780019_INSPECTIONS_20171231

' �� C�iDi"vision of Water Resources • : ..
Facility Number ®- ® O`Division of Soil and Water Conservation
® Other Agency
Type of Visit: Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
1
Reason for Visit: (2 outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: ® Arrival Time: : OQ Departure Time: :3h County: Region:
Farm Name: z- /, j,,t,(�� 1�.rt)Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: ��G/tcc��dl ,r Title: Phone:
Onsite Representative:
Certified Operator: 15, -
Back-up Operator:
Integrator: s�Z(2!! ��,/
. 1
Certification Number: 1;�zp3./
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design Current
�!I a Design m- nit
Swore "h'
Capacity Pop.
Wet Poultry. Capacity Pop. F
,
CatEle ap i7= Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
..
DairyHeifer
Farrow to Wean
Design Current
D Cow
Farrow to Feeder
D . foul_
Ca aci $o
Non -Dairy
Farrow to Finish
Lavers
Beef Stocker
Gilts
Layers
Beef Feeder
Boars
Pullets
Beef Broad Cow
Turkeyshas
Other
Turkey Points
Other
Other
no
� !�N
��
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 tallo ❑ NA ❑ NE
[:]Yes [:]No
[::]Yes [:]No
[—]Yes [—]No
❑ Yes RNo
❑ Yes CA -No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412015 Continued

4
Facility Number: Date of Inspection.
Waste Collection & Treatment
i} 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑Yes ®No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [. 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 [R No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ® No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes 0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): l v"'crsr""
13. Soil Type(s): Hy?Z /JJ�►►fj`- f �i,� __
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 0 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ®No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes B 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
M No
❑ 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
ONo
❑ 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 [:1120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[allo
❑ NA
[] NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Dg-No
❑ NA
❑ NE
Page 2 of 3
21412015 Continued

Facili Number: 7s, - /9- Date of Ins ection: f,3
til 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes EffNo
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes allo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [M No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ® No
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
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
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
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes L4 No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [ No
34. Does the facility require a follow-up visit by the same agency? ❑ Yes E No
NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
r] NA ❑ NE
❑ NA ❑ NE
C (. 9 P Y y al,recommendateans ar any other eoinme— VU4
omrnen!$ refer to question Ex Isen an ES answers andflor an addifion y III! hq..i: p,• i .:r L;lwll - a �'�fir �,I IN`uq i.: I,.`.IAII. � Il I!- TJT d { fir, 1� l'r � I� !Ir4! '� +{,; I� �1
Use drawings of.facility:Ito;Abetter,egpla�n.,s�tuati&B use additi6nal es as necessa �.:�: .. r _ ��.,9 ,,,_� �w'
Reviewer/Inspector Name:
Reviewer/Inspector Signature: _41f2 Z,
Page 3 of 3
Phone:
Date: 6, /;Z—,zV
21412015

f�
'"ion of Water Resources
Facility Number ®- / O Division ofi Soil and Water Conservation
OO Other Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: fy- D— J Arrival Time: Departure Time: L.1 County: ,�__ltegion: O
Farm Name: p sjyni d r Owner Email:
Owner Name: b�"-I) d ism; Phone:
Mailing Address:
Physical Address:
Facility Contact: ,- r Title: l--- Phone:
Onsite Representative: Integrator: _Sr- /W/
Certified Operator: LJ ca-: �� Certification Number:3�/
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity P.
Wean to Finish Layer
Design Current
Cattle Capacity Pop.
DairyCow
DairyCalf
Wean to Feeder
]Non -Layer
eeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Cnrrent
D . P,ouI Ca aci I;o
Layers
DairyHeifer
Cow
Non -Dairy
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Othe
Turkeys
urkey Poults
Other
rTOther
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?
[:]Yes RNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
MV No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facility Number: Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
allo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 12
Observed Freeboard (in): ZZ
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
allo
❑ 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
JNo
❑ 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
[RrNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[RNo
❑ NA
❑ NE
maintenance or improvement?
Waste Aoolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
1 l . Is there evidence of incorrect land 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 Approved Area
12. Crop Type(s): /m`r�dr �d vrrs7r�
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes allo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes �No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [allo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes No ❑ NA ❑ NE
❑ Yes [ No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes J� No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes MNo ❑ NA FINE
the appropriate box.
❑WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes JE� No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[—]Yes No
[:]Yes [ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facifi Number: - 9 Date of Inspection:U-
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes J No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes ja No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [RNo
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes 0 No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes jo No ❑ NA ❑ NE
❑ Yes [, No ❑ NA ❑ NE
❑ Yes [2� No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
[-]Yes [q No
❑ Yes [S] No
❑ Yes ®. No
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
Reviewer/Inspector Name: S�z"��`� ��— Phone:lJ-�p3 D�J
Reviewer/Inspector Signature: Date: 6 —7[>
Page 3 of 3 21412015

Type of Visit: &'Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance I
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: a Departure Time: '3D County: 7yj4s,, R___-
Farm Name: /ty3 ` l� ��� �e�l/a"'��Owner Email:
Owner Name: `mac iY1 71 Phone:
Mailing Address:
Region: 1­� D
Physical Address:
Facility Contact: 1 Title: Phone:
Onsite Representative: Integrator: s rfz?0-1-k
e
Certified Operator: _ I 4�A_cl—
Back-up Operator:
Location of Farm:
Latitude:
Certification Number: z;��_o
Certification Number:
Longitude:
gli_Design
Current
Design
Current
Design Current
Swine:1, f, . Ca acity
.. P
Pop.
R'et Poultry
'
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
I I Layer
Dai Cow
alf
Wean to Feeder I INon-Layer I
t
Feeder to Finish `%
Dai Heifer
Farrow to Wean
Design
CurrentDry
Cow
Farrow to Feeder
D : P,oW
@a aci
P,o ..
Non -Dairy
Beef Stocker
Farrow to Finish
Layers
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
AS
Turke s
Ot
Turkey Poults
Other Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
[]Yes EjNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
[:]No
❑ Yes
No
❑ Yes
® No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412014 Continued

Facili Number: M - . /,P1 I Ds ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes allo ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): %
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[gNo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[E,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
[� No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Apiplication
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 Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12, Crop Type(s):
13. Soil Type(s): %%7 /3 Z
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes ® No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [D 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 [4 No ❑ NA ❑ NE
❑ Yes M No [DNA ❑ NE
Repuired 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 allo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design D Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes J�j 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 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 21412014 Continued

FacilityNumber: - / Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes E,No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes allo ❑ 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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes 2 No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes [, No
❑ Yes [a No
[:]Yes J[�No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to.gnestion #) Ezplaur any YES answers -and/or any additional recommendations or any other comments:' �F
TT -.� .�
Use drawings of;facility to better eaplatn situations'(nse_additronal pages as necessary}="' � x _ w x
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
��.�✓. s� ��cs P; <kYel
Phone: M)-y5 —3150`>
Date:
21412014

,.A
Type of visit: q:g-uomphance inspection V operation Review V btructure Evaluation V 'l echnical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: :3 O Departure Time: 0P County: Z-2k=;Z L Region: I /-.-
Farm Name: .� ,�i�?'7i r 3 l�'rOt� Emnif.
�} p !" � �` �sYL. owner Ema' .
Owner Name: ILA i a F � I r ; �, Phone:
Mailing Address:
Physical Address:
Facility Contact: ; a-yl Title: /" Phone:
Onsite Representative: Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Certification Number:
Longitude:
Design Current Design Current
Swine Ca aci Po Wet Poul Ca aci ' Po
p t3 P• �y MORN, p•
Design Current
Fettle C►a aci Po
P ty P•
Wean to Finish
La er
D ' Cow
Wean to Feeder
Nan -La er
D ' Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
.7
�I y " `
Design" 'Current
D . I?oul Ca aci_ Po
La ers
Non -Layers
Da' Heifer
D Cow
Non -Dairy
Farrow to Finish
Beef Stocker
Gilts
Beef Feeder
Boars
Pullets
Turke s
ITurkey Poults
I 10ther
Beef Brood Cow
11 Othe
OtherI
Discharees and Stream lmaacts
1. is any discharge observed from any part of the operation?
❑ Yes
RNo
❑ 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 DWR)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
® No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
Q No
❑ NA
❑ NE
of the State other than from a discharge?
Page l of 3 21412014 Continued

Facili Number: 70- / g Date of ins ection: 5G — /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
21 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):_
Observed Freeboard (in): a.2 Le
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
0 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
RNo
❑ 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
RNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
®.No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9_ Does any part of the waste management system other than the waste structures require
❑ Yes
CgNo
❑ 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. 1s there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes SNo ❑ 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): /YhcG /'*�'_s y d
13. Soil Type(s): e! W
14. Do the receiving crops differ from those designated in the CAWMP? []Yes �o [DNA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes S No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [&No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ®. No ❑ NA ❑ NE
❑ Yes allo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [:]Yes 0,No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes [allo ❑ 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 NNo
❑ 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 (&No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? []Yes FNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

FaciHty Number: - Date of Inspection: —G —
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Q No ❑ NA ❑ NE
' 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes RNo ❑ 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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
fa No
❑ NA
❑ NE
❑ Yes
ENo
❑ NA
❑ NE
[:]Yes
allo
❑ NA
❑ NE
0 Yes PE�No ❑ NA ❑ NE
[:]Yes [ZNo ❑ NA ❑ NE
❑ Yes ®No ❑ NA ❑ NE
❑ Yes DkNo
❑ Yes [R No
[:]Yes �No
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
lComments`(refei twquestion f : Explain any YES answers and/or any additional recommendations or any other comme©ts
Use-drawings of facility to better explain situations addrtional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 92' 2 "4`33 �
Date: 1. f=L
21412011

K r �3 N4, IV �b
Type of Visit: (gZoutine
ante Inspection O Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time:Departure Time: County: Region:
Farm Name:Owner Email:
Owner Name: J P44I "` �JC`L`'�- '^`�.1/ Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
c
LG
Certified Operator: Gt
Back-up Operator:
Location of Farm:
r Title: Phone:
Latitude:
Integrator: A (J 76 ✓ L
Certification Number: a— 0 3 kf
Certification Number:
Longitude:
Design Current Design Current Design Current
Iine Capacity Pop. We[�Paultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish
Wean to Feeder
La er
Dairy Cow
Layer Dairy Calf
Dairy Heifer
Design Current Dry Cow
Dr. P,oul Ca achy R.5p Non -Dairy
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Turkeys
urkey Poults
Beef Brood Cow
Other
Other
Other
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [go�o [] NA ❑ NE
❑ Yes [] No
❑ Yes ❑ No
❑ Yes [] No
❑ Yes E3'No
❑ Yes Ja'No
e'NA ❑ NE
QUA ❑ NE
DlA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page I of 3 21412011 Condnued

Facih Number: Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [ .N6— ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [50 A [] NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes g:1—Nm ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
W. 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
Ewo
❑ 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 I;F<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 ManurelSludgc into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
U]�I'�o
❑ Yes
[B-156-
❑ Yes
[;kK5
❑NA ❑NE
❑ NA ❑ NE
0 NA ❑ NE
❑ Yes [D►lo ❑ NA ❑ NE
❑ Yes q?< ❑ NA ❑ NE
Re uired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[—]Yes Rio
❑ NA
0 NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes EUX6 _
[] 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 [gO<
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes Ff�
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes L_l No
❑ 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 QLNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 3o ❑ 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 Q-Ko- ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [ErKo [DNA ❑ NE
Other issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[:]Yes
[ 10
[] 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
VXo
❑ 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
E3 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:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
dlNo
❑ 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
H3<o
❑ NA
❑ NE
Comments (refer to -question;#) Explain any. YES answers and/or any -additional recommendations or any�6ther.�comme _
Use-drawin s of:fac�Ii �to`better ex lain situations (useadditional° a esasneressa
Ct 6 a_e!
S la_� s
�j P 7J
Reviewer/Inspector Name:
4 q33` ,13J
Phone.
Reviewer/Inspector Signature:
Page 3 of 3
Date:
V412011

fI a. /7 f\
rvision of�Wster Quality � - -_ -
Facility Number ;L7U1171 ®Division of Soil and Water Conservation
�y
Other Agency
Type of Visit: om Hance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Timer Departure Time: County f _
Farm Name: ffrnk b �( .ti esk�4' 1 t I i Owner Email:
Owner Name: �� �( Phone:
Mailing Address:
Physical Address:
c
Facility Contact: c
Onsite Representative: ( {
Title:Phone:
Certified Operator: l (
Back-up Operator: �o sue. �� V
Location of Farm:
Latitude:
Region: 1WC/
Integrator: 015
Certification Number: "3 V
Certification Number: ! U T
Longitude:
HN Design_. -Current
p ity Pop.
Swore Ca e
Wean to Finish
DesJgn`s Current
l
Wet Poultry :: t__Catpacityl'op.
La er
Non -La er
-' '
Design: Current
D , P,oulCit aeI 1,Po
Design
Cattle Capacity
Current
Pop.
DairyCow
Wean to Feeder
Da Calf
Da Heifer
Dry Cow
Feeder to Finish
Farrow to Wean
{?
Farrow to Feeder
Non-Dae
Farrow to Finish
Layers
Non -Layers
Beef Stocker
Beef Feeder
Gilts
Boars
Pullets
Turkeys
Turkey Pouets
10ther
Beef Brood Cow
Other
Other I I
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?
❑ Yes [/No ❑ NA ❑ NE
❑ Yes ❑ No [E(NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
LNA
❑ 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
Jj NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[]r&o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[—]Yes
F(No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

[Faeility Number: 0 -r t [ jDate of Inspection: f M I J [
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [DNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [3No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed?
] Yes
dNo
❑ 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
FC o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[YNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[�Vo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[] Yes
[BNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
FL-;rNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes E!�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): {J t,1y►. via,
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes C! No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [RNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [IVo ❑ 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
[Pl<o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
M No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[ZV&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 6No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [—]Yes (No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [Y"No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
VTo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
[j No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
Wo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[ZkNo
❑ NA ❑ NE
Other issues
2& Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
Ca4o
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
[2/No
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
[3"No
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
[] N' o
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[!!rNo
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
dNo
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[(No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
comments (refer to. question;t)::l;xptatn any YES answers and/or any aaattionat recommendations or any _other Comments:€ A 71 €.
Use drawings of facility to better explain situations (use additional pages as necessary).
5
Reviewer/Inspector Name: u Phone:
Reviewer/Inspector Signature: 00Date: J
Page 3 of 3 21412011

0 zfa41ra
11
Type of Visit: ® Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: ® Routine 0 Complaint Q Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 'j a�/� Arrival Time: a`�p�}� Departure Time: as County: d64�
Farm Name: H k [ �p k M Owner Email:
Owner Name: � � h Phone:
Mailing Address:
Physical Address:
Region: 4?
Facility Contact:O_T�, Title: Tf\AP—R Phone:
T'
Onsite Representative: p�\ g9_0 S Integrator:
T
Certified Operator:' �^�Q Q � 1 g Certification Number: A %a j
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design Current
Design Current
SwineCapacity
Pop.
Wet Poultry
Cup ty „ Pop.
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
11%10 `� ['b
='`" 4
Dairy Heifer
Farrow to Wean
esign Current
Dry Cow
Farrow to Feeder
D , P,oultry.
Ca achy .- P,o ,
Non--Dai
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Cnher
Other
Dischary-es and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes [No ❑ NA ❑ NE
❑ Yes ❑ No 0 NA ❑ NE
[:]Yes [:]No ZNA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [:3[�' Yes [SNo A ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes dNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

=- 1
F'acili Number: Tl$ JDate of Inspection: 7Jlag
Waste Collection & Treatment
4, Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [D-1 o [DNA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No G NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway"
Designed Freeboard (in): 1-
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [:.No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes ff 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 Q No
❑ NA
FINE
8. Do any of the structures lack adequate markers as required by the permit? []Yes allo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes []'No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes [ZNo
❑ 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) dam] R'rR V
13, Soil Type(s): m a
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [El No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [a No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes E f 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
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes Q No ❑ NA ❑ NE
❑ Yes [fNo ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
[:]Yes [t]No ❑ NA ❑ NE
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �-170
❑ 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 [!j`No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes ❑ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
["NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: 1 - 1 q Date of Inspection: 3 9_; r 7
24. Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes [j�No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [2'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 [g-f�o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [;�No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[ 3"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
[Et -No
❑ NA
❑ NE
pen -nit? (i.e., discharge, treeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below.
❑ Yes
[2'No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[ 1 1C o
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[ZNo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
ffNo
❑ NA
❑ NE
Comments (refer to question #): Explain any=YES answers:and/or any additional recommendations orany other emments. {.
Use drawmi g of:facilit_y to better explarn srtuahons;{use.additionai pages as necessary)"
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 9to -3 0g-6&5'- %
Date: 3 aft /
21412011

Type of Visit (yCompliance Inspection 0 Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit 0Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: #-2$ -/O 1 Arrival Time: Departure Time: 3:OD County: Robeson! Region: 'rev
Farm Name: w _S�t� 3 �N �'�`" ` 7 _ Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: is 4 d H e5 Title: Phone No: p
Onsite Representative: ram►' e5 Integrator• XAu vp L:tj
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: [= o =1 Longitude: 0 0 =1 = u
Design Current
Design Current
Design C•orrent
Swine Capacity Population
Wet Poultry
Capacity Population
Cattle C►opacity Population
❑ Wean to Finish
ID Layer
❑ Dairy Cow
❑ Wean to Feeder
ID Non er
'
El Dairy Calf
❑ Dairy Heifer
[A Feeder to Finish -77Z O 7 ZO O
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
El Non -Dairy
El Layers
❑ Farrow to Finish
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Beef Brood Cow
❑ Boars El Pullets
❑ Turke s
Other
❑ Turkey Poults
EENumber
of Structures:
❑ Other Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes.. notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes Er< ❑ NA ❑ NE
❑ Yes
❑ No
E NA
ElNE
ElYes
El& No
A
❑ NE
[31 A
❑ NE
❑ Yes
❑ No
❑ Yes
No ❑ NA
❑ NE
❑ Yes
9-1vo
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

0 1
Facility Number: 7g— Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Now❑ NA
El NE
a. If yes, is waste level into the structural freeboard?
El Yes
E
Li'No ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[R< ❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
LYNo ❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify
DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No ❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require NA NE
maintenance or improvement? ❑ Yes ❑ No El NA
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or l 0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) 'i (OV-ws-<—a
13. Soil type(s) Ma,A
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 ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Comments(refer•to•questioit.#): Explain apy YES, answetsGa6iuor any recommendations. any otYfhCller comments.
ty p w , ( addI oral pages as neeessarj) Use drawings of facility to heifer ex lain situations use
Reviewer/inspector Name �, cry /�(S ' ' Phone: 910. $133.33 00
Reviewer/Inspector Signature: Date: *'2$ — 2 0 / 0
12128104 Continued

Z
Facility Dumber: -7 g — / Date of Inspection 4-2e-'/0
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes BNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ff ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
ENo
❑ 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
❑ NA
[I NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
�B<o
[`No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
B�,<�o
[I NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
Ls <o
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
BINow
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
L1"No
❑ NA
❑ NE
Other Issues ,--�
28. Were any additional problems noted which cause non-compliance of the permW it or CAMP? ElG Yes No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
DTo
❑ 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`?
El Yes
,-,�
R
❑ 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
El Yes
�
D o
❑ 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
�
El NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
2 o
❑ NA
❑ NE
Page 3 of 3 12128104

3i: tw s 5-.-1 9 - c!
ision of Water Quality
Facility Number %g �� 0 Division of Soil and Water Conservation
Q Other Agency
Type of Visit
Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
,ommppliance
a Koutine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: R-/I _0 Arrival Time: vT 4 .#.,, Departure Time: County: A7A6=—*,W • Region:
Farm Name: Nakg- Si>«i�Gt�r. 4 �>yg� Farms / Owner Email:
Owner Name: 1"l + a, Smite Phone:
Mailing Address:
Physical Address:
Facility Contact: -R�C-La -A i44`1 "' i Title: Mw�n5tr Phone No:�}
Onsite Representative: RI—C.� fcL Integrator: 41K►'.0/9'a — Brwl1n
Certified Operator: Operator Certification Number:
Back-up Operator:. RtG�na✓`� " Back-up Certification Number: 7-0.31?1
Location of Farm: Latitude: = e 11
Longitude: = ° = 1
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
rElLayer
❑ Non -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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design.'.
esign' Curren#
Cattle Capacity Poptilat un
❑ DairyCow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy_
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: ED
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
ff�NA
❑ NE
❑ Yes
❑ No
l/NA
L
❑ NE
❑ Yes
[--]No
L�SNA
❑ NE
El Yes
D'Noo
ElNA
ElNE
❑ Yes
RIG
❑ NA
❑ NE
12128104 Continued

Facility Number: T3—
Date of Inspection / -O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2
Identifier: _ _ �! -
Spillway?: Nb
Designed Freeboard (in):
Observed Freeboard (in): 51 I/
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 are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes /No ❑ NA ❑ NE
❑ Yes B o ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 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? El Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 9'1vo ❑ 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 L�'No ❑ NA ❑ NE
maintenance or improvement'?
Waste Application ��
10. Are there any required buffers, setbacks, or compliance alternatives that need [I Yes E o ❑ NA ❑ NE
maintenance/improvement? �,�
11. Is there evidence of incorrect application? If yes, check the appropriate box below. El[ Yes o ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12.
Crop type(s) rw�Kcf'a� .(� Cs1'�tiwJ Cb
13.
Soil type(s) Mo_A
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
LU7, N�o
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
L�f oo
[INA
ElNE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:]Yes
O NNo
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
EI NNo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
'' No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
-�3
T
Reviewer/Inspector Name Phone: 2/0, 9.33 .
Reviewer/Inspector Signature: Date: ^ ��
12128104 Continued

Facility Number: -7 — / Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ffNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ NA ❑ NE
the appropirate box. ❑ U7T Tp ❑ Ch kl' is ❑ D ❑ Ma ❑ ruu
ec is es rg P. er
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 V Rain Inspections ❑ Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No ❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
PrNo ❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
DO< ❑ 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
Ej<o ❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
OeNo ❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
To
[I NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[I Yes
<
©Tlo
❑ 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
2 o
❑ 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
2<o
❑ 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
❑ NA
El NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
,[�Io
L7 No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

STA(S 'tWk'rd 7-01-es
Type of Visit
Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
p6ompliance
(j 'Ro�utine 0 complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: '27 Og Arrival Time: aQ /Departure Time: f1,�6V County:�Region:
Farm Name: +- st 4�`�_l� .3 �arwt L,� Ftrr" Owner Email:
Owner Name: 0.. F. s+ Phone:
Mailing Address:
Physical Address:
Facility Contact: i\A. i Ve_ PD1 S`h7 ti _ Title: P�Yw M f K Phone No: 910• 4, Z9 , % S3
Onsite Representative: Nk i V-s-_ P0Integrator: Aik'ie
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: [=1 o = I = u Longitude: = o ='
0 u
Design Current �, Design Current Design Curren#
ne Capacity Population Wet Poultry Capacity Population Cattle3 Capacity Population
rRET
ean to Finish
❑ La er
❑ DairyCow
to Feeder
❑Non La er
❑ Dairy Calf
Feeder to Finish
97,0
_ ❑ Daia Heifer
J ❑ D Cow
Dry�,Poultry _
- ❑ Non -Dairy
❑ La ers
❑ Beef Stocker
❑Non -La ers
❑ Pullets ❑ Beef Feeder
❑Beef Brood Cowl
;.❑ Turkeys
El Turkey PouIts �F
❑ Other Number of5truetures: LU
❑ Farrow to Wean`
❑ Farrow to Feeder
❑ Farrow to Finish
❑Gilts
3
1 Boars
O them
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2- Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
aN.
❑ NA
❑ NE
❑ Yes
Na
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
0 �o
❑ Yes
2' o
❑ NA
❑ NE
❑ Yes
91 o�
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

il I
Facility Number: 7919
—
Date of Inspection 6 -z7-
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?
Structurqv Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z Z
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 ffNo ❑ NA ❑ NE
❑ Yes GhToT ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 31q_o_ ❑ NA ❑ NE
❑ Yes Ejmoo ❑ 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 [Tl o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 3-Wo- ❑ 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 E3-m-- ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [3"1,;ro-- ❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [Tlqo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) skedj
\ 0,3
' l O w
13. Soil type(s) i� M oL S /4 b F> , 3
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes B1 0—❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes a o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes ,2- l�ol�o El NA ❑ NE
17. Does the facility lack adequate acreage for land application? ElE Yes 5o ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes 0lgo­ ❑ NA ❑ NE
Reviewer/inspector Name �. =� µ -V �, N j Phone: G%O, yam, CVO
Reviewer/Inspector Signature: Date: 1p—L-7— zoo 8
Page 2 of 3 12128104 Continued

j
Facility Number: -J9 Date of Inspection
Required Records & Documents ,-,,�
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes L7 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 appropiate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps gp ElOther
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 V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge'?
❑ Yes
l�.��_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
,5
L71vo��❑
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[ to ❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
B'1 o ❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
8"1<0❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑iqo— ❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑'1 o� ❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
0'r0❑ 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
a175 ❑ 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
E3q-o--❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
giftr-f] NA
❑ NE
Page 3 of 3 12128104

B 1Nj gjf-116-? v 1
® Division of Water Quality
Facility Number 7 S f q 0 Division of Soil and Water Conservation
t1l Other Agency
Type of Visit *Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ® Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: �'/%' Z7`% Arrival Time: Departure Time: 2: 3 County: 46esor✓
Farm Name: Nokc 514:44 3'e-. 03 Far... Owner Email:
Owner Name: S La_ V o,_ E. Sisi V4_ Phone:
Mailing Address:
Region: �R`�
Physical Address:
Mt 4 a S 'j
Facility Contact: WI411k a 1 Title: Phone No: 17/0, &Zg.7/5_3
Onsite Representative: i c.L.`yc� +r-5 Integrator. marj2L , — &L-,,4 1
Certified Operator: Operator Certification Number:
Back-up Operator -
B
ack -up Certification Number:
Location of Farm: Latitude: =]o =' = Longitude: =]O 0' E:J u
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ La er
❑ Nan -La er
❑ Wean to Finish
❑ Wean to Feeder
® Feeder to Finish 7 g Z D 7___j
70
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Discharges & Stream Impacts
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkex Poults
❑ Other
Design Current.
Capacity Population
❑ Dairy Cow
❑ Dairy Cali
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures:
1. Is any discharge observed from any part of the operation?
❑ Yes
C] 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
E� No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
(4 No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
0 No
❑ NA .
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
® No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

w
Date of inspection
Facility Number: %
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
(I No
❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: 426 #
Spillway?: /V D
Designed Freeboard (in):
Observed Freeboard (in): ,3Z.
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
QO No
❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
E4 No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
[� No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
51 No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[A No
❑ NA ❑ NE
maintenance/improvement?
1. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
(A 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)
4
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E0 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
No
❑ NA
❑ NE
17. Does the facility tack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[g No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name pljGk Re-V<jS Phone: 910,V-53.3330
Reviewer/Inspector Signature: Date: 5't—//— Zo o 7
12128104 Continued

Facility Number: 79 Date of Inspection
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 [0 No ❑ NA ❑ NE
the appropiate box. ❑ W`UP ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes q No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
[V 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
Wo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[� No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[� No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
q 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)
f
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:
12128104

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
December 1, 2006
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Julia F Smith
Hoke Smith Jr #3 Farm (Hedge Farm)
4029 Iona Church Rd
Fairmont, NC 283408685
Subject: Application for Renewal of Coverage for Expiring NPDES General Permit
Dear Permittee:
Your facility is currently approved for operation under one of the Animal Waste Operation NPDES General Permits, which expire on
July 1, 2007. Due to changes in federal rules, facilities that do not discharge nor propose to discharge may choose whether or not to
retain coverage under an NPDES General Permit. Copies of the draft animal waste operation NPDES general permits and the State
Non -Discharge General Permits are available at http://h2o.enr.state.nc.us/ans/afou/downioads.htm or by writing or calling:
NCDENR — DWQ Animal Feeding Operations Unit
1636 Mail Service Center
Raleigh, North Carolina 27699-1636
Telephone number. [phone]
In order to assure your continued coverage under one of these two types of general permits, you must submit an application for permit
coverage to the Division._ Enclosed you will find a `Request for Certificate of Coverage Facility CurrentlCovered by an Expiring
NPDES General Permit' The application_ form must be completed and returned by January 2 2007. Please note, you must include
two (2) covies of your most recentWaste_ Utilization_ Plan with the application form.
Failure to, request renewal of your coverage under a general permit within the time period specified may result in a civil penalty.
Operation of your facility without coverage under a valid general permit would constitute a violation of NCGS 143-215.1 and could
result in assessments of civil penalties of up to $25,000 per day.
If you have any questions about the draft general permits, the enclosed application, or any related matter please feel free to contact the
Animal Feeding Operations Unit staff at 919-733-3221.
Sincerely,
Ted L. Bush, Jr., Chief
Aquifer Protection Section
Enclosures
cc (w/o enclosures): Robeson County Soil and Water Conservation District
Fayetteville Regional Office, Aquifer Protection Section
AFO Unit Central Files - 780019
Carroll's Foods Inc
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636
Internet: www.ncwatcrgualinLqM Location: 2728 Capital Boulevard Raleigh, NC 27604
An Equal 0pportunfty1Affimk&e Action Employer- 50% Recycledil(M. Post Consumer Paper
Telephone:
Fax 1:
Fax 2:
Customer Service:
tv"allb,
Carolina
(919)
[phone]
[phone]
[phone]

.ti
Type of Visit • Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ®Routine 0 Complaint 0 Follow up 0 Referral O Emergency 0 Other ❑ Denied Access
Date of Visit:Arrival Time: , 40AW1 Departure Time: 1 /0! 215 County: R06V-5,Tti Region: Jc "O
Farm Name: Ho Ke - S4,,:4i, fir , *'3 Fbu -, (H-d-J4 i- F-Im � Owner Email:
Owner Name: __ -�s kk \ 1 a F. _ Stu 1"k, Phone:
Mailing Address:
Physical Address: nn
Facility Contact: i� Q e_ k 1'0 kS-1p n l Title: Phone No:
Onsite Representative:
Certified Operator:
Back-up Operator:
Integrator• m uTr _8J-0WAf
Operator Certification Number: Z 0 3 7Q
Back-up Certification Number:
Location of Farm: Latitude: = o = ` 0 `+ Longitude: 0 0 = I 0 U
Design C►urrent
Swine Capacity Population
Design Current
Wet Poultry Capacity Population
Cattle
Design Current
Capacity Population
Elto Finish
❑ La er
❑ DairyCow
to Feeder
❑Non -La er
El DairyCalf
RWean
Feeder to Finish 20 1
El Dairy Heifer
ElFarrow to Wean
D . Point ,
❑ Dry Cow
to Feeder
❑ Non -Dairy
❑ Farrow to Finish
El❑Farrow
Layers
El Beef Stocker
❑ Gilts
❑Non -La Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
m ' .
❑ Turke s�
Other °
❑ Turke Poults
ia,.
��
❑ Other
❑ Other
_ �NumlierE�Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
14 No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
[A No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes. notify DWQ)
❑ Yes
VNo
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
[M No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation'?
❑ Yes
[1No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
M No
❑ NA
❑ NE
other than from a discharge?
Page l of
12128104
Continued

a
Facility Number: Date of Inspection O --12-0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[)6No
❑ 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): 37
5. Are there any immediate threats to the integrity of any of the structures observed?
[]Yes
10"'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
[2 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
[NNo
❑ NA ❑ NE
8. Do any of the stuetures lack adequate markers as required by the permit?
❑ Yes
[A 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
[9 No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
lNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below.
❑ Yes
EN No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window [:]Evidence of Wind Drift ElApplication Outside
of Area
ce
12. Crop type(s) !� eyat u, do'- _ S� 6 v4i N
f
13. Soil type(s) NcL 8 NoS %ij�p A, Ge1a ,8
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[A No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
❑ Yes
14 No ❑ NA ❑ NE
14 No ❑ NA ❑ NE
lNo ❑ NA ❑ NE
[$ No ❑ NA ❑ NE
Comments (refer to question # ): Explain any YES answers and/or any recomme.ndations�or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary) s?''
T
Reviewer/Inspector Name
c� �rw et Phone: `ilp� 33-33 a
Reviewer/Inspector Signature:
e-e,G� Date: O� -/z — Za0 Cp
Page 2 of 3 12128104 Continued

Facility Number: _3-g — (g Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP El Checklists El Design El Maps El Other
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes Eg No ❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EgNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
[A No
❑ NA
❑ NE
❑ Yes
� No
❑ NA
❑ NE
❑ Yes
[A No
❑ NA
❑ NE
El Yes
[MNo
El NA
❑NE
❑ Yes
[A No
❑ NA
❑ NE
❑ Yes
EyNo
❑ NA
❑ NE
❑ Yes W No ❑ NA ❑ NE
❑ Yes [VNo ❑ NA ❑ NE
❑ Yes [$ No ❑ NA ❑ NE
❑ Yes Qff No ❑ NA ❑ NE
❑ Yes
[XNo
❑ NA
❑ NE
❑ Yes
[P]No
❑ NA
❑ NE
Page 3 of 3 12128104

e"
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: W—,rD -'I6 lrrival Time: �fJ�7 Departure Time: County:
Farm Name:J17 Owner Email:
Owner Name- a( � SI'�%1� Phnne-
Mailing Address:
Physical Address:
Region: f-y
Facility Contact: _hLfZ- L r L ,a4Lftitle: Phone No:
Onsite Representative: �ti -� _ Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = o = t = tl Longitude: = o = g =
Swine
Design Current. Design Current
Capacity Population Wet'Poultry Capacity Population
❑ 1 Layer
❑ Non -La er
—+
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
Epp
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Dischar>?es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ElApplication 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 Heifei
ODry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system`? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
I
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
PQNo
❑ NA
❑ NE
❑ Yes
JQ No
❑ NA
❑ NE
❑ Yes
M No
❑ NA
❑ NE
❑ Yes
rO No
❑ NA
❑ NE
❑ Yes
A No
❑ NA
❑ NE
12128104 Continued

Date of Inspection S
Facility N u mber:71!ffl
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
U(No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
,� No
❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
J&No
❑ NA ❑ NE
Oe/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
7RNo
❑ 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
RNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑Yes
rur
❑ 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
14 No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
KNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
qNo
❑ 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 Drifi ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Ep No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
Cl Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination' ❑ Yes
1� No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
EqNo
❑ NA
❑ NE
18. Is there a tack of properly operating waste application equipment?
❑ Yes
KNo
❑ NA
❑ NE
rr
t�
Reviewer/Inspector Name �' ' - ,.-8-�� .�= Phone:
Reviewer/Inspector Signature: Date: la — gp--
I2128/04 Continued

Facility Number: — Date of Inspection s
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 4 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes D�No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ ❑ Maps
Design
g p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes KjNo ❑ 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
KNo
❑ 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
ElNE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
ElYes
PINo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
1KNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
16o
❑ 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
G, No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
XNo
❑ NA
❑ NE
Addchonal Commentsandlor Drawidgsns�
12/28/04

Type of Visit ! Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit • Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Time:
Q Not Operational Q Below Threshold
Gfermitted 9<ertified 0 Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: bLvkg Sw,: g ri-. )5acen 03 -- .&PeAr- + ---- County: X04gJasi FiPO
Owner Name. �����F. -S ls+, ��t. _ .. p ' Phone No:
Mailing Address: _ 40 !en <.e., C� a-4 �ry�2c� _ FG ,'r %.e.t� lllL
Facility C',�kntact: _ ..Title:
Onsite Representative:
Certified Operator. Al • e.A orr l ki✓- &.14&n ••
Location of Farm:
Phone No:
]integrator..
Operator Certification Number.
marine ❑ Poultry ❑ Cattle ❑ Horse Latitude • �' �" Longitude * 0"
Cu a east i : Y 4- - D Current
SwiDe r-ani ma MP.s tss:, :�.:PQ 9 k.._ ,sC�na� tv ;Pem�tgtian
Wean to Feeder
Layer
to Finish
17120
Non -Layer
MINIM
_ Desfga �-�� Curireat
: Farrow to Wean
Farrow to Feeder Other _
Farrow to Finish Tam DeS7gn C#pacgy}
Gilts =
<- lM
Boars ':To#a2SSI:W
Dischames 8 Stream
1. Is any discharge observed from any part of the operation? ❑ Yes M-Ko
Discharge originated at_ ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑qq6
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes 04TO
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑-905
2. Is there evidence of past discharge from any part of the operation? ❑ Yes OKo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes &M
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes [9-No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: _ . -- / - . -
Freeboard (inches): 3 "
1282/03 ConUinued

Faci$ty Number: 7— 1 Date of inspection a 3 v
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenanceltmprovement?
8. Does any part of the waste management system other than waste structures require maintenance/inaprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenancerunprovement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ElPAN ❑ Hydraulic Overload El Frozen Ground ❑ Copper and/or Zinc
12. C.-^p type
❑ Yes G�
❑ Yes Iallo
❑ Yes [Wo
❑ Yes 0,Ko
❑ Yes 24<o
❑ Yes ❑ No
❑ Yes ❑ No
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 ❑.Alo
16. Is there a lack of adequate waste application equipment? ❑ Yes 10-No
Odor lasses
17_ Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes [ NO
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes [}No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes a -No
Air Quality representative immediately.
Use � al' f� to bcr awn s�. E� P� � r9k �,fTsald Copy ❑ Fi�ral Notes c-- � � -
A.
l 1 /
FGr.r► {'s dr - ^9 p rG �oairal �d pf'..�f c..��a l A`7
Reviewer/Lu1mctor Name- �:
j �NI� f{ \ITZ� � J � �" ywe-3fF.. �-`�u'• T...:S.t'"'a.L...Gi,'�.......R�.'.—'—+�.Ax.-�.i���.r�.. .... ���� V-1
Reviewer/Inspector Signature: IaL4L Date: 10 • a -v
l!✓lWVJ wrwaasrac�s

Fa8lity Number: 7 Z — Date of Inspection T30'a
Reauired Records & Documents
21 _ Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
22_ 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
23. Does record keeping need improvement? If yes, check the appropriate box below_
❑ Yes
❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
25_ Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
27. Did Reviewer/Inspector fail to discuss reviewftnspection with on -site representative?
❑ Yes
❑ No
28. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
NPDES Permitted Facdides
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32_ Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

-...4 »- <x ....,._...:.-'-:.:..,
Type of Visit ® Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit ® Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facilih- lumber t Date of N"icit: Time:
t
not O erational 0 Below Threshold
® Permitted ® Certified 0 Conditionally Certified ❑ Regiisst_er`ed\ Date Last Operated or Above Threshold:
Farm lame: niC� t j(. FG�nn �4}�GQGp--- C o u n n7
: _ nr ,am- E&d
N.
Owner Name: = Phone No: Iq l O I(. I
Mailing Address: 412.1 e, C.L., ta, i20-1_ _ D-9340
Facilit%- Contact:
Title:
Phone No:
Onsite Representative: YN11 C.VNKel f 4A S Integrator: car-,rs (t_ � _
Certified Operator: Operator Certification number. Aaa 20 Z q z
Location of Farm:
®Swine ❑ Poultry ❑ Cattle ❑Horse Latitude 0• 04 " Longitude �• 0��
Design Current
Design Current Design Current
Swine Capacity Population
Poultry
Ca acity Po ulation Cattle Ca acitf Population
❑ W-can to Feeder
❑ Laver
❑ Dairy
® Feeder to Finish
❑Non -Laver
❑Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
❑ Boars
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present HoLagoonArea S ray Field Area
Holding Ponds I Solid Traps ❑ No Liquid waste Mana etnent System - j
Discharges 4- Stream Impacts
1. Is anv discharge observed from any part of the operation?
Discharge orizinated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is obser<ed, 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 now in gallmin?
d. Does discharge bypass a lagoon system? (If yes. notifi 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 & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure ? Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches): _
05IV3101
❑Yes FNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
P No
❑ Yes
P No
❑ Yes
P No
Structure 6
Continued

Facility 1`umber: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑YesNo
seepage. etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes A 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 stucrures lack adequate. gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste AnBlic2tion
10. Are there any buffers that need maintenance/improvement? ❑ Yes [KNo
1 I- is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type 9dr V" to d 6, -k7- S e A . Ceram .,n O .S
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan {CAtil"vIP}? ❑Yes 19 No
14- a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a -.venable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
I5. Does the receiving crop need improvement? ❑ Yes r�'01No
16. Is there a lack of adequate waste application equipment? ❑ Yes ® No
Required Records & Documents
17- Fail to have Certificate of Coveraec & General Permit or other Permit readily available? ❑ Yes L&No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUP, checklists. design. maps. etc.) ❑ Yes qNo
19. Does record keeping need improvement? (ie/ irrigation. freeboard. waste analysis & soil sample reports) ❑ Yes O 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
27. Fail to notify regional DR-Q of emergency situations as required by General Permit?
(ic, discharge. freeboard problems. over application) ❑ Yes No
23_ Did Reviewer Inspector Tail to discuss revieaiinspecrion with on -site representative. ❑ Yes No
24. Does facility require a follow-up visit by same agency? ❑ Yes No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes No
J(] No violations or deficiencies were noted during this Asir. You %iH receive no further correspondence about this visit.
Gommenti (refer to icesti6ni— ft 'Eipla"in" : YES saswieim_ 'z naloraay reconameadations or aav im&6F commeutiLyam'` ' • Y
Use drawings of faeiuty to better explain sttttations. (asc addittotxitl pages as necessary) Ej � Field Copv ❑ Final Notes '
Reviewer/Inspector Name
Reviewer/Inspector Signaturo Date: (}
05103101 L Continued

y
Facility Number: �L9- Date of Inspection
Odor- Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there anv dead animals not disposed of properly within 24 hours? ❑ Yes No
2& Is there anv evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure. and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes N No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes [0 No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submersed fill pipe or a permanent temporary cover? ❑ Yes ❑ No
Additional: Comments:andlor Drawins:;
05103101

h
\V
Type of Visit ® Compliance Inspection C) Operation Review O Lagoon Evaluation
Reason for Visit ® Routine 0 Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facilitv Number Cate of Visit: aZ Time:
Not erational 0 Below Threshold
Permitted ® Certified �J❑ Conditionally Certified © Registered Date Last Operated or Above Threshold
Farm Name: _ _ _�:6+Js�y'frice- - _-,-- County
Owner Name: 14411 � • l �K, � �. 4-- -- Phone No: rg"i5o "y — 7/ r�
Mailing Address: _ W.2
Facility Contact: Title: Phone No:
Onsite Representative:���r/ �-r/�/� lntegrator:
Certified Operator: _ %�JF/ l "/Sfi7i� Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude a " Longitude ' 1
_ - - "Design
Swine
°Swine ` acit
❑ Wean to Feeder
Feeder to Finish 1 71926
' ❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Guts
❑ Boars
Current,-:- Desirt, _Current
o ulation . Pottitry . Capauty Po2ulation -Cart'
r—
❑ Other
-Total Design Cs
T664
=Cprieni -
Po intateon
Number of Lagoons ' ' ❑ Subsurface Drains Present IrOlLnoonArea ❑ S p rsv Field Area
Holdiag Pouds7 Sohd<Traps , _ ❑ No Liquid Waste Management Svstem
_
Dischar-es & Stream Impacts
1- Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Laeoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes. notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes. notify DWQ)
2. Is there evidence of past discharge froth 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?
N%`aste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
❑ Yes 10 No
❑ Yes q No
❑ Yes 0 No
❑ Yes ERNo
❑ Yes P-No
❑ Yes 10 No
❑ Yes P.No
Structure 6
Continued

0
Facility Number: 78 — /9
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6- Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
❑ Yes [ No
❑ Yes [�No
❑ Yes O�No
❑ Yes ;9 No
❑ Yes P;�No
❑ Yes J9 No
❑ Yes Y No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes CRNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
ANo
b) Does the facility need a wettable acre determination?
❑ Yes
;$No
c) This facility is pended for a wettable acre determination?
❑ Yes
�R No
15. Does the receiving crop need improvement?
❑ Yes
�No
16. Is there a lack of adequate waste application equipment?
❑ Yes
R) No
Reauired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
�No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
[4 No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
PQ No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
Wo
22- Fail to notify regional DWQ of emergency situations as required by General Permit.,
(ie/ discharge, freeboard problems, over application)
❑ Yes
PKNo
23- Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
P No
24. Does facility require a follow-up visit by same agency?
❑ Yes
[� No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
[KNo
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
ComEnents.(refer to question #) Explain aay YES anss� ers aatd/or any recommendations or an a titer'comments.
Use drawingo s f fac7tty to better explain sttuattoas Ease additional pages as neeesry:
❑Field Conv ❑Final Notes
a
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility lumber: — 9 Date of inspection IOII� DZ
dor- Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discbarge atlor below
❑ Yes
NJ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
rQ No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
No
roads, building structure, andlor public property)
/M
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑Yes
XNo
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
IN No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
([No
32.
Do the flush tanks lack a submerged fill pipe or a permanentiternporary cover?
❑ Yes
XNo
-Additiona]Cominents.andlor=Drawings:`:.-
A.
05103101

D
ruts na of Water ty -
j " ,D�vtsiop of Soil and Water:Conservation s
Q'Othet'Agency _.
:- ..
Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit OtRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Time: [== Printed on: 10126/2000
Q Not Operational Q Below Threshold
Permitted [3 Certified t3 Conditionally Certified U Registered Date Last Operated or Above Threshold:
Farm Name- ..e. . �rK Countv: �.J ......................
............................................................ �% ...rt-.............. .
Z 7/ S3
Owner Name:........5 ti ..1_C ..... E.......... N�! l Phone No 4� �f
/�,� 1 D f .. --
Facility Contact. 1,1 E cAr,4_0....P8 1 .......'1'itle:.........A. .l........................ Phone No
.. q /�` �J...... ,l...,.............
Mailing Address: ...... I .Z....L......... .t ��......-.[..�h ,.....[` �........ �....!.!..�� ..... ..
Onsite Representative: [,..;, tq.'......................... . /...-.................................. Integrator:......... ........ti....f�i, `i7..�1.. ........................
p ��aUl..G�.......................................
Certified O erator•,�e...--..,-„ _.- .----,.-„ ,,,,,,,,,,,,a,,,,,,,, ,.-�� Operator Certification Number:,..
......... ............... .
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �' �� �� Longitude �• ��
Design Current
,wane Capacity Population
❑ Wean to Feeder
Feeder to Finish 7911Z6
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current
Poultry Capacity Population
❑ Layer
❑ Non Layer
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy
❑ Non -Dairy
Total Design Capacity -79 ZO
Total SSLW
Number of Lagoons JE1 Subsurface Drains Present ❑ Lagoon Area I [] Spray Field Area
Holding Ponds / Solid Traps JE1 No Liquid Waste Management System
Discharees & Stream Impacks
1. is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes No
b. If discharge is observed. did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes No
c. If dischargc is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DVI�Q) ❑ Yesto
o
2. Is there evidence of past discharge from any part of the operation? ❑ Yes
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yesr
0
Waste Collection & Treatment
A-0-4. Is storage capacity (freeboard plus storm storage) less than adequate'? ElSpillway ❑ Yes
SIFUCLUrc I Structure 2 Structure 3 Structure 4 Structure 5 Structure h
Identifier:................................................................ ......
Freeboard (inches):
5100 Continued on back

Facility Number: 7 — Date of Inspection -'l! Printed on: 10/26/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ®No
seepage, etc.) '
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement?
❑ Yes
k"No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
❑ Yes
Po
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
KN 0
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
No
it. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
No
12. Crop type ret.. JM , r der
13. Do the receiving crops differ with those design din the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
o
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
o
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 Iack of adequate waste application equipment?
❑ Yes
P(No
Reouired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
�No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
k(No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge?
ElYes
qNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
VNo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
ANo
24.
Does facility require a follow-up visit by same agency?
❑ YesyNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ONO
N6- iolatigtjs'or deficiencies -were noted- during (his'visit: - Yob wiii•reeeiye Rio i'ai-tiier
correspa deice. abouti this visit:
Comments (refer to W..:#Explain any YES answer§ and/or iny recommendatiois'or any ohqur- comments _,.;
_.
Use drawings of facility to:better explain situation: (use additional pages as necessary)
Fie Sure `tO qB Sot Sc4...DS f rw All— 'fl/t QerOPo `
�IeiJ [jr+ eq�'�,/4f q.re Co+•Z r' �t i
Pi'ce_ lacskiot y ncrm.
1W
ReviewertInspector Name
Reviewer/Inspector Signature: Date: D 5100

Facility Number: _ Date of Inspection
Printed on: 1/4/2001
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
32. 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.)
33. Do the animals feed storage bins fail to have appropriate cover?
34. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes No
❑ Yes No
❑ Yes o
❑ Yes No
❑ Yes
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Reviewer/Inspector Name �_ a kFz;� a _.: Mar:.'...: �,.i=
Reviewer/Inspector Signature:
Date:
01/01/01

® Routine Q Complaint Q Follow-up of D= inspection Q Follow-up of DSWC review Q Other
Facility Number 7 Date of Inspectiion �!
Time of Inspection -o 24 hr. (hh:mm)
® Permitted [] Certified [3 Conditionally Certified [3 Registered JE3 Not Operational Date Last Operated
Farm Name: ..........6. ... � 3........ +... .. ................ County: ........... Am4' sO.v...........................................
Owner Name: a �/� �^ • T� Phone No:
..................�JJ....--......................./_..... .................../... _.........-.....'.71.......�.�._ ..�_�.
Facility Contact:: v�ifG/ .Z ... Title: . Phone No: .............--..................---
Mailing Address: ......... r,T B.Z... L� ...�1. ....l�fllf''°.. l! �..G................. ��(J
�t✓�..._ tr4............ / 2
�../j r...
Onsite Representative:.._..,[/{. ` ' �.1� .. ,1�, 1 ........................... Integrator:... G �.E��£'(� - .�✓G' G,
Certified Operator:........ % G✓-... 13i`� .................... Operator Certification Number: ................................ ........
Location of Farm:
Latitude • ==1 =11 Longitude = o =` =11
Dest Gurretit �; :Desi :Current- Dent Current -
_ -
s-_.:,•.-, Ca act :`Po nlabon Poultry, _Ca acity,,-Po "'ulatioii , .Cattle Ca` act `Po ulatton
❑ Wean to Feeder ❑ Layer ❑Dairy -
Feeder to Finish 7 9Zo 2U ❑ Non -Layer ❑ Non -Dairy
". ❑ Farrow to Wean =
❑ Farrow to Feeder ❑ Other
Farrow to Finish -
Total Design Capacity
❑ Gilts
To ❑Boars ` tal SSLW.�
:: ,.
Numberof L Dons ;. t ❑ Subsurface Drains Present ❑La171
goon Area ❑ Spray Field Area
Holding Ponds%5ohd Traps ' ❑ No Liquid Waste Management System L Pq
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes A No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes &j No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes 4!qNo
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If -yes, notify DWQ) ❑ Yes g] No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes j$No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes A] No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6,
Identifier:
011
Freeboard (inches): .............
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes tj No
seepage, etc.)
3/23/99 Continued on back

Facility Number: 7g — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes Q 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 Pj No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes P No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes RNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes P No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes NNo
12. Crop type47
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP). ❑ Yes IRNo
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 13No
15. Does the receiving crop need improvement? ❑ Yes RNo
16. Is there'a lack of adequate waste application equipment? ❑ Yes (RNo
Reauired Records & Documents
IT.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
RNo
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
RNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
QN0
20,
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
a o
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
fallo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
❑ Yes
JTNo
23.
Did Reviewer/Inspector fail to discuss reviewrinspection with on -site representative?
❑ Yes
j No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
R No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ONo
(1'YiQ��1EtQI�S O (�� IC} �iCiES ry re ilQt. 0... g 4)ij5.v15it� YOB W jTi'CT1Ve {i0 trtii
6rresb, ndeitce: abi6f this visit ......:.::..::.:::....:......:..: :
r
ra w
Reviewer/inspector Name - 3 , Y' �` �� .Ow
Reviewer/Inspector Signature: .s• Date: '7Z4­zav�6

Facility Number: 7P Date of Inspection G Z�
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below []Yes �No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes PNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ONo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes 2tNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (Le. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes P•No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ANo
32. Do the flush tanks lack a submerged fill pipe or a perrnanent/temporary cover? ❑ Yes allo

/R 4
Division of'Siitl and Water Conservation Operation Reviewfn s
a 3 Division of Soil and Water"Conser.vation Compliance lnspec
tion
Division of Water Quality:- Compliance' Inspection
e a
Othergency Operation Rev�ewa
_
Routine O Cam laint Q Follow-up fjfDWQ inspection O Follow-u of DSWC review Q Other
1 j . Facility Number % Date of Inspection
Time of Inspection 24 hr. (hh:mm)
Permitted ❑ Certified 13 Conditionally Certified 13 Registered 3 Not Operational I Date Last Operated:
Farm Name: eAGIC� �r County:.......
/....... ...........I ...... ...................................... .... ,..................................--.......
Owner Name:..... 34 IlQ
...... .............�rlt.tt• �- Phone No: ................fP. GI....."..7�
Facilitv Contact: ,A ° y /TX�
Title:�L�'„• Yhi:ne No: rC..1E`/... / _............
cm\•tailing Address: ........ ��...�1I!TU.. �rfzr ��' ........... .................................
..........................
.. .. ....�..................
Onsite Representative...... i. l ... .......... '............... .... Integrator ............ 5� .fit.!" .r i�..L.f....................................
J q
Certified Operator:, !i.tG iG P� 5 ,. ..................... Operator Certification Number:...._3..70...........
Location of Farm:
a<
................................................................................................................. ..... ........................... ............ ..... . --.. ...... y
Latitude ' a 44 Longitude 0 C &°
Design Current
Nwine Capacity Population
❑ Wean to Feeder
Feeder to Finish Zo
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ soars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer I I I[] Non -Dairy
❑ Other l I
Total Design Capacity 79Z4
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Disci & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Discharge originated at: ❑ Lagoon Spray Field ❑ Other
a. If discharge is observed, was the conveyance ratan -made?
h. if discharge is observed. did it reach: ❑ Surface Waters ❑ Waters of the State
c. if discharge is observed, what is the estimated slow in gal/min'?
1 d. Does discharge bypass a lagoon system?
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts to the waters of the State other than from a discharge?
!Paste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate'?
Structure I
Identifier � � It
Freeboard (inches): ............................
Structure 2 Structure i Structure 4
XYes ❑ No
❑ Yes WNo
❑ Yes JZ(No
❑ Yes N No
❑ Yes 9No
❑ Yes ANo
❑ Yes XNo
Structure 5 Structure 6
1/6/99 Continued on back

racility umber: 7� Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7- Do any of the structures need maintenance/improvement?
8. Does any pact of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings?
❑ Yes XNo
❑ Yes ONo
❑ Yes RNo
❑ Yes ONo
Waste Ap2lication
10. Are there any buffers that need maintenance/improvement? ❑ Yes P(No
11. Is there evidence of over applic tion? ❑ Po ing ❑ Nitrogen ElYes ONO
12. Crop type CQ.r.n........f ,�, - ..... ... .I'�J.,° .1k1. ...... �rL....l!1.!t:. t ........ !s! ... lc.?fr!.............
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ANo
14. Does the facility lack wettable acreage for land application? (footprint)
❑ Yes No
15. Does the receiving crop need improvement'?
❑ Yes WNo
16. Is there a lack of adequate waste application equipment?
❑ Yes No -
Required Records &_ Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes No
19. Does record keeping need improvement'? (ic/ 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 certified operator in responsible charge?
❑ Yes j No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes No
(ie/ discharge, freeboard problems, over application)
,'No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
24. Does facility require a follow-up visit by same agency?
El Yes WNo
0: No' * . at.. ..or deficiencies .were noted during this -visit. `You witl.reteive nor further .: .
eorr&'66 idenee; "bilf this visit.; ; . ....... " . ...... . .. . ' ' ' ' ' ' ' ' ' ' . ' . ' ' '
Cotnments'(refer to question #): Explain any YES answers and/or any recommendations or any other comments.-'--- W
_
Use drawings of facility to better explain situations. (use additional pages as necessa ry}
1, �ia°reOr7T rnTJ i �- -�`e I
`
eh. erect `Par,.— (_6CA c/1 i>�cJ�/ 7 e oral 5�pred bcLj �tr#--
I]GI /COCL19
Ala,- .Q �{ 9% a 5! *--,. G "' ',ri TJ� Q(OG/� d,4c 1� �wI Gr eX i/� �O�/�t� A 574,I
0, W,M4 ,X+ Qc " fl
Loco.rdkeeep;,jIoo lc 5
�v wive
arm 11e�,A c e-Mle
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: Z--//-12 11/6/99

State of North Carolina
RECEIVED
Department of Environment
and Natural Resources
JUL 2 i998
Division of Water Quality
James B. Hunt, Jr., Governor
FAYETTEVILLE
REG. OFFICE'
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
June 26, 1998
Julia F. Smith
Hoke Smith Jr #3 Farm (Hedge Farm)
4029 Iona Church Road
Fairmont NC 28340
A ffl-?WA
kqCDENR
NORTH CAROUNA DEPARTMENT OF
ENVIRONMENT AND N/;TURAL RESOURCES
Subject: Reissuance of Certificate of Coverage
No.AWS780019
Hoke Smith Jr #3 Farm (Hedge Farm)
Swine Waste Collection, Treatment, Storage and
Application System
Robeson County
Dear Julia F. Smith:
The Division of Water Quality modified the Swine Waste Operation General Permit originally issued to
this facility on June 9, 1997. In accordance with the issuance of the revised General Permit, we are
forwarding this Certificate of Coverage (COC) to Julia F. Smith, authorizing the operation of the subject
animal waste collection, treatment, storage and land application system in accordance with General
Permit AWG100000. This approval shall consist of the operation of this system including, but not
limited to, the management of animal waste from the Hoke Smith Jr #3 Farm (Hedge Farm), located in
Robeson County, with an animal capacity of no greater than 7920 Feeder to Finish and the application to
land as specified in the Certified Animal Waste Management Plan (CAWMP).
The COC shall be effective from the date of issuance until April 30, 2003, and shall hereby void
COC No AWS780019 dated.June 9, 1997. The COC shall hereby incorporate by reference any specific
conditions of the previous COC issued to this facility. The purpose of this COC is to allow coverage
under the revised General Permit. Please review the revised General Permit (enclosed) and pay
particular attention to Condition II.10 regarding tree removal from lagoon embankments, Condition III.1
regarding inspection frequency of the waste treatment, storage and collection system and Condition 111.6
regarding notification requirements for system failures, spills and emergencies. Pursuant to this COC,
you are authorized and required to operate the system in conformity with the conditions and limitations
as specified in the General Permit, the facility's CAWMP, and this COC, with no discharge of wastes to
surface waters. An adequate system for collecting and maintaining the required monitoring data and
operational information must be established for this farm. Any increase in waste production greater than
the certified design capacity or increase in number of stocked animals above the number authorized by
this COC-will require a modification to the CAWMP and this COC and shall be completed prior to
actual increase in either wastewater flow or number of animals.
Please be advised that any violation of the terms and conditions specified in this COC, the
General Permit or the CAWNIP may result in the revocation of this COC, or penalties in accordance
with NCGS 143-215.6A through 143-215.6C including civil penalties, criminal penalties, and injunctive
relief.
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Certificate of Coverage AWS780019
Hoke Smith Jr 93 Farm (Hedge Farm)
Page 2
Upon notification by the Division of this COC's expiration, you shall apply for its renewal. This
request shall be made within 30 days of notification by -the Div* iot}.
This COC is not automatically transferable. A name/ownership change application must be
submitted to the DWQ prior to a name change or change in ownership.
If any parts, requirements, or limitations contained in this COC are unacceptable, you have the
right to apply for an individual non -discharge permit by contacting the engineer listed below for
information on this process. Unless such a request is made within 30 days, this COC shall be final and
binding.
The subject farm is located in the Fayetteville Regional Office. The Regional Office Water
Quality Staff may be reached at [phone]. If you need additional information concerning this
COC or the General Permit, please contact Sue Homewood at [phone] ext. 502.
Sincerely,
1_0
or ;ton Howard, Jr., P.E.
cc: (Certificate of Coverage only for all cc's)
Robeson County Health Department
Fayetteville Regional Office, Water Quality Section
Robeson County Soil and Water Conservation District
Permit File

E3 Division of Soil and Water Conservation 0 Other Agency
$Division of Water Quality
140 Routine O Complaint O Follow-up of DWO inspection O Follow-up of DSWC review O Other I
Facility Number
rT
ale of Inspection
ire of Inspection nr� 24 hr. (hh:mm)
0 Registered Wertified © Applied for Permit XPermitted © Not Oeerational I Date Last Operated:...... ,
Farm Name: -MTh - 3 ��!7 �*� County �D.Sd h
....................^'?...............................................----..,.....................................................
Owner Name: �.! „1 ........ Phone No: �`a $�— <��3
...... .......................... ................................. •.........................................
FacilityContact: .. � ..4 -L-•--•----PO /S fa Ya. Title:................... . Phone No:.................................................. .................... . ................... ....................
Mailing Address:....... .L...,: �4 a.... t•-�7 vr:l2 alb. t .!►!� !i .. l VC .................
a `f
...............
Onsite Representative:....L.:..I11.C...q"C-......... 192 �5................................. Integrator:....... C qr ? ..5......l.L-'4 j...x t?......
Certified Operator:................A .C.IneT iS....I.�1......................... Operator Certification Number, a��5�2....
Location of Farm:
C
C
Latitude • ° 4t Longitude • =` =11
kh Design
Cnrrettt" _. Design s €urgent #� Design Currentry
=4 Swine ' "` ; `Capacity
Poplin tton `XPonitry Gapacity;,;Populatioia Cattle x " Capac,ty Popalatton
❑ Wean to Feeder
❑ Layer Dairy
Feeder to Finish D
❑ Non -Layer" Non-Dairy
EEI
u ❑Farrow to Wean
„ ._ h Wit•e ' 5 ,.
�.
��� ❑ Farrow to Feeder j
❑ Farrow to Finish
Total Design Capacity 99, Q
❑ Gilts*
;,. ❑ Boars
r =1�
= a -,a,-_' ,.--'ap�-.ter �ta•Tota FSSLW
m
Area
iVumber of Lagoons/ ft Oing Ponds° ❑ Subsurface Drains Present ❑ Lagoon❑ Spray Field Area
, ❑ No Liquid Waste Management System
.mow.-� ,�,� �,� ,� M 4 q ,.,� � �; �,,,�
neral
1. Are there any buffers that need maintenancelimprovement? ❑ Yes Otlfqo
2. Is any discharge observed from any part of the operation? ❑ Yes XNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes No
b. If discharge is observed, did it reach Surface Water? (If yes. notify DWQ) ❑ Yes 19 No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
• ❑Yes Pd No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
fl4 No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
O No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
IN No
maintenancelimprovement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
�No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
ANo
7/25/97
Continued on back

Facility Number: —
8. Are there lagoons or storage ponds on site which need to be properly closed'?
Structures (Lagoons.liolding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Identifier:
Cl Yes XNo
❑ Yes P�No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 0
Freeboard (tt): ............o1r..
10. Is seepage observed from any of the structures?
11. is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenancelimprovement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste :application
14, Is there physical evidence of over application?
(If in excess of WMP, o�r runoff entering waters of the State. notify DWQ) /
15. Crop type .......... ..... `ZA?!!! 1dFt.,....5� ....d�_. 1�1'f�..LM�+� .................
16. Do the receiving crops differ with those designated in the Animal Waste Manaoement Plan (AWMP).
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AW,MP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0 No.violations or deficienries.were noted during this visit. You.will receive no further
correspondence about this:visit:• . • ;
❑ Yes X\o
❑ Yes A -No
AYes ❑ No
❑ Yes XNo
❑ Yes ANo
JXYes ❑ No
❑ Yes ;KNo
❑ Yes 00 No
❑ Yes 0 No
❑ Yes U(No
❑ Yes X No
`Yes ❑ No
❑ Yes KNo
❑ Yes No
❑ Yes f No
'Cotntnents.(refer toquestion #j Explain any Y`ES answers`and/or any recommendations,onany oWencomtnents.
Use;drasvings of faceitty Eo better`expiwn situations. (use additional pages as necessary)
- `e V1aJt Cb i- Ql� �'`1" i a�� / f J CTh �'►siaP
CC o 5 of
� �b�� ►s se,- - crap
Calm P l L2 I 7/25197
r2 Am- - - (A1 r 11
Reviewer/Inspector
Name 3:
Reviewer/Inspector Signature: Date: Jr X-2— /Y

Facility Number: 1 Date of Inspection:
ddtio1 _
� 0
� fir, rr
4/3U/Y j

ODSWC-Aiii ot, perAfiihi,
outine 0 Complaint 0 Follow-up of Dn inseection 0 Follow-ue of DSWC review 0 Other
IFacility Number
Date of Inspection 7- Z Z�11
Time of Inspection O: ! t7 24 hr. (hh.mm)
Total Time (in fraction of hours
Farm Status- [] Registered 0 Applied for Permit (ex:1.25 for I hr 15 min)) Spent on Review
D Certified . g'Permitted or Inspection (includes travel and processing)
I Not Operational Date Last Operated:
Farm Name: County:
Land Owner Name: -Z
. ...... Phone No:l-.7.-- -/.K
Facility Conctact: Title: Phone NO:
Mailing Address: A
Onsite Representative: ... —h C.L..; .. ke! -------- Integrator: . ... . ....
Certified Operator: Operator Certification Number:
Location of Farm:
4n .... al
Latitude 4 u Longitude
TvDe Of Operation and Design CRD2CitV
—W"
�'-qDesiknd N�Xx z e r Design .nt
W11 ltr V.,
apact w�p 61a Pao - y ��NXPODWiti"K Cattle Ca aci 01)ulahori�
1E3 xv can to Feeder Layer 13 Da
Feeder to Finish El Non -Laver L1 Non-Daiaf I
Farrow to Wean m At
v,
0 Farrow to Feeder 4ZT.6fid Design a I Z
�JH�
W.—
0 Farrow to Finish 1 15
Ad* "wo "0Z
ther W ­o.s.
2 '20, 4NO
Oki,msso-, ''M
Numb,er ofT 'W"
V p ps,kH61dingToniti,� U
M
0 SU bsurface Drains Present
0 Lagoon Area 10 Spray Field Area
Gegr,ral
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Lagoon 0 Spray field 0 Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (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)
3. is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/97 maintenance/improvement?
E]Yes A 0
0 Yes �No
❑ Yes K No
No
El Yes KNo
[I Yes U[No
1 11.1
❑
Yes PNo �
❑ Yes �(No
Continued on back

Facility_ umber ...,_—...fig
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes )(No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes JKNo
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes 1No
/
Structures (Lagoons and/or Ifolding_I'onds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes )(No
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
10. Is seepage observed from any of the structures?
❑ Yes ,KNo
11, Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes �,�No
12. Do any of the structures need maintenance/improvement?
❑ Yes O-kqo
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes ' o
Waste Application���
14. Is there physical evidence of over application?
❑ Yes �}.ZY0
(If in excess of WMP, or runoffenteringwaters of the State, notify DWQ)
15. Crop type r,�ii! 4.... ............ ..... __.... _.... ...... ......._.........
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes KNo
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes No
18. Does the receiving crop need improvement?
❑ Yes ' \No
l9. Is there a lack of available waste application equipment?
❑ Yes No
20. Does facility require a follow-up visit by same agency?
❑ Yes �[ No
'0,,No
21. Did Reviewer/Inspector fail to discuss rcview/inspection with on -site representative?
❑ Yes
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
Yes ❑ No
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes A No
24. Does record keeping need improvement?
❑ Yes ANo
Comments (refer to"question j#) EXplatn any YES `answeis and/or any recommendat�o�is or any;ather comments: h
Use:drawin s of lityto better ex lain situations use addthonalP#9 es as necessary'...,,zw r s y
44� 43e.ti►wAas F%a% avm�1c,htie oc+4'e -V„,,e o_� #his
tnsFe `i oRl. �i Copy w,s rjLAej+e4 a,tj w4S tic 6 red rLs_c+ar•
Ap-r-r- relli@�7 �� rn5�ec'�o je jAS�GToh1 IS CanSiderc� Cs��..
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: 7"2-1-77
cc: Division of Water Quality, `Water Quality Section, Facility Assessment Unit 4/30/97

.411�
State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
N.
E)F=HNFZ
- DIVISION OF WATER QUALITY
July 8, 1997
Mr. Robert Smith
Rt. 3, Box 734
Fairmont, NC 28340
SUBJECT: Annual Compliance Inspection
Hoke Smith Jr. Farms
Registration Nos. 78-17, 79-18, 78-19,
& 78-76.
Robeson County
Dear Mr. Smith:
On July 2, 1997, staff from the Fayetteville Regional Office of the Division of Water Quality
inspected the subject swine facilities. Please find enclosed a copy of our Compliance Inspection
Report for your information. It is the opinion of this office based on the information provided and
observations made during the inspection that the facility was in compliance with 15A NCAC 2H,
Part.0217 at the time of the inspection_ Please refer to the comments section on the rear of the
inspectionJim for information regarding your facility.
..ice. '
You informed'me in your letter that Mr. David Hedgepeth was working with you in getting
your waste management plans revised for the above mentioned farms. Please be advised that since
these farms are permitted, there are many more items that have to be addressed in the waste
management plans. Please read the permits carefully and make sure all components are with each
plan at each site.
If you need any of the copies of the information which you forwarded to me please let me
know and I will return it to you.
If you have any questions concerning this matter, please call John Hasty at [phone].
cc: Operations Branch
Central Files
Audry Oxendine - FRO DSW
Ed Holland - Robeson Co. MRCS
Sin ,
ohn C. Hasty, Jr.
Environmental Specialist
Wachovia Building, Suite 714, Fayetteville �T���• FAX [phone]
North Carolina 28301-5043 11 An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/10% post -consumer paper

"C Anlmal Feedlot Opera
Z.
Z AnilmalFeedlot Operati
Follow-up of
Facility Number
Follow-up of DSWC review Q Other j
Date of Inspection
Time of Inspection 10,1 / Q 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: ❑ Registered ❑ Applied for Permit (ex:1-25 for 1 hr 15 min)) Spent on Review
❑ Certified Permitted I or Inspection Cincludes travel andprocessing)
❑ Not OperahonaI Date Last Operated:
Farm Name, ���AA County: Q.�------ ...........„.
-IZ71
Land Owner Name: �L__.. + Phone No: qZz
10 ..--- ----- -- — ,
Facility Conctact: _ 4 q Title:. 1w11lce.. '� D!J Phone No:.t/ 1 a z k m �?.ii_
Mailing Address:.
OnsiteRepresentative: _Na.1L.� . �. .. Integrator CarCQ 1+ {
Certified Operator: T . _. s/Lti + f _ . Operator Certification Number: _..1
Location of Farm:
EP
.
�s c, �Ic.
R -
Latitude �• �` u Longitude �• �u
Type of Operation and Design Capacity
s. z waa ^DCSI C>Crent x%� w
Designer >Current�� _ gn _ �Des�gn� Cp*rent
S9vine z POnitry Ca aCity Po" ulati Tii.^CattleC9 8Ci "Po ulatiOn a .,u ... r". < < � • r Ca aci < PO Ulatlon r
a° ❑ Wean to Feeder ' La ❑ D
[`Feeder to Finish
Non -Layer " t ❑ Non-
Farrow to Wean '3-:-
�t»a' a ».
Farrow to Feeder d rxTtitid"W i " Capacity f
Farrow to Finish 14<
r ....... �� Total SSLW
❑ Others
Number of Q,,�ons"1 Hoidm Ponds ❑ Subsurface Drains Presents
der v w s
❑Lagoon Area MQ Splay Field Area
Genend
1. Are there any buffers that need maintenance/improvement? ❑ Yes PNo
Z. Is any discharge observed from any part of the operation? ❑ Yes NJ/No
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes RNo
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes ®No
c. If discharge is observed, what is the estimated flow in gal/min? 1A\
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes E No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes 121No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes PPNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes PNo
4/30/97 maintenance/improvement?
Continued on back

Facjlity Number-:
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
S. Are there lagoons or storage ponds on site which need to be properly closed?
Stru . and/gr s
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure Structure 2 Structure 3 Structure 4
Z.
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
Immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes )K(No
❑ Yes N No
❑ Yes �No
❑ Yes XNo
Structure 5 Structure 6
Waste Applicatiog
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering/waters of the State, notify DWQ)
I5. Crop type _..­c1)i ..„
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
F2r Certfisd Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes )I�No
❑ Yes ANo
❑ Yes JE3�0
❑ Yes o
❑ Yes *0
❑ Yes KNo
❑ Yes -�(No
❑ Yes b(No
❑ Yes K No
❑ Yes R�No
❑ Yes MNo
10 Yes ❑ No
❑ Yes No
❑ Yes No
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):
�y
w-L4e ►v1annan"aPar' W0.s rid+ 0.UcuC'++'e +•Lw•e
irfpej+ op►1. A Copp LO LS rerlAe''� anj Loas rdeee1vec� tr►5Pcctor.
4
ibi
X+er reUteui IDy '11,5pe-c-6 . +-ge 1n5(L-c-4;orJ .15 CArsiQerrj C61^11FI'4e .
NO
Reviewer/Inspector Name
Reviewer/Inspector Signature: !-
Date: — ZTf``f -7
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97

State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. Robert Smith
Rt. 3, Box 734
Fairmont, NC 28340
Dear Mr. Smith:
E)F.=HNF;Z
DIVISION OF WATER QUALITY
July 3, 1997
SUBJECT: NOTICE OF DEFICIENCY
Sugar Hill, Hedge Farm,
Savannah Pond & Aaron Swamp
Facility Nos. 78-17, 78-19, 78-19,
& 78-76
Robeson County
On July 2, 1997, staff from the Fayetteville Regional Office of the Division of Water Quality
conducted an inspection of the Hoke Smith Complex. At the time of the inspections, no one from the
farms was present. These inspections were conducted with the help of Mr. David Ray, service person
for said farms. The waste management plans for these farms were not available to the inspector,
therefore a complete inspection could not be perfomed. These waste management plans should be
kept on site and made available for future inspections.
In regard to the deficiency noted during the inspection, the following actions are requested:
Please provide this office with a copy of the waste management plans, including waste and
soil analyses and irrigation records for the above mentioned farms so that a review of the
plans may be conducted and the inspections completed.
Please provide a written response to this office on or before July 16, 1227 as to the actions
taken or proposed to be taken to resolve this deficiency. Nothing in this letter should be taken as
absolving this facility of the responsibility and liability of any violations that have resulted or may
result from these deficiencies.
Wachovia Building, Suite 714, Fayetteville N%`� FAX 910 4$6 0707
North Carolina 28301-5043 An Equal Opportunity Affirmative Action Employer
Voice 910-486-1541 50% recycled/10% post -consumer paper

Page 2
Mr. Smith
If you have any questions concerning this platter, please call John Hasty at [phone].
Sincerely,
4ohn C. Hasty, Jr.
Environmental Specialist
cc: Operations Branch
Central Files
Audrey Oxendine-FRO DSW
Ed Holland -Robeson Co. MRCS
Carroll's Foods-Laurinburg Office