreage: Z 3 S
Setback Criteria
Is a dwelling located within 200 feet of waste application? Yes a No 0
Is a well located within 100 feet of waste application? Yes 0 .,Nos"
Is animal waste stockpiled, within 100 feet of USGS Blue Line Stream? Yes ❑ No [3
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream? Yes ❑ No
AOI -- January 17,1996 - s j,•

Maintenance
Does the facility maintenance need improvement? ` Yes ❑ No
Is there evidence of past discharge from any part of the operation? Yes ❑ No al"
Does record keeping need improvement? Yes ❑ No all"'
Did the facility fail to have a copy of the Animal Waste Management Plan on site? Yes S' No ❑
Explain any :Yes answers 1 In i s iV'e , i s+e ed v ee. rAb" i 5 'aAJ e XisS Ii Afr7 A1V,- /
1`'S 'VZgL...i06+0 nl AN c1D�yt✓z-j was a w�ct�.IaS�INtcru`�
_(:a-F- I� ta-4zon�� al�a� tau �z�w.low �, IJ9-7 p mar Sko"a �z uu''r 44,44-
f�Wg-4ie�J 1.aS �t�;o�i.► v����i ti �� e�vw. S�urS �uv- ei.�e� dn�fw. �j CoL'ec_�iesN
cc. Facility Assessment Unit
Drawings or Observations:
AOI — January 17,1996
Date:
Use Attachments if Needed
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