780021_INSPECTIONS_20171231

Division of Soil and Water Conservation ❑ Other Agency
10 Division of Water Quality
10 Routine O Complaint 0 Follow -tin of
Follow-up of DSWC review O Other
• Facility Number "� ,
Date of Inspection I d-9-9
Time of Inspection /� 24 hr. (hh:mm)
D Registered )4 Certified ©Applied for Permit JWPermitted
� Not O erational Date Last O era-ted�• ...
............
Farm Name: ........... F........ v4n�. ...
County .f............ I..........
Owner Name: ...............�.q................. 1.6;1a:�i.......................................
.
�....�...................
Phone No: ...........
Facility Contact: ........... —:...... ............. Tiile:.........................................�.....................
Phone N`o....... .... .......... I ......... I....................
14iailiug Address: i�"T�......... J�..........�tpjC....... ............................
... ..........
....... J............... _W3{,
r. t...±.!'Z:?� !" �r................ ..... ..................
r,/ r
Onsite Representative: ..... E. ie......._._ �hh5 7
I
Integrator: ............... fly l..�.. ._.. .... �r's... .
Certified Operator•,.,.._....fstG1ff..!� ..... ................. arm .
.��q4 Ut S.------....-----
Operator Certification Numher;..-_...__......._..L..
Location of Farm:
C
G
Latitude �_�' �' �" Longitude �• �' C"
Deli Desi Current Current
; Current „ -�^ ' - a- .� 19! u
Wean to Feeder
O
D
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
y
❑ Farrow to Finish
❑ Gilts
❑ Boars
Non -
Other
,.
LL Totat lDestgn
-ti mT • Na -rr � r`.
f'T "+^ _ � �R _ � � . . �iY•a riti. s'd.¢c w" n-'S _,. .
Non-Dairvl I '
General
1. Are there any buffers that need maintenancelimprovement? ❑ Yes [9No
2. Is any discharge observed from any part of the operation? ❑ Yes 0 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ 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
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes ATNo
❑ Yes 0 No
A11A
❑ Yes KNo
❑ Yes A No
❑ Yes ;[ No
❑ Yes % No
❑ Yes 0 No
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes K No
Continued on back

Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed? Cl Yes WN0
Structures (Lagoons,11olding Ponds, Flush Pits, ete.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? El Yes 0 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: ............................. ... I ................. ....... ......................... ................................... ...................................
...................................
Freeboard (ft):
I I ........... 3re ..... I ......... .................................... ................................... .......... I ......................... .............................
....................................
10.
Is seepage observed from any of the structures"
Yes
RNo
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
R No
12..
Do any of the structures need maintenance/improvement?
❑ Yes
No
(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 inaximuni liquid level markers?
El Yes
XNO
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
KNo
15.
(if in excess of WMP, or runoff entering waters of the State. notify DWQ)
Crop type .. a4a;Lx ... Lit ........ ......
ry" .....
.t... - mwk ..... ......... ;:;
...... ..........................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
PQ No
17.
Does the facility have a lack of adequate acreage for land application'
Yes
;9..No
18.
Does the receiving crop need improvement?
❑ Yes
JX No
19.
,Is there a lack of available waste application equipment?
❑ Yes
X No
20.
Does facility require a follow-up visit by same agency?
C1 Yes
No
21.
Did Reviewerlinspector fail to discuss review/inspection with on -site representative?
0 Yes
No
22.
Does record keeping need improvement?
El Yes
No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
C3 Yes
Od No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? 0 Yes No
25. Were any additional problems notedf which cause noncompliance of the Permit" El Yes No
13 No.viola'tions or deficiencie's were no'te'd-dur'ing'this. visit.- Yo'u.w'ill receive no further'
correspondence about this.visit'.,
toquie'stion Explain any ''VtSanswers and/or '�tn d recorftmendations�.or any, o er�comm6nts�"-,,�,,.'
facility to bette 'explain situations
drawmgs.. r. 16se.additiona pages as s� F
LO C"
7/25/97
x7w��
Reviewer/Inspector Name a
e,
Reviewer/inspector Signature-.— Date:

tO-ltoutine O Complaint O Follow --up of DWO inspection O Follow-up of DSWC review O Other I
I Facility Number I
Farm Status: C.e rr�+ _Z4 ad
Date of Inspection — `7
Time of Inspection 1 /0,1301 Use 24 hr. time
Total Time (in hours) Spent onReview
or Inspection (includes travel and processing)
Farm Name: ' �• c S Owsl - County: G be—5 o ^
Owner Name: U141 e t'1 M150� _ Phone No:... --
Mailing Address: DS LJSAf 1` ondk
1
Onsite Representative: -�- L Integrator:Ere) J
Certified Operator: 1 e To < oAj - Operator Certification Number:
Location of Farm: i
Latitude Longitude
13 Not O erational Date Last Operated:
Type of Operation aad Design Capacity
�+,�',��:"ry�d :z�?.y s� �,� � d`� �d.h''�•uG` a���s:,c. -r^�' '�y��Y �,;.�fR»^ � �n'i5�'°
Number � � ^N Poultr3'Y � . �N_ nether Cattle j: ' N`im
ean to Feeder. ❑ ❑
Feeder to Finish ❑ Non -Layer ; ❑ Beef Ia
Farrow to Wean,Y�w..: °k
€� Farrow t0 Feeder'13wy
Farrow to Finish Other Type of Livestock
. .x...�..-&._�/r...4° .3 -.1, F�+r� re+e+bOY�w.::.-Y .�ea.4��^'�"'�. .�.u••.-£ r�"f :�,w <�i:.5r_ `4 r r:.�Y"4. In `-K.: �Af'X<'N� .��b'.'�, u.'C�b:?�'i•.. ,'Y:,.
miier afsLagoans Y/ Holdrng Porids> �fi ❑ Subsurface Drains Present
�- ���� -.�- °��� ��„,. ❑Lagoon Area Spray Field Area
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes X-
No
2_ Is any discharge observed from any part of the operation? ❑ Yes O
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 o
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ ❑ Yes M-No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes [ No
4. Was there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes [ No
maintenancelimprovement? ff
Continued on bark

6. Is facility not in compliance with any applicable setback criteria?
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/l/97)?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures aeoons_and/or Holding Ponds)
9. Is structural freeboard less than adequate?
Freeboard (ft): Lagpon I Lagoon 2 Lagoon 3
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 adquate markers to identify start and stop pumping levels?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. crop type e r r^ "4,0.
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
17. Does the facility have a lack of adequate acreage for Iand application?
18. Does the cover crop need improvement?
19. Is there a lack of available irrigation equipment?
For Certified Facilities Only
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal Waste Management Plan in any way?
22. Does record keeping need improvement?
23. Does facility require a follow-up visit by same agency?
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
❑ Yes OL'o -
❑ Yes ®No
❑ Yes f No
❑ Yes ANo
Lagoon 4
❑ Yes *No
❑ Yes XNO
❑ Yes E(No
❑ Yes j (No
❑ Yes 4rNo'
❑ Yes A(No
❑ Yes A No
❑ Yes P(No
❑ Yes -PCNo
❑ Yes R
No
❑ Yes �No
❑ Yes PNo
❑ Yes )No
❑ Yes PNo
'Camrnents'{refer toquestron ##)Explarrr'arzyl'S aiisovers and/o anyie�c�o'iuneridatxons�oF arty otherea mezlts i
i,.I• 6"t+.i. � �K=x '�a iiUv�. r�ir�-M�s y�S- 3`'.s..�.� �''.A�' >.�d"t�`a 4 , `!�iT Y...'"fi'�"•�..-i`�%U�Y6a �� �y �.p.ra.G�5`y�,{ 3� +i
Use dr�witigs�offact�ityto better:eXp�aan�srtiiatrons ,(use addit<onalpages as gecessa� ���< �: �°rC'���� 5� ��
s'ta e _
�ih2m i 5 �n aoo� P
g
4
R"
Reviewer/Inspector Name
Reviwer/lnspector Signature: Date:
cc. Division of Water Quality, Water Quality Section, Facility Assessment Unit 11/14/96

s- - ti . _ . . _ ._.- -_ -
State of North Carolina
Department of Environment,
Health and Natural Resources
Fayetteville Regional Office
.lames B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Mr. Eddie Johnson
Rt. 1, Box 443
Fairmont, NC 29340
Dear Mr. Johnson:
M?WAIT 0 0
A&4�ja
IDF=HNFR
DIVISION OF WATER QUALITY
June 2 , 1997
SUBJECT: Annual Compliance Inspection
ELJ Farm & Eddie L. Johnson Farm
Registration Nos. 78-87 & 78-21
Robeson County
On May 20, 1997, staff from the Fayetteville Regional Office of the Division of Water Quality
inspected the sub}ect swine facility. 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
inspection form for information regarding your thcilit}+.
Please be aware that all swine facilities with a liquid waste collection system designed for a
minimum of 250 hogs must have a certified waste management plan on or before December 31,
1997. The district NRCS office, Agriculture Extension office, or the Division of Sod and Water
have specialist available to assist you with upgrading of existing facilities and certification.
If You have any questions coming this matter, please call John Hasty at [phone].
Sincerely,
(9. r/
ohn C. Hasty, Jr.
Environmental Specialist
cc: Operations Branch
Central Files
Audry Oxendine - FRO DSW
Ed Holland - Robeson Co. NRCS
Wachovia Building, Suite 714, Fayetteville FAX 91GA86-0707
83
North Carolina 201-5043 NQ C An Equal opportunity Affirmative Action Employer
Voice 91D 486-1541 50% recycled/10% post -consumer paper

ICP*vtitine O Complaint O Follow-uo of DWO inspection O Follow-up of DSWC review O Other 1
I Fac ity Number I
Date ofImpection I S =YAQ •R `7
Time of Iwgwc bu ' D Use 24 hr. time
Firm Stat= Ge CLO Total Time (in boars) Spent onReview
or inspection (#aduda travel and processing)
Farm Name CL• o_ Cowsty. O e 5 D ti
Own&2) , ZS'-U-9� er Naa3e; � - W Phone xo: — — —
Afailing Address: by r W bI4Ie P O nA FgA 1 rw+o n+t i to C_
Onsite Representatives Iategt r•. Ca r- D t iS
C.atfied Operator: Opermor Certilkation Nimtber. ;
Lacatioa of Farm;
Latitude Lomgltvde ��•�' ��a
Q Not Operational Dote Wt Opermte&
Type of Operation and Design Capacity
Z$wine a��s Noultry ,� Nambet�ttle umba�' ^z
R can to Feeder / ❑Laver
s�Miry
k
Feeder to Finish Non- l3eefr <
FlMwtoWtauFRMM to Feeder
k
a
v
Farrow to finish Otha Type of LWCStOC1L
.- h� .� �;'."�hcY x-.�s,...,: a'"�','�"�.�'� s �'k-z�ri SltvSs..y, �a �r,Ssi4..'.3. � ', ,:�.:3i�� �'�j�,<��a. ;'`•'S '°Yy�� .,� � ��[;,y � ;'� .-..ram,-, pax
gaj=g
s
Subsurface Drans Preent
lsgoon Area Spray Field Anew �,
rancrul
1. Ara there auy buffos dW uftd maintnnaaceJzmprovtm�?
2. Is any discharge observed fiam any part of the operation?
a. If discl>erge is observed, was the conveymcc man-made?
b. If discharge is observed, did it reach Surface Water! (If yes. notify DWQ)
c. If dirge is observed, what is the estimated flow is gallmin?
d. Does discharge bypass a lagoon system? (If yes, aatify+ DWQ)
3. Is there rvideaae ofpast discharge from any part of the operation?
4. Was these any adverse impacts to the waters of the Stare other than from a discharge?
S. Does any part of the waste management system (other than lagoons&olding ponds) require
mainteosecrJ�prvvamtnt?
❑ Yes No
E3 Yes Pio
i] Yes AND
❑ Yes o
❑ Yes No
E7 Yes No
❑ Yes No
❑ Yes �No

C Is. fi=14 not in Compliance with any applicable setbsdk criteria?
Yes 0
7. Did the facility fie to ban a certified operator in reVousible charge Cif btspection after MN7)?
Yes �No
& Are there lagoons or storage ponds on sibs which need to be properly ckaw
D.Yes A(No
§MLWres (Lagoons and/or Holding on=ds)
9. Is s==W fiteboard less than adequate?
13 Yes NO
Freeboard (ft): I Lagoon 2 Laga.= 3
Lagoon 4
10. Is seepage observed from any ofdw structures?
E3 Yes XNo
I I - Is erasion, or any ad= &mats'ea, Oki integrity of ay if the structures observed?
E3 Yes KNo
12. Do any of the aructam need Vemew
El Yes *0
(if any of quesdons 9-12 was answered yes, and the situation posts an
Immediate public health or environmental threat, notify DWQ)
. markers to identify start and " pumping levels?
13. Do any of the structures lack adquate
EJ Yes I�No
Waste A 9 AC=I Nfl =
14. Is them pbysical evidence of over application?
E3 Yes �No-
.(If in excess of WUN, or runoff entering waters of the State, notify DWQ)
15. Crop type C rA 16dt1.-
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
0 Yes ANG
17. Does the facility have a lack of adequate acreage for land application?
E3 Yes �No
18. Does the cover crop need improvement?
0 Yes �No
.
19. is there a lack of available irrigation equipment?
E3 Yes 1PCN,3
Eor Certified FacOMes OnIv
20. Does the facility fail to have a copy of the Animal Waste Management Man readily available? 13 Yes 'No
21. Does the facility fag to comply with the Animal Waste Management Plan in any wuy? E3 Yes ;!(,No
22- Does record keeping need improvement? E3 Yes O(No
23. Does facility require a follow-up visit by same agency? E3 yes IRI"No
fNo 24. Did Reviewedhispectur W to discuss re-viewrinspection with owner or operamr in charge? El Yes K
Coaimrn� (refer to rty YFs
.I1!ii7dzjiw:-m 6­-iPfktY"tq`beftcr . td4i&4-j"
g,
Revirwer/Inspector Name -3
Reviwer/Inspector Sipstare: Date:
=.- DiV4iOn Of Water L?UOfity, Water Quality Section, Facility Assessment Unit

sion of:Sotl and Wtt#er'Conservat�on = Ope anon
Drv�Review
Division of Soil and,Water Conservation - Coinphance Inspection ` s '
Division of Water Quality- Compliance Inspection
` Other;Agen"cy ='Oper.
ation Review u�> t
Routine Q Complaint Q Follow -tip of DWQ inspection Q Follow-up of DSWC review O Other
Facility- Number Z Date of Inspection
Time of Inspection 24 hr. (hh:mm)
0( Permitted ©Certified Q Conditionally Certified Registered Not U erationaI Date Last Operated:
r '
Farm Name: ..--� e a TCounty: �ILiGO�..................... .......................
1................-....>............................................ ....
Owner Name:...zdi&-e......... .............r Q..LICJl1. Phone No: ............ [Q.5..rfr.3.a-.ICt
Facility Contact: ...�9G�nE . _
................................. Title:............... ---..I............-..-........................... Phone No: �-
Mailing Address: 1 8a'6 YY3
Onsitc Representative: ,,,,.6-elk ..........� t /,a� .
Certified Operator . ... ....................
Location of Farm:
........ i r... .G..h � ...,1..I1. C................... 2f.344,1
Integrator: Cdtea. �1. ... +
................ . . .. . .. . . . . S. ....................................
Operator Certification Number: ......... 1.f1 .......
t............................................................................................................................................................--......................................................t
Latitude Longitude • �° ���
Design Current
awme . Lapaciry ropulation
Wean to Feeder -7Q
❑ Feeder to Finish
❑ Farrow to Wean
[] Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I I ❑ Dairy
❑ Non -Layer I I I IE]Non-Dairyl
❑ Other l I J
Total Design Capacity r -71
Total SSLW
Number of Lagoons 10 Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Dischart_es & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)? ❑ Yes { No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other / j
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed. did it reach: ❑ Surface Waters ❑ Waters of the State
c. if discharge is observed. what is the estimated flow in gal/min''
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?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: 23,1
Freeboard(inches):.......................................................................................
1 /6/99
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes VNo
Structure 6
Continued on back

l
a .-4%;
Facility Number: -7 — Z
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Laeoons.Holding/Po�nds, Flush Pits, etc,)
9,kstora;2e�t.a vity (freeb9 ptbs storm sto les
Structure I Structure 2 Structure 3 , Structure 4
I
Freeb&r6 (ft). .....................
\► 10. Is seepage observed from any of the structures?
�y11. 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
___`414. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering,wategs of the Slate, notify DWQ)
\ 15. Crop type ......... Lelg•.1�►:1. A rl�.. a.....r-- gh sm-ra.,/.,�1kt,Ft{/.....( 9
V 16. Do the receiving crops differ with those designated in/the Animal Waste
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?
�120. Does facility require a follow-up visit by same agency?
1r21. Did Reviewer/Inspector fail to discuss reviewrinspection with on -site representative?
Plan (A
r 22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
---j 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 AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes N No
Yes o
5 tructure 6
❑ Yes WNo
❑ Yes No
❑ Yes No
❑ Yes P(No
❑ Yes ANa
? ❑ Yes
ANo
❑ Yes
ANo
❑ Yes
�f No
❑ Yes
gNo
❑ Yes
ONO
Cl Yes
ro
❑ Yes
�No
❑ Yes
RNo
❑ Yes
fNo
❑ Yes
ONO
No. viol it ions' deficiencies.were-noted-during this,'AA - You.W'i0 ikei ive`no-f&iher :
cderespQndehO about this: visit: ; ;
Good )60A.h ►rt . /f 4
8 ) i , ti , Dom' P,,, rd S,
Vert� GU � I�iIL
!Veea Me4rble- acrem e e rpt?waL4l� jd_;1_f.
9
7/25197
Reviewer/Inspector Name
Reviewer/Inspector Signature: VL,,, mo,� Date: 2 - /�

�ECENE
State of North Carolina DU
Department of Environment
and Natural Resources JUL 2 3 1998
Division of Water Quality
James B. Hunt, Jr., Govemor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E.,
Eddie Johnson
Eddie Johnson
905 White Pond Rd. West
Fairmont NC 28340
Dear Eddie Johnson:
FAYEwEVILLE
REG. OFFICE
Director
June 26, 1998
A P?W'A
IT 0 0
4;JaIL
NCDENR
NORTH CARQLINA DEPARTMENT Or
ENVIRONMENT AND NAnjRAL RESOURGEs
Subject: Reissuance of Certificate of Coverage
No.AWS780021
Eddie Johnson
Swine Waste Collection, Treatment, Storage and
Application System
Robeson County
The Division of Water Quality modified the Swine Waste Operation General Permit originally issued to
this facility on April 21, 1997. In accordance with the issuance of the revised General Permit, we are
forwarding this Certificate of Coverage (COC) to Eddie Johnson, 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 Eddie Johnson, located in Robeson County,
with an animal capacity of no greater than 7104 Wean to Feeder 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 AWS780021 dated April 21, 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 R.10 regarding tree removal from lagoon embankments, Condition IH.1
regarding inspection frequency of the waste treatment, storage and collection system and Condition 1111.6
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 Pemut, 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 CAWMP may result in the revocation of this COC, or penalties in accordance
with NCGS 143-215.6A through 143-215.6C including civil penalties, criminal penalties, and injunctive
relief.
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 AWS780021
Eddie Johnson
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 Division.
. 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,
a
or ston Howard, Jr.,
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

13iYlS O"1 ialyjoK --
Type of Visit 1& Compliance inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency Other ❑ Denied Access
Date of Visit: Arrival Time: 1, t70 Departure Time: , 30 t] County: Region:
rLA
' 0�1aS
Farm Name: Owner Email:
Owner Name: le
�1h�1/li0"1 Phone:
Mailing Address:
Physical Address: nn Eddie- ^ 7yC �
r 0J ,rte, Phone No: AbKy- 7Y0- rf4
Facility Contact: �djp �Qhnt� -y�. L Title:
Onsite Representative: 1� 4� Jnhrx �n Integrator:
Certified Operator: — �i� —004vt h Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [= Q [= i = Longitude: = ° = I = u
Design Current Mesign Current Design C►urrent
Swine Capacity population W Poupacity Popufaho Cattle " Cap ty Population
❑ Wean to Finish
t.:
❑ Layer
❑Dai Cow
Wean to Feeder
❑ Non -Layer
� . � �..
�' Dry Poulf
aY
❑Dai Calf
El Dairy Heifer
❑ Feeder to Finish
❑ Farrow to Wean
❑ D Cow
❑ Farrow to Feeder
Non -Dairy
❑ Farrow to Finish
❑ Beef Stocker
❑ Gilts
❑Beef Feeder
TV.❑
Boars
Other
❑ Other
❑Beef Brood Co
� � - -
Numbe101 Structures:
xm
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharses & Stream Impacts
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 DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
ONo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
®WNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

• Facility Number: —, Date of Inspection 1l011?l�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
RNo
❑ 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): 19
Observed Freeboard (in): Q3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
❑ No
❑ NA
[RNE
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
9NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
2 No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ yes
❑ No
❑ NA
(RNE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
DINA
10 NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 9No ❑ 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
,�I❑ Evidence of Wind Drift El Application Outside of Area
12. Crop type(s)Q rI���P&Atl l0.. PonkIr . ` sa. 0N 13_ Soil type(s) S
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes IRNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA R NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes ❑ No ❑ NA D "NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes Q No ❑ NA ❑ NE
❑ Yes RNo ❑ NA ❑ NE
Comments refer to uestian "
q #� rEaplam any YES,�answers and/or any recommendations or any other comments.
Use drawings v#�facili#y to better explain sttuafivnst(use additional pages aslnecessa y "
Reviewer/inspector Name a�/ SCOVEIC7P Phone: ( -' I432 -330OX3331
Reviewer/Inspector Signature: Date: Ia 12 08'
Page 2 of 3 V 12128104 Continued

" Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ER NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA [RNE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 5 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes CR No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No [.51 NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
RNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
[NNA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
IR No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
[RNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
NNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
CRNo
❑ 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
tRNo
❑ 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
R No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
tallo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
CRNo
❑ NA
❑ NE
Additional Comments and/or 1rawt€2gs
SpeC(a l r'r1+ -o ch k t^eccrds ate- h�o -frae6vo-d i,, SPff L- n aoos
-a4 , Reei ca I t b(aW if) Oc4obr, VAlvak n 1 bac,�#—
14, S mail 9rajYi �1 a� � ate+ a rues a 0, # -
-7, Ey'eIi'P'jt )a,J9 rcrss C Over,
Page 3 of 3 12128104

r
00
Type of Visit S 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: I _314108 Arrival Time: �� Q�` Departure Time: 1p County: Region: i- li
Farm Name: JTOAJI-0i7 41 _ __. Owner Email:
Ownei­Name:."d,,e Sl A nsw Phone: (qIp)6,1k3-8396
Mailing Address:
Physical Address:
Facility Contact: &ktt Title:
i1
Onsite Representative:
Certified Operator:
Back-up Operator:C JO�v►SU+'+
Phone No:
IntegratorAllu'roky ,`
Operator Certification Number: ``1919`�
Back-up Certification Number: r,5"
Location of Farm: Latitude: = o = ❑ fl Longitude: ❑ n ❑ 6 0 «
Design Current
Design C*orient
Design
Current
5.�ine
Capacity Population Yet Poultry _
Cal%ae ty Population
Cattle
Capacity
Population
❑ Wean to Finish I
i Cow
Wean to Feeder
D Non -La er
❑Dai Calf
Feeder to Finish
~
.` .
❑ Dairy t-Icifer
❑ Farrow to Wean
Dn Poultry.'`
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La cis
❑ Beef Stocker
❑ Gilts
❑Non -Lavers
❑ Bcef Feeder
(] Boars
El Pullets
❑ Beef Brood Co
❑ Turkeys
: _. ... .
Other
❑ Other
❑ Turkey Poults
❑ Other
Number of Structures:
r
_
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Ycs
n No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
[nNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
$5NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
(n NA
❑ NE
2_ Is there evidence of a past discharge from any part of the operation?
❑ Yes
&No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
� No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12178104
Continued

f 4
Facility Number:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. I f yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: I
❑ Yes It No ❑ NA ❑ NE
❑Yes [:3 No ®NA El NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): lot
5_ Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes L*2PNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes 29 No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes allo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes �3 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 tR No ❑ NA ❑ NE
maintenance or improvement?
Waste Apl2lication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 09 No ❑ NA ❑ NE
maintenance/improvement?
I 1 _ is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 91 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu. Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drift El Application Outside of Area
12. Crop type(s) �'�UrhOrMtedcl &qss (4s4,,-0
13. Soil type(s) �ik—i�b� l AxA s —PQ
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes M No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes n No ❑ NA ❑ NE
I7_ Does the facility lack adequate acreage for land application? ❑ Yes M No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ® No ❑ NA ❑ NE
Comments (refer'to question #): Explain any YES answers and/or any recommendations or anv other comments.- =
Use drawings of facility to better explain situations. (use additional pages as,necessan)
Reviewer/ lnspector Name I
6Phone
A.r:(qA9 `t3 3tO
Reviewer/inspector Signature:
Date: / fi16
Page 2 of 3 12128104 Continued

'iI
Facility Number: —A r Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes T No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes VO No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes (PNo ❑ 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
F No
❑ NA
❑ NE
23.
If selected, did the facility fait to install and maintain rainbreakers on irrigation equipment?
❑ Yes
J4 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[ANo
❑ NA
[INE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
PNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
P No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
®No
[3 NA
[:3 NE
Other Issues
I
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
[:1 Yes
q] No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
`P'' No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
� No
[I NA
[I NE
Page 3 of 3 12128104

Division of Water Quality
Number Q Division of Soil and Water Conservation
O Other Agency 11
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: S p Arrival Time: Departure Time: County: VObeSOr1 Region:
Farm Name: Tt' 11sap\ it'l Owner Email:
Owner Name: 1'e l�vtSinn Phone: ' 10) 62 An B391,
Mailing Address: 9oS ![lark_ Pond 1jT O� Al 2$341p
tr
Physical Address:
Facility Contact: 'e _ SD MS0 h Title: Phone No:
Onsite Representative: N Integrator: M UAL 0 �'1 tl
Certified Operator: Operator Certification Number: 1919 '
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: = 0 0 $ = Longitude: = 0 01
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
Wean to Feeder 1104 1 jq9,3
El Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non -La ei
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream [mnacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes MNo ElNA ❑ NE
❑ Yes
❑ No
§9 NA
❑ NE
❑ Yes
❑ No
y NA
❑ NE
❑ Yes
❑ No
V9 NA
❑ NE
❑ Yes
V9 No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Date of Inspection SI 11(QLJ
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: I
Spillway?:
Designed Freeboard (in): qq''
17
Observed Freeboard (in): c7C)
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 tpNo
❑ Yes ❑ No
Structure 5
❑ NA ❑ NE
P NA ❑ NE
Structure 6
❑ Yes V No ElNA ElNE
❑ Yes F] No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures tack 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 V1 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ElNA ElNE
maintenance/improvement? PO
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 91 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 / Windowr ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) ��.�a ll I Ci�a�, PA�S+t�x�Pl r SritQi � "n 0"4-5i@!j
13.
Soil type(s) 9oA I
14_
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[P No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
� No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
V9 No
❑ NA
❑ NE
IT
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
�9 No
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
4t�t9e_ PM a 1 t-ri ck+ o^ �v►15r
ALS�qv.
CreaJ ✓. ei ep,+ reCP►ri A.1,
Reviewer/Inspector Name klvM Phone: /0 `{3 3 00
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: Date of inspection
Reguired 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 appropirate box.
❑ WUP El Checklists ❑Design ❑Maps El Other
❑ Yes
F No
❑ NA
❑ NE
❑ Yes
[A No
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes W No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus toss assessment (PLAT) certification?
Other IssuCs
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 concem?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Additional Comments and/or Drawings:
❑ Yes
[A No
❑ NA
❑ NE
❑ Yes
E�No
❑ NA
❑ NE
❑ Yes
WNo
❑ NA
❑ NE
❑ Yes
W No
❑ NA
❑ NE
❑ Yes
1p No
❑ NA
❑ NE
❑ Yes
ER No
❑ NA
❑ NE
❑ Yes
Fallo
El NA
El NE
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
[hNo
❑ NA
❑ NE
❑ Yes [P No ❑ NA ❑ NE
❑ Yes
Q9 No
❑ NA
❑ NE
❑ Yes
Ffi No
❑ NA
❑ NE
12128104

Type of Visit ®Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency O Other El Denied Access
Arrival Time: :00 Departure Time: Counh': Ro6ZSo�.1 Region: F'eO
Date of Visit: - 07-06
Farm Name: ,e dd ie, Se C- _T Owner Email:
Owner Name: Cddl' e<- T o (,J So ^-f Phone:
Mailing Address:
Physical Address: Facility Contact: FCW i e< J o I,*- N So ►.s Title:
Onsite Representative:
Certified Operator: Acids L -t, a �►N_5o tsl
Back-up Operator: ° N
Location of Farm:
L9L Jh1tt— Phone No:
Integrator: %Jiu 4.. -- Oi-oodAl
Operator Certification Number: RW 1819�'
Back-up Certification Number: .4 0 Is 1`IS _
Latitude: = o = ' a Longitude: = o = 4 0
lei 1Desig_-n�rent
Design ,Cui en� rk 4 �* . Desiga Current
ahon_Wt Poultry
Cap ty Populaho Cattle `" Capacity Population
...
e
❑ Wean to Finish
t> ❑ Layer
ti El Dairy Cow
Wean to Feeder
7 i0 ❑ Non -Layer I
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifej
❑ Farrow to Wean
Pointry
ran
' D Cow
❑ rs=
❑ Farrow to Feeder
r ❑ Non -Dairy
❑ Farrow to Finish
s.
is
`< El Stocker
❑ Gilts''
w; El Beef Feeder
❑ Boars
❑ Beef Brood Co
Other
_
i Y;.
❑ Other
Cs Number of Structures:
❑ La ers
❑Non -La Non -Layers
El Pullets
❑ Turkeys
❑ Turkey Points
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
El Yes
0 No
❑ NA
❑ NE
Discharge originated at: El Structure El Application Field ❑ Other
a. Was the conveyance man-made?
El Yes
E9 No
El NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
ER No
[I NA
El NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
fo No
❑ NA
El NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
[RNO
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
U5 No
❑ NA
El NE
other than from a discharge?
12128104
Continued

a
•Facility Number: % $ — Z + Date of Inspection 3-O -OCp
Rc uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes X 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
A No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El 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
Q9 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
X1 No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 91 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
B 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
L� No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
® No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
® No
❑ NA
❑ NE
Additional Commit n6 and/oir Dirawings
12128104

r I
Facility Number: 7$ — Z
Date of Inspection
Waste Collection & Treatment
KNo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ NA ❑ NE
a. Ifyes, is waste level into the structural freeboard?
❑ Yes
PC No
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 23
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
19 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
T Do any of the structures need maintenance or improvement?
❑ Yes
N No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[;RNo
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require
❑ Yes
® No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
CR No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
[!?No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
[:]Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside
of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ 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?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Reviewer/Inspector Name 1 C .keif 2. t ��'� Phone:
Reviewer/Inspector Signature: Date: 3 --07- ZOO (v_
12128104 Continued

s f
:?z.y..„, ,..-..,....u.. r:-2.. �-. _�.-:-.'gib :w .. - _�;��, '!f. '�:=x� ^*':. ..-:.,.--..r-t.. ._ «_ .. .. - � _.• _ - •__� . ..... �... .. _..w. s«__.�..:h ..,,-s.a...�.:�;-.- . —
Type of Visit ® Compliance Inspection Q Operation Review Q Lagoon Evaluation
Reason for Visit * Routine O Complaint O Follow up O Emergency Notification Q Other ❑ Denied Access
Facility Number �
I Date of Visit: %��o Time: � ' �'
Nat Operational 0 Below Threshold
[� Permitted ® Certified 0 Conditionally Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name: &e—We_ S.4e- � -- County: /Pb��cJOAJ ,tb
Owner Name: �—��' c TO pa s a Pbone No: 9 t� C a?" g 3 94
Mailing address: f sJh t"a I?d ",,e WL4 f 6: i r /s+ o n`7 A/C_ q _N';0
Facility Contact:
Title:
Phone No:
Onsite Representative: Y d'_1#11e aln L iu s o t1 Integrator. ? u • -L1
Certifed Operator: �+ d h ►.1 S a Operator Certif cation Number: l* i 9 4
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' 0 0" Longitude �• �• ��
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Ca atari Population
® [Wean to Feeder Gji Laver E
Dairy
Feeder to Finish ❑ Non -Laver Non -Dairy
❑ Farrow to Wear
❑ Farrow to Feeder Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ` ❑ S rav Field Area
HoldingPonds / Solid T -- raps 0 ❑ No Li rid Waste Management System
DischarLyes & 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, notiA- DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notif}• DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there anv adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection 8- Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inched:
30 "
❑ Yes M No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes 10 No
❑ Yes I No
Structure 6
05103101 Continued

z Facili;,y Number: 7S — ,? 1 I Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ® No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/nnprovement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenaneel'improvement? ❑ Yes No
9. Do any stuctums. lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes ®, No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes to No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ® No
❑ Excessive Poonding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground❑ Copper and/or Zinc
12. Crop type r u ke, 144.4 I4 r a zxre
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes [2 No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes fp No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c)11is facility is pended for a wettable acre determination? ❑ Yes 93 No
15. Does the receiving crop need improvement? ❑ Yes (B No
16. Is there a lack of adequate waste application equipment? ❑ Yes ® No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor 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 to No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes PNo
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 10 No
Air Quality representative immediately.
'Cow (re%atoq�on:#k��'.lYFsaawetrs a�dlorany° arm{ath��com�mt�s.LL ��-� �a
:-r-�,., :x - _.r.-z� _ ems..-'� '•�-a2�' r .., �'+"'- - ..'""��a -s °T. :�.""'w �. - _.�:.,:.d...'"' ��
ruse drs�v of, aTt3►xo b tfict ar�m.�. { e sdd canal P 9) Feld Copy 0 Final Notes ' r
. ��• .>...ziz=. rr_a,.... �._.�.:arxs�'as::_ x, _:-:.=.�' -� :,.x x"a�-.w.- �,-..:::e, ram:--6�.�..:vr a.�:�: ,..:5i�.ivz�s"....�'�. ��: "".'.x;ra
,5a► y SCrip�c, as no-�
"E=vi:emwerAkSpecIor
er/Inspector Name
Signature: o Date:
12/12M V Continued

Facility Number: % k— / Date of inspection
Reauired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes [P 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
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
Oel discharge, freeboard problems, over application)
❑ Yes
No
27. Did Reviewer/€iispector fail to discuss review/mspwdon 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
[I No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
W No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ERWO
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
M140
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

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
Facility- Number 1 Date of Viot: (1 Time: fl
- N t O erational 0 Below Threshold
® Permitted ® Certified 13Conditionally Certified O Registered Date Last Operated or Above Threshold:
Farm Name: Count.•: t j 6l1 _
Owner Name: Erk(Ait Phone No: 10 g?
Mailing Address: Q,0.5 W, ,i Pad C_:2_Vj4,<�_
Facility Contact: Title: Phone No:
On site Representative: . E it'- ,Cn!n tnf9r,, Integrator: _. C G rrr,
Certified Operator =Cu i a, sra"" St,-r` Operator Certification Number: I Q i Cf'4
Location of Farm:
M Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' " Longitude ' •
Design Current
Design Current Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle Ca ackv Population
Wean to Feeder
0
❑ Laver
I
I
JE] Dairy
❑ Feeder to Finish
❑ Non -Laver
I
I
JE1 Non -Dairy
❑ Farrow to Wean
El Farrow to Feeder
Other
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
[[:].Boars
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present LagDon Area ❑ S rav Field Area
Holding Ponds I Solid Traps ID No Liquid waste Management Svstem
Discharges & Stream Impacts
1. Is anv discharge observed from any, part of the operation? ❑ Yes o
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is obsmed, did it reach Water of the State? (if ves, notify DWQ) El Yes ❑ No
c. If discharge is observed, what is the estimated flow in eal/min?
d. Does discharge bypass a lagoon system? (If ves, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes 0 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [BNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillwav ❑ Yes 5 No
Structure 1 Structure 2 Structure 3 Structure 4 Structure i Structure 6
Identifier:
Freeboard (inches): 1 S
05103101 Continued

Facility Number: — ( Date of Inspection .7 �
5. Are there any immediate threats to the integrity of any of the structures observed? {ie/ trees, severe erosion, ❑ Yes [59 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 W 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 P No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes W No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes rQ No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes V No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes N No
12, Crop hype B :t r'yyrn t.A CN(S_ a _ Q ` S ,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes allo
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 [Q No
16. Is there a lack of adequate waste application equipment? ❑ Yes N No
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
0 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
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
IRNo
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
%No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Canaments.{refer to;questian #}: Elp' lain onv S,aesners and/or any recommendations,dor aawother comments. fi
tUse dra pvrtgsgs ofifacilEty�tb betfer-exah plain situosas(t�se addihonal.;pages as necessary)' ❑Field Copy El Final Notes
tom,=€ _
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
0510.3101 U ��Continued

Facilih• Number: -fiq-34 Date of Inspection
Odor Issues
26, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atior bclou
liquid level of lagoon or storage pond with no agitation?
2T Are there any dead animals not disposed of properly within 24 hours?
28. Is there anv evidence of wind drift during land application? O,e. residue on neighboring vegetation, asphalt.
roads, building structure. and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. NVere anv major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan biade(s)_ inoperable shutters. etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanendtemporary cover?
❑ Yes KNo
❑ Yes ® No
❑ Yes No
❑ Yes [Q No
❑ )'es ®No
❑ Yes ® No
❑ Yes [0 No
05103101

t
Type of Visit ® Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up fJ Emergency Notification O Other ElDenied Access
hate of visit: /� OL Time: 9 = 3�
Facilih• Number 7� �
Not Operational 0 Below Threshold
Permitted N Certffiie�d� 0 Condittiionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: County:
Owner Name: c / �i�/%%�J Phone No: /r//d L 4�zoa `"21jr, _.,.
Mailing Address:_1.Ca2
Facility Contact: Tide: Phone No:
OnsiteRepresentative: Integrator:
Certified Operator:/ice ��6�� ��� .. Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' �• 0 K Longitude '
- :Design "..Curl
_Swine Capacity `Penvlf
Wean to Feeder
7/ d
7�4
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Sprav Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b_ If discharge is observed, did it reach Water of the State? (if yes. notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d_ Does discharge bypass a lagoon system? (If yes. notify, DWQ)
1 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 I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
7 ey
Freeboard (inches): ,33
05103101
❑ Yes No
❑ Yes [3No
❑ Yes PNo
❑ Yes N No
❑ Yes QNo
❑ Yes A No
❑ Yes �&o
Structure 6
Continued

Facility Number: 7? — Z/
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 stealth 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
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records &- Documents
17. Fait to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, check]. , design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/lnspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes J No
❑ Yes tot
PN No
❑ Yes �allo
❑ Yes �INo
❑ Yes PNo
❑ Yes ® No
❑ Yes Wo
❑ Yes KI No
❑ Yes No
❑ Yes ;R No
[:1 Yes JQNo
❑ Yes ANo
❑ Yes gNo
❑ Yes KNo
❑ Yes 19rNo
❑ Yes No
❑ Yes No
❑ Yes Jallo
❑ Yes kNo
❑ Yes PNo
❑ Yes ONo
❑ Yes -K] No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Camments.(refer to -question #) 'E:plstn�any:YES_answets and/or any recommendations or anV:other.commenm
Use -drawings of fatty to=better ezplaut sii,iatiot%: (use Sddi�onSl pages as aecessarv) = = _ '- = Y -
_ _ . 3 1❑Field Cotes Final Notes
--
/ /77�� �'7 ��.Cd � �•FCG��
�! y� .S
INV
Reviewer/Inspector Name
ReviewerAnspector Signature: Date: Z2 ;jO O z
O510310l Continued

0
Facility lumber: 7 -Z/ 1 Date of Inspection �oz
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atfor below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. is there anv evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads. building structure, and/or public property)
29, Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s). inoperable shutters. etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover?
O516310I
❑ Yes NNO
❑ Yes A No
❑ Yes �kIvo
❑ Yes IN
❑ Yes No
❑ Yes Pr,
❑ Yes XNo

ti
Dtvisivn of Water Quality W `
r u Dtvtsibi 4 Soil and Water Conse7atioi
_ `Q:Other:Agency� a = _ • k =, -
Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ArRoutine Q Complaint O Follow up O Emergency Notification Q Other ❑ Denied Access
Facility Number Date of Visit: �Time: f t� Printed on: 10/26/2000
Q Not O erational Q Below Threshold
Permitted E3 Certifie © Conditionally Certified [3 Registered Date Last Operated or Above 'Threshold
Farm Name: 1. s.a y"�SC"�� County:......�fQ......................................
............................................OTC—.................
Owner Name: G.G� e.p�j s Phone No: r Z
.................s.......................................................................... `...
Facility Contact: ...... 4V-tJlt.Ia..r....................................Iisle:.................. ...... Phony. No: .... '.1..
J(� ................. ...................
MailingAddress:.../....................... ....................... ............ ...l.1.....................................C� ? �
Onsite Representative: .............. 40-W44,,C--r-7__............................ ..... Integrator:...... �t 0!1142
...................!.....................................
Certified Operator:..6�..,e.t.............. .. �, itsffa,
. .,.... Operator Certification Number:.
Location (if Farm:
❑ Swine ❑ Poultry []Cattle ❑ Horse Latitude • 4 '1 Longitude a 4 «
Design Current
Swine C nnacity Pnnulatinn
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I ❑ Dairy
❑ Non -Layer I 1 ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons JE1Subsurface Drains Present ❑ Lagoon Area Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharge,, & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes NO
Discharge originated at: [ILagoon [ISpray 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, nolity DWQ) ❑ Yes ' CNO
c. II'discharge is observed. what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system'? (lf yes, notify DWQ) ❑ Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes 0 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes dvNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes
Io
Structure I Su-ucture 2 Structure ; StrUCtUrc 4 Structure 5 Structure 61/
ldcntificr:...........................................................................................
Freeboard (inches): Z6
5100 Continued on back

Facility Number: %f —?- Date of inspection I:Z-D 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 0
seepage, etc.) Y 1l
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes LVNo
(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 maintenancelimprovement?
❑ Yes ILI,o
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes j j•Ala
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes No
11, Is there evidence of over applicati n) ❑ Excessive Po ing ❑ PAN El Hydraulic Overload
El Yes � 0
12. Crop type 4 f r rK UX q ri Z4 ` A-
13. Do the receiving crops differ with those designated in t Certified Animal Waste Management Plan (CAWMP)?
❑ Yes JKNo
14. a) Does the facility lack adequate acreage for land application?
❑ YesTNo)
b) Does the facility need a wettable acre determination'?
❑ Yes
c) This facility is pended for a wettable acre determination?
El o
15. Does the receiving crop need improvement?
❑ Yes ❑ No
16. is there a lack of adequate waste application equipment?
❑ Yes ;�No
J�
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes XNo
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 D(No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes 0
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
ElYes KO
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes ANo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes (i"(No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes �iVo
"`L
24. Does facility require a follow-up visit by same agency?
❑ Yes
/, 0
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
El Yes qo
Nd-Ab'Wioris or def cie do s iv re hoed- ft ing (his'visic . Yout :wii1-I'lleeeeiye Rio fut •thee
correspondence. about this visit
Comments (refer to question #) Explain any YES answers abd/or arty recaratnendattohs:or;any other comments
Use drawings'_of facility to -better explain situations (use.'additional pages as necessary) T
_W-. ..
se be�i� 1 I I r
P �.: f er /beds S�.e r.J�ed Cc-a�Tr+o 1.
uc �11
D , 4,Lr-44 1dakf S dpe.d .
Reviewer/Inspector Name
ReviewerlInspector Signature: Date: 5/00

11 _
Facility Number: — 2l Date of Inspection % —Q Printed on: 10/26/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
bona omments an or raw
.... ......
❑ Yes hKNo
❑ Yes P(NO
❑ Yes -or
No
❑ Yes PNo
❑ Yes *0
❑ Yes No
❑ Yes ❑ No
AL1
5/00

State of North Carolina
Department of Environment
and Natural Resources
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
October 2, 2000 ` C E jPV`
CERTIFIED MAIL
RETURN RECEfPT REQUESTED OCT 13 2000
Eddie Johnson
Eddie Johnson
905 White Pond Rd. West
Fairmont NC 28340
Dear Eddie Johnson:
FAYETTEVI LLE
PEG. 0 =;=I(1'E
Subject: Notification for Wettable Acre Determination
Animal Waste Management System
Eddie Johnson
Facility Number 78-21
Robeson County
A letter dated January 15, 1999 was sent to advise you about concerns associated with Certified Animal
Waste Management Plans and the method by which the irrigated acres within the plans were calculated. Only
the acres that are wetted can be credited in the waste management plan as receiving waste application. Any
acreage within the plan that can not be reached by waste application equipment can not be used as part of your
plan.
An evaluation by John Hasty on 2/16/99 was made to review the actual number of acres at your facility
that receive animal waste during land application. The evaluation of your facility has yielded one of the
following two results as indicated by the box marked with an "X".
Category 1:
❑ The evaluation of your facility could not be completed due to a lack of information. Please
contact your Technical Specialist to assist in providing John Hasty the necessary
information to potentially exempt your facility from undergoing a complete wettable acre
determination. Please submit this information to John Hasty, at 225 Green Street, Suite
714, Fayetteville, NC 28301, within in 90 days of the receipt of this letter. If you have any
questions please contact John Hasty at [phone]. If within 90 days you are unable
to provide John Hasty with the information you are automatically required to complete
a Wettable Acre Determination as described by Category 2 below, within 180 days
of receipt of this letter.
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper

Notification for Wettable Acre Determination
Animal Waste Management System
Pabe 2
Category 2:
Your facility has been identified by the Department of Environment and Natural Resources
as a facility that may have overestimated the number of acres actually receiving animal
waste. Therefore, some or all of your fields may be exceeding the allowable loading rates
set in your Certified Animal Waste Management Plan.
In order to resolve this issue, please contact a designated Technical Specialist to have him
or her conduct a Wettable Acre Determination for your facility. The Technical Specialist must
be one that has been approved by the Soil and Water Conservation Commission to conduct
Wettable Acre Determinations. Many Technical Specialist with the N.C. Cooperative Extension
Service, the Soil and Water Conservation Districts, the Natural Resources Conservation
Service, and the Division of Soil and Water Conservation have received this special
designation. You may also contact a private Technical Specialist who has received this
designation, or a Professional Engineer.
All needed modifications to your Animal Waste Management System must be made and
the Wettable Acres Determination Certification must be returned to DWQ within the next
180 days. If the needed modifications are not made and if the form is not returned within the
required time, DWQ will be.forced to take appropriate enforcement actions to bring this facility
into compliance. These actions may include civil penalty assessments, permit revocation,
and/or injunctive relief.
Once a Wettable Acre Determination has been completed, a copy of the attached Wettable
Acre Determination Certification must be submitted to the address listed on the form. Please
note that both the owner and the Technical Specialist must sign the certification. A copy of all
the Wettable Acre Determination documentation that applies to your Waste Utilization Plan
must be kept at your facility. DWQ and the Division of Soil & Water Conservation Staff will
review all documentation during their annual visit of your facility. An additional copy must by
kept on file at the local Soil & Water Conservation District Office. Please note that if you install
or modify your irrigation system, a designated Irrigation Specialist or a Professional Engineer
must also sign the Wettable Acre Determination Certification.
Please be advised that nothing in this letter should be taken as removing from you the responsibility or
liability for failure to comply with any State Rule, State Statute, Local County Ordinance, or permitting
requirement.
If you have any questions regarding this letter, please do not hesitate to contact Sonya Avant of our
Central Office staff at [phone] ext. 571.
Sincerely,
Kerr T. Stevens
cc: Fayetteville Regional Office
Robeson County Soil and Water Conservation District
Facility File

[3 Division of Soil and;Water:Conserrvahon -'Operation Review
t [] Division of Soil and Water_Conservah,C on ompliance L%spectron'�
M �2
i ©Division of Water Quality Compliance inspettaan yq t M
'{ [].Other Agency OperatEosRevrew
® Routine 0 Cum taint 0 Follow-u of DWQ inspection 0 Follow-u or DSWC review 0 Other
Facility Number ? / Date of Inspection L6 Z-I -
Time of Inspection �'. D 24 hr. (hh:mm)
© Permitted ❑ Certified [] Conditionally Certified ❑ Registered 0 Not O erational Date Last Operated:
/ p ..........................
Farm Name: ��✓ ,�¢�r�..... �1 v�•. 7?? �9<.. "-....... County: .....A................................................. ss."7/..........I............
Owner Name:..................'�?'/......d Phone No:...../...... ... .1......... . .
Facilitv Contact: cf..£ u�✓jsJ
_..........�.../.................�..................................... Title: .............................. .................................. Phone No:.............................................-.-..-
Nfailing Address:.........9 � '. ... ^/ . �CQ�Y ��. .� ... �(�.�^ •�'..% .... .. .1 .s . dr........ ..........................
Onsrte Representative: i ` .� ., Integrator:...- � �/ --f .�
Certified Operator:........-..�i:�s ..�..-..�.:...lY �ro!J Operator Certification Number:......... .......................
..... ..... ............... .........
Location of Farm:
r...........................................................-
Latitude Longitude • �° �"
4 swine
41 Wean to Feeder
❑ Feeder to Finish
_: ❑ Farrow to Wean
❑ Farrow to Feeder
]] Farrow to Finish
❑ Gilts
❑ Boars
Design Current = Design Current - Design
Poultry. : Capacity Po o illation Cattle m •Ca aci
❑ Layer JEJ Dairy
❑ Non -Layer I JE] Non -Dairy
❑ Other
Total Design -Capacity C
Total-SSLW C
Current
opelation. _
=F �l�lumber of Lagoons / ❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area
:Holding Ponds / Solid Traps _ ❑ No Liquid Waste Management System _
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ET 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 ggNo
c. II -discharge is observed, what is the estimated flow in gal/min?
d. Dees discharge bypass a lagoon sStem? I1'es notif • DW ❑ Yes 19 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 B'No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes W No
Structure I Structure 2 Structure 3 Structure 4 Structure's Structure 6
Identifier:
Freeboard(inches): ..................................................................................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? Ge/ trees, severe erosion, ❑ Yes [-No
seepage, etc.)
3/23/99 Continued on back

J
Facility Number: % — Z / 1 late of Inspection
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 Apelication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management PIan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required_ Records _&_ Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
iVo•violati4ns:o'r• &ficiencies rr re JnOf. ....zing. his'visit: - VO :wilt �ee�iye 06 futfte -
Correspondei'ice: aborts this visit . • : ...............
.....
nments{refer to question #)y`,-Explaiii.any:YES answers
_.r
;drawings of'facility�to :better explainsituations (use,ad
Reviewer/Inspector Name
Reviewer/Inspector Signature:
F � �
Date:
❑ Yes IkNo
❑ Yes XNo
❑ Yes RNo
❑ Yes 1%No
❑ Yes ANo
❑ Yes ANo
❑ Yes ENO
❑ Yes �Q No
❑ Yes RT No
❑ Yes [�-No
❑ Yes®" No
❑ Yes (�` No
❑ Yes qNo
❑ Yes E� No
❑ Yes 15 No
❑ Yes RNo
❑ Yes r9� No
❑ Yes OM
❑ Yes (KNo
❑ Yes [�No
❑ Yes 4No

Facility Number: 7 f — 2-1l)atc 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 WNo
liquid level of lagoon or storage pond with no agitation?
2T Are there any dead animals not disposed of properly within 24 hours? ❑ Yes XNo
29. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes XNo
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 O(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 KNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ekNo
32. Do the flush tanks Iack a submerged fill pipe or a permanent/temporary cover? ❑ Yes "0
ihona omments an or raw�n - — — ,

Type of Visit: 0 Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: 0 ►'4 Departure Time: I 1p,'A9g.4. I County: �_O^ Region:
Farm Name: i f 0 k Ca p^r" Owner Email:
Owner Name: Q lI�O�' Phone:
Mailing Address:
Physical Address:
r;
Facility Contact: �° A aIt /�QN Phone:
It
Onsite Representative: Integra#or: .!5;"1 "41W
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Design :
Current
Design Cnrrenf
wine Capacity Pop.
Wet Poultry>
Capacity
Pop.
Cattle Capacity Pop.
eanto Finish
La er
Dai Cow
ean to Feeder
k
Ikon -La er
Dai Calf
riilts
eder to Finish
DairyHeifer
Farrow to Wean
Design
Current
D Cow
arrow to Feeder
D , 1'pult .
Ca aci
1P,o .
Non-Dairyarrow
to Finish
La ers
Beef Stocker
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
ther
'Turke Pointsther
do
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)?
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 P No ❑ NA []NE
❑ Yes
❑ No
�n NA
❑ NE
❑ Yes
❑ No
Q9 NA
FINE
❑ Yes
❑ No
g� NA
❑ NE
[] Yes
}na No
❑ NA
❑ NE
❑ Yes
{Q] No
❑ NA
❑ NE
Page I of 3 21412015 Continued

acili Number: - 2/ Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? FWYes ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes Q1 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 [] 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? T��
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 Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence o Wind Dri Application ,Outside of Approved Area
12. Crop Tyr() C�
e s : Q , Jew •l/ 14,4-
13. Soil Type(s): _
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 1" No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes R No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes r---LNo ❑ 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 P No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes (9 No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design [:]Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P
No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall [-]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes 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 21412015 Continued

facility Number: 19-24 jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes V] No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes No ❑ NA ❑ NE
the appropriate box(es) below. P
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes tP
No ❑ NA 0NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes [P No ❑ NA ❑ NE
❑ Yes N No ❑ NA ❑ NE
❑ Yes P� No ❑ NA ❑ NE
[-]Yes q No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [P No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes FL] No ❑ NA [] NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes R No ❑ NA ❑ NE
Comments (refer to question #): Explaimany YES answers and/©r. any additional recommendations or any other§co!j%nts:;
Use'drawrns of,faedity',,to jbetter explain sitaakrons ('use addstiona ' l I pa�es:as necessary) - aaa�, _ I:
V —
�'06w_ - /---I - b
qro-6Zq-If0W
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
it
Phone: y/4_�
Date:
21412015

Type of Visit:. • Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: ® Routine O Complaint O Follow-up O Referral O Emergency Q Other O Denied Access
Date of Visit: --��Arrival Time: r. Departure Time: I °S County: 8E��
Farm Name: tJ19//A-56Zit-Al Owner Email:
Owner Name: Y�010
1 9 SOV l Phone:
Mailing Address:
Physical Address:
ter-
Facility Contact: 6A � V oX "'." Title:
Onsite Representative: I f
Certified Operator:
-H
Region: )=,-R1?
Phone:
Integrator: W
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Swine Capacity Pap.
Wean to Finish
Wet Poultry
Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
VA 9
1 jNon-Layer
Dr. P,oul
I
Design
Ca `aci
V
Current
Po
Dairy Calf
Feeder to Finish
Farrow to Wean
Dairy Heifer
Dry Cow
Farrow to Feeder
Non -Dairy
Beef Stocker
Farrow to Finish
Layers
Gilts
Boars
Non -Lavers
Pullets
Beef Feeder
Beef Brood Cow
Other -
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes R No ❑ NA ❑ NE
❑ Yes ❑ No [PNA ❑ NE
❑ Yes ❑ No NA ❑ NE
.t
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 ® No ❑ NA ❑ NE
of the State other than from a discharge? TT��
Page I of 3 21412014 Continued

[Facility Number: fig- Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes M No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 6771 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 Qq 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
M No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[�LNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
TT
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[P No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
� No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes P 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 a /'❑_ �Evvidence of Wind Drift }❑ Application Outside, of` Approved Area
12. Crop TYpe(s): i .S &'yn" [y'YRse� . /'�ifS'1�r�/ . Sit, , �:_Otxa 5�d
13. Soil Type(s): Nd A , k1a oe
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes � No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes [ No ❑ NA ❑ NE
acres determination? T
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes Q0 No ❑ NA ❑ NE
[:]Yes [�PNo [DNA ❑ 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 ER No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [] Yes No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Trahsfers
❑ 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
Page 2 of 3
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
NA ❑ NE
❑NA ❑NE
21412014 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 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 to provide documentation of an actively certified operator in charge? ❑ Yes [ No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
P No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
[—]Yes
(� No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
M 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
[F] No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[B No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
1p No
❑ NA
❑ NE
Comments (refer to'question xplain any YES answers and/or any additional recommendations or an ,;other cowmen
;. y
r
Use drawingsof facet to ez lam situations use add�t:onal, a es as necessary
tY P ( _ pages rY)-
_,
„�
S EJ 4,1yf`oh U - )_D/h
Reviewer/Inspector Name: _�(447
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: P
21412014

I'ype of visit: W Compliance inspection V Uperation Review U Structure Evaluation U 'Technical Assistance
Reason for Visit: • Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: j b Arrival Time: Departure Time: County: O,0950/r
Farm Name: �n 5 o 11 wt f7` / Owner Email:
Owner Name: 411 V 0 4 n 50 rl Phone:
Mailing Address:
Physical Address:
Facility Contact: i iy 07xt SO4 Title: Phone:
&I
Onsite Representative:
N
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator: UIVP
Certification Number:
Certification Number:
Longitude:
Region:
Design
Current
Design
Current
Design Current
Swine Capacity
Pop.
Wet Poultry -
Capacity
Pop.
Cattle Capacity Pop.
inish
La er
Da' Cow
eeder
Non -La er
Da' Calf
Finish
Da' Heifer
Wean
ign
Current
Cow
Feeder
K
D .P,oW
Ca a '
P,o
Non-Da
Finish
La ers
Beef Stocker
Non -La ers
Beef Feeder
jPullets
Beef Brood Cow
Turke s
Qther
Turkey Poults
Other
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
❑ No
❑ NA
® NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
J�g 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
❑ No
❑ NA
Vj NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

acili Number: - ,2 Date of Inspection:WZZ
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No ❑ NA � NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA M NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ No
❑ NA
§@ NE
(i.e., large trees, severe erosion, seepage, etc.)
T
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
❑ No
❑ NA
1p 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
S. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ No
❑ NA
NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[—]Yes
❑ No
❑ NA
NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
❑ NA
NE
maintenance or improvement?
r
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA P] NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) TT
❑ 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
iindDrrift ❑ Application Outside of Approved Area
12. Crop Type(s): ,_ L9 57T�st�� SIN • (�7'af yt �j�Qi/'
13. Soil Type(s): Alp,41 W�
14. Do the receiving crops differ from those designated in the CAWMP? []Yes [:]No ❑ NA Rn NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes [:]No ❑ NA NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [:]No ❑ NA NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes ❑ No ❑ NA NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ❑ No ❑ NA NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes �d No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. []Yes ® No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard [:]Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Fscili Number: 7K - Date of Inspection: QA
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes W No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes M 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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA [P NE
❑ Yes ❑ No ❑ NA 0 NE
❑ Yes ❑ No ❑ NA §a NE
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 ❑ 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 ❑ No
❑ NA M NE
❑ NA [ NE
❑ NA NE
❑ NA T� NE
Comments re er to question AT..Explaifiany.---YES-itiisWtft,-afid/6r any a bona. recommendabons_orV@M.1- then comma e
Use dr8WHIgs.of fac, ' to tieifer. ...p n'situahous>'(nse addittonalwpages as necessary) =.
l�il'e 12e4,ecc nyleJeW oh fir,,/
5 ebb•, 7� & co l� bW. 2-01
P �
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 10 -7
93 r33�a
Date: 3 C /I�:
21412014

RECEIVED ,�V
OCT 14 2014 NCDENR
North Carolina Department of Environment and Natural Resomes
DENR -FAYETTEM LLE REGIONAL OFFIG`
Pat McCrory John E. Skvada, III
Governor Secretary
October 10, 2014
Eddie Johnson
Eddie Johnson Farm
905 White Pond Rd W
Fairmont, NC 28340
Subject: Sludge Survey Testing Dates
Certificate of Coverage No. AWS780021
Eddie Johnson Farm
Animal Waste Management System
Robeson County
Dear Eddie Johnson:
The Division of Water Resources (Division) received your sludge survey information on
September 23, 2014. With the survey results, you requested an extension of the sludge survey
requirement for the lagoon (Lagoon #1) at the Eddie Johnson Farm. Due to the amount of
treatment volume available, the Division agrees that a sludge survey is not needed until 2016.
Your next sludge survey at this lagoon should be performed before December 31, 2016.
Please call me at [phone] if you have any questions.
Sincerely,
Miressa D. Garoma
Animal Feeding Operations Program
Water Quality Regional Operations Section
Division of Water Resources, NCDENR
cc: F_ayetteville Regional Office, Water Quality Regional Operations Section
Permit File AWS780021
1636 Mail Service Center, Raleigh, North Carolina 27699-1636
Phone: [phone] Internet: http:1fwww.ncdenr. c v1
An Equal Opportunity 1 Affirmative Action Employer - Made in part by recycled paper

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 0 Denied Access
Date of Visit: Arrival Time: 1,, Departure Time: County: Region: yPha
Farm Name; r ,�h�rati� Owner Email:
Owner Name: P ✓ ylot'? Phone:
Mailing Address:
Physical Address:
Facility Contact: lmlQ rr-44 ,nSD! Title:
71
Onsite Representative: , Gam* 2 c1o�.,S0r1
Certified Operator:
Back-up Operator:
V
Phone:
Integrator: *_411 .,
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Design
Current::-
Design
Current
Design Current
Swine
Capacity
Pop _Wet1P.,oultry .:
Capacity
Pop. -
Cattle Capacity Pop.
Wean to Finish
IY W La er
Dairy Cow
Wean to Feeder
7/O
Non -La er
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
_
Dry Poul
Design
Ca aci
Currents
P,o
Dry Cow
Non -Dairy
Farrow to Feeder
Farrow to Finish
ILayers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Turkeys
Beef Brood Cow
Other
= _ 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 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 ® No ❑ NA ❑ NE
[:]Yes [:)No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
No
❑ Yes
No
® NA ❑ NE
® NA ❑ NE
23 NA ❑ NE
[3 NA ❑NE
❑NA ❑NE
Page 1 of 3 21412011 Continued

acility Number: % - 2 / Date of Ins ection: 6
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
® No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
FM NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3D y
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
M 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 DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
`f" No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[9 No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑Yes] No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes P 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
�op Window ❑] ceg
Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 6,es//Y n ctWr CaiS �L`TL, I'Paf T�-.-�' sl`t U-ra, �•
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
�] No
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes [P� 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 21412011 Continued

WaciliW Number: 129, - jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes [0 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes NJ No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
§0 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.
T
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
� No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
T
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
No
❑ NA
❑ NE
33. Did the ReviewerMnspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question Explain any YES..answersandlor any mendatioas or any�o erAc��meats
U e draw ngs of. facility to better. explain situ lions (use additional pages as neces �)additional:recom
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: `1 1 D-``(3 3133 oo
Date: C' 'I
21412011

f 1
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: D$1 Departure Time: County: Region: 00
1J =t {
Farm Name: Lue Owner Email:
Owner Name: �� r D�yt S�I7 Phone:
Mailing Address:
Physical Address:
Facility Contact: I;L,56v� Title: Phone:
n Onsite Representative: f- t�t�! 11SO►'' integrator: Iq �r14"VA
Certified Operator: le tZOtGtf� �J�'1nS4+� Certification Number: g19�
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
91/ N
"Design Current
Design Current
Design Current
hw
Swine "�Ca aa` Po 3Wet Pult Ca a r Po
��P ,�,�Y P• I � ry _ p t3' ..,� . P•_
Wean to Finish Layer
Cattle Ga aci Po
P �' p•
Dairy Cow
Wean to Feederq, 61 0q
Non -Layer
Dairy Calf
Dairy Heifer
01 Feeder to Finish
Farrow to Wean"
Design Current
t
Dry Cow
Farrow to Feeder
D . P,'oul • ..' :.: Ca achy Po .
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 0 No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No [!RNA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes [—]No rp NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) [:]Yes ❑ No NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 2/4/2011 Continued

f )
Facility Number: jDate of Inspection: t j I jig
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
® No
T❑
❑ 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 DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[V No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[P No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes M 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 ❑n�Evidence3o�f Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Jct ITSS t'1 li)aS�
13. Soil Type(s): 1!j&,r-
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
f�2] No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[ No
T
❑ NA
❑ NE
Re uired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
[] NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [—]Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [] No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility,Number: - Date of Ins ectiou: q a L
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [] No Pn NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
P No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[:]Yes
C� 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
EpNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
T No
❑ NA
❑ NE
Reviewer/Inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
Phone: 910 `1/ pD
Date: 41 I-3
21412011

Type of Visit: 0 Compliance Inspection Q 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: yI 5/ r l t� Arrival Time:Departure Time: ,pQ County: RAG_4�.j Region: 00-0
Farm Name: `mod �`�,�,�5 oh -� Owner Email:
Owner Name: ��rt� N Phone:
Mailing Address:
Physical Address:
Facility Contact: ! ��nSow+ Title: Phone:
Onsite Representative: << tie 7O4 r15., T Integrator:
Certified Operator: to Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine
Design Current=
C•apAN Pop.
Wet Poultry
,.
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
'7101I
'71of
Layer
Dairy Calf
Feeder to Finish
sue,''.
Dairy Heifer
Farrow to Wean
D , �Po�lt
Design
Ca aci
Current
P,o P.
Dry Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Beef Feeder
-Layers
Boars
Pullets
Turkeys
Beef Brood Cow
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 4No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No Cff NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No [? NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No )n NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes N No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes EQ No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

iFacili umber: - Z Date of Inspection: u Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Struc e l Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
No ❑ NA ❑ NE
❑ No NA ❑ NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Wo ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.) TT
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [P No ❑ NA ❑ NE
waste management or closure plan? TT
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes E4 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? T
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes E�No ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.))
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of WiRd Drift ❑ Application Outside of Approved Area
12. Crop Type(s): i taCtS�► �Q SS xl�i� 1 " 'M--�Q,✓�Or -
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ NE
[:]Yes
EpNo
TLNo
❑ NA
❑ NE
[—]Yes
❑ NA
❑ NE
❑ Yes
[P No
❑ NA
❑ NE
[::]Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
E4 No
❑ NA
❑ NE
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements []Other:
21 _ Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E]� No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes `T No
[] NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: IDate of Inspection: Ie (z.
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes v�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 No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
rF NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes] No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
T
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes No ❑ NA ❑ NE
9
If yes, contact a regional Air Quality representative immediately.
34. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes FR 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
9
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non _compliance of the permit or CAWMP?
❑ Yes NJ No ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No ❑ NA ❑ NE
Comments (refef.tb question ft.. Explain any YES answers and/or any. nendatians or any ther eommer Ets. 1
Use drawings of facility to better explain situations (use additional . l pagesastnecessary}.
S[ud�p sv.'r'� ,S dt...2 `-f 's
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
voa...-, pf'6QSc cc?r'f1,_,4 far? 0,eC ?llzotZ
Phone: 9 io-{j33 -3 3 ao
Date:Z—
V4MII

type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1 /III/11 I Arrival Time: I bq: 035;_1 Departure Time: County: QD�SDA/ Region: fqZD
Farm Name: v_ jotn � i*� Owner Email:
Owner Name: �44� �k++Soh Phone:
Mailing Address:
Physical Address:
,� j r
Facility Contact: Gu f Jigt, ,!�Oh Title: Phone:
Onsite Representative: tl t Na,-, y TO4n 504 Integrator i1 j
Certified Operator: W Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design,,,4,Curreat
L4 , "
l Desi nCurw=ent
- ,; g �
esi Dn Current
g
Swine, Ca act ��
p h' �� Po
Wet Poult Ca aci Pop.
•
Cattle Gbapactty Pop.
Wean to Finish
Layer
DanyCow
Wean to Feeder
110Y
0
Non -Layer
Dairy Calf
Feeder to Finish
*k r _:.
sDestgw Current
apaci D . IPoult , " "'
Ca acPo
La ers
Dairy Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
Non -Dairy
Beef Stocker
Farrow to Finish
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other _
Turkey Poults
Other
Other
- -.� ter— ...._1..,
Dischar es and Stream Impact
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
(RNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
W 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?
T
T
Page 1 of 3 21412011 Continued

iFacilit34Number: - Date of Inspection.
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1
Spillway?:
Designed Freeboard (in).
Observed Freeboard (in):
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 §Z 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 ® No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ®No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window r ❑ Evidence of Wind 1Drift ❑ Application Outsides of Approved Area
12. Crop Type(s): �-oct [j�'MkA V+n� 5 t wo2". p !. ,S►K. � ,�., Qil��'S�Pd. e-n�. LJj�2aff s�'7
r
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes P] No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes K]No ❑ NA ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable []Yes N No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes No ❑ NA ❑ NE
❑ Yes [ No ❑ NA ❑ NE
fj
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [] Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [—]Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking [:]Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes [ 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

acili.Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes C] No
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 No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32_ Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
refer.-to;question ft Explain any YES answers and/or any additional recoi
s of'facility to better explain situations (use additional pages as necessary)
sf,dy sway 5 JA--e 4-Ls 74p,.- 2t W.
F� Ctt I?,tj t-EC04 P4af(V)
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ Yes R No ❑ NA ❑ NE
❑ Yes W No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No
[—]Yes No
❑ Yes No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Phone: qIy-y33-33 CV
Date: 6 1It
2/4/1QII

Division of Water Quality
L �FaciIity Number �— 0 Division of soil and Water Eonservation
Other Agency
Type of Visit 0 Compliance Inspection Q Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 46 Routine 0 Complaint 0 Follow up 0 Referral Q Emergency 0 Other ❑ Denied Access
Date of Visit: f Arrival Time: Departure Time: County: Region: F -0
j
Farm Name: _ �ta.t`�13b h .5 i _t .. Owner Email:
t Jot M 5on
Owner Name: �.{� i � Phone:
Mailing Address:
Physical Address:
Facility Contact: Fl y J Goan Title: Phone No:
Onsite Representative: Integrator: _
Certified Operator: Operator Certification Number 819y
Back-up Operator: �O K SVk Back-up Certification Number: l ��
Location of Farm: Latitude: [� ° Longitude: °
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
Design
Cattle Capacity
C►urrent
Population
❑ We to Finish
❑ La er
❑ DairyCow
We to Feeder
10
ODD ❑Non -La er
❑ DairyCalf
❑ Feeder to Finish
Dry poultry
❑ Layers
❑ DairyHeifer
❑ Farrow to Wean
❑ Farrow to Feeder
❑ D Cow
❑ Non -Dairy
❑ Farrow to Finish
❑ Beef Stocker
Feeder
Gilts
❑ Non -Layers
❑❑Beef
Pullets
poBoars
❑ Beef Brood Co
Other
❑ Turkeys
❑ Turkey Pouets
Number 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 [MNo ❑ NA ❑ NE
❑ Yes
❑ No
PNA
❑ NE
❑ Yes
❑ No
MNA
❑ NE
PNA
❑ NE
❑ Yes
❑ No
❑ Yes
[PNo
❑ NA
❑ NE
❑ Yes
tij No
❑ NA
❑ NE
Page I of 3 12128104 Continued

Facility Number: — Date of Inspection f/LO J
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes [RNo
❑ Yes ❑ No
Structure 5
El NA El NE
&NA ❑ NE
Structure 6
❑ Yes 91No ❑ NA ❑ NE
❑ Yes 9No ❑ 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 VNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below_ ❑ Yes
[? No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN 7 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window Evidence of Wind Drift Application Outside of Area
12.
Crop type(s) t.da=i ;k--
13.
Soil type(s) M A I
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
O 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'? ❑ Yes
E� No ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
$1 No ❑ NA
❑ NE
T 4,4 ;j$. g.
Comments (refer to question ft Explain any YES answers audlor and recommendations orKany otherocomments
Use drah g of facility. to better explain srtuaons (use additional pages as necessary)° rvtn s;
y�
QQj �Lm gy-cet 64 re c"
Reviewer/inspector Name
.:
„ Phone: l0 3'3Z00
Reviewer/Inspector Signature:
Date: Z a
Page 2 of 3 1212VO4 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19_ Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes )a No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes P9 No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E3 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 ° Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23_ if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
19 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
23No
❑ 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
PfNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
1P 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
9No
❑ 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
91 No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
P1 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
0 No
❑ NA
❑ NE
Additional Coinments and/or Drawings:40
Page 3 of 3 12128104

Type of Visit 49 Compliance Inspection U Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral Q Emergency 0 Other ❑ Denied Access
Date of Visit: Q Arrival Time: !l 2� Departure Time: p' County: RaBEsoA) Region:T-
.-go
Farm Name: / dd ;t ' TAU SOn 44 Owner Email•. Owner Name: EduF't? L, Jo4 n SOh Phone:
Mailing Address:
Physical Address:
�� �a!tnSo�
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator: —PIvw, LLC
Operator Certification Number: lgmq
Back-up Certification Number:
Location of Farm: Latitude: 0 e = { = u Longitude: = ° ❑ 4 [� "
Swine
Design = Current Design Current
Capacity Papua l lion Wet Poultry Capacity Population
Design
Cattle Capacity
C►urrent
Population
❑ Wean to Finish
❑ La er
❑ Dai Cow
Wean to Feeder
er
❑ Dai Calf
Feeder to Finish
❑ Dai Heifer
R.
❑ Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
ElNon-Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑Boars
❑ Pullets
❑ Beef 13rood Co
—_ ❑ Turkeys
Other
- ❑ Turkey Points
❑ Other
❑ Other
Number of Structures:
Discharees & Stream Impacts
1. is any discharge observed from any part of the operation?
❑ Yes
P No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
V1 NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
�'No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
'4PNo
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number: �—
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(iel 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 PiNo ❑ NA ❑ NE
❑ Yes ❑ No D NA ❑ NE
Structure 5 Structure 6
❑ Yes P10 ❑ NA ❑ NE
❑ Yes Wo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes � No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA [INE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes RNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type� 6Z [s) Firm wk "S S 6264ure ) , 5M , CwrL,-. O
13. Soil type(s) Alw4lK'Itfalt 1 kin S— RR
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes T No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 10 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ yes fig 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 RNo ❑ NA ❑ NE
❑ Yes IE4�No ❑ NA ❑ NE
Comments {refer to q stion #): Explain any YES answers`and/or�ariy recomimendahons or any other comments.
f f'b_R taUse drawtn
R.as'necessays oacrlthtoetter ee lainsituations.' useadditi 4�
S
tit Cor►�p e< �/I%
Reviewerlinspector Name"Phone:
Reviewer/Inspector Signature:
Date:
12128104 Continued

Facility Number: — Date of Inspection
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 JANo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n El Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �&No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
P No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
tANo
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
joNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
QjNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
EINo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
YbNo
ElNA
❑ NE
Other Issues
1
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
F3 No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
71-"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
$)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
6%
❑ 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
53No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
�No
❑ NA
El NE
12128104