780089_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

- Divvision of Watei• Resources
Facility Number I__L_i?� - ® Q Division of Soil and Water Conservation
Q t?ther Agency
Type of Visit: Ercompliance Inspection 0 Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit: Routine Q Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other O Denied Access
Date of Visit: Arrival Time: U ` Departure Time: County: U Region: r�
Farm Name: (� y �o j ✓�Cr/r�-`� Owner Email:
Owner Name: ; J J y �-(� , Phone:
Mailing Address:
Physical Address:
Facility Contact: —! rl 7�t P, +��` h Title: u,„ r Phone:
Onsite Representative: ��,_. Integrator:
Certified Operator: Certification Number -
Back -up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Swine C►apaty Pop,
Design Current
Wet Po>rtltry yC„apa 4 Pop.
Design Current
Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non-l_a er
I
Dairy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Qp
U
60
Design Corrent
D . P■onl Ca aci Po
Layers
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
21
113eef Brood Cow
Other
Turkeys
Turkey Pouets
Other
Other
Disehames 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 ® No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
[:]Yes
K[No
[:]NA
[:]NE
Page 1 of 3 21412015 Continued

i Facili 1Vumber: - gnq jDate of Inspection:
0�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
[5 NA
❑ NE
a. If yes, is waste level into the structural freeboard?
[] Yes
❑ No
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in): `j-1 0
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[_1 No
E]-NA
D 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
JaNA
FINE
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
VINA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[:]No
ED-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
'0 NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
fA NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No [aNA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes © No fA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ED No 5g7A ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ® No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
® No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? ifves, check
0 Yes
FV_1 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
A No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
` ? . No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
E4-No
❑ NA
❑ NE
Page 2 of 3
21412015 Continued

o Facili Number: jDate of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [—]No [gNA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No aNA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes fD-No ® NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes []No O NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWM P?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes P No [] NA ❑ NE
[:]Yes �gNo ❑ NA ❑ NE
❑ Yes M_No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes allo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Comments (refer to question #). Explain any, YES answers and/or any additional recommendations or any other comments, ,
-L. ikE i.. l,;C jai �, -,! '. `.- Cl.
Use dra+Nvmgs'gf facility to better explain situations (nseU additianal pages as necessarSiry.;
Reviewer/inspector Name: vim.. ��n Phone: 20 - 7,p i%/ 5
Reviewer/inspector Sigrtature:
Page 3 of 3
Date: /-- '70 4
21412015

iwston of Water Resources
Facility lvumber ©- .© - ®Division`of Soil and Water Co�tservation
- ®Other Agency
rype of visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
lesson for Visit: G Ltoutine 0 Complaint 0 Follow-up O Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: —/ -/ Arrival Time: ' p Departure Time: / Z_7_z County: Region:
Farm Name: iz& Owner Email:
Owner Name: fj`1 ,` y Phone:
Mailing Address:
!� rr
Physical Address:Z.-2�
Facility Contact: Ila"'17— ����f f��. Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone.
Integrator:
Certification Number:
Certification Number:
Longitude:
DestgnCurrent= r— Design' Curren# I� Design Current
Swine Capacttyr Pop'° _.: � " WetWP ultryxCapacity� Pop: Cattle Capacity Pop.
La er DairyCow
Non -La er DairyCalf
..
DairyHeifer
'"� � Design Current D Cow
:D Poult Ca act _ 4 Po Non -Dairy
F Beef Stocker
Beef Feeder
} Beef Brood Cow
- # =71
Other_ -_ M
Other
Wean to Finish
Wean to Feeder
Feeder to Finish Q ,3-
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Layers
Non -Layers
Pullets
Turke s
Turkey Pouets
Other
D'rschar es and Stream Impacts
1. Is any discharge observed from any part of the operation`?
Discharge originated at: ❑Structure ❑Application Field ❑Other:
a. Was the conveyance man-made'?
b. Did the discharge reach waters of the State? (]f yes, notify DW R)
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 DWA)
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
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
®No
❑ NA
❑ NE
❑ Yes
©No
❑ NA
❑ NE
Page 1 of 3 2/4/1015 Continued

t Facility Number: - DInspection:
"
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 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 0 n •
E'1 J
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
ElYes
2jt ❑ NA
EINE
(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
R NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environments
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑Yes
❑ NA
®NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Jo ❑ NA
[2-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 [a No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes MNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Wo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): /y —
13. Soil Type(s): prfU'l
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 [3-No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes allo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
® No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
[:]Yes
® No
❑ NA
❑ NE
Renuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
S-No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? 1f yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box_
❑ WiJP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement'? if yes, check the appropriate box below.
❑ Yes
® No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard []Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[] Yes
� No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ZNo
❑ NA
❑ NE
Page 2 of 3
21412015 Continued

• 1facili Number: - fi Date of Ins ection: 11,,2 �D W z' %t%Jf�V
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ NA toNE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA [O_NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes © No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Q No ❑ 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 ONE
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? 0 Yes 0 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
0 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
IR 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
E4 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
6�j No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
A)C2
Reviewer/Inspector Name:
Reviewer/Inspector Signatw
Phone:
Date: �1
21412015
Page 3 of 3

r
f
Type of Visit: &Uompliance Inspection U Operation Review O Structure Evaluation Q Technical Assistance I
Reason for Visit: Dunne 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: -Arrival Time: Departure Time: County: Region:
Farm Name: /� /� i ►� e Owner Email:
Owner Name: r rtd.` r, Phone:
Mailing Address:
Physical Address:
Facility Contact: �q tr�lEilc%`n �� Title: �"'Phone:
Onsite Representative: ��� Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity .Pop.
Design Current
Wet Poultry Capacity Pop.
I I Layer
Design Current
Cattle Capacity Pop.
jDairy Cow
Wean to Feeder
I jNon-Laer
Dairy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
/
Design
D . Poal Ca aci P,a
La ers
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turke Poults
Other
DischarlZes 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 14 No ❑ NA ❑ NE
❑ Yes [] No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
[] No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
JZ No
❑ NA
❑ NE
Page 1 of 3
21412014 Continued

Jf�
[Facility Number: jDate of Inspection:
Waste Collection & Treatment
` 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No
[�g 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
Q 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
E] 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
el No
INA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
❑ No
[ANA
❑ 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 0 Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
=T
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes S No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ® Yes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No ® NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes D No ® NA ❑ NE
❑ Yes ❑ No K) NA ❑ NE
Required Records & Documents f
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes C.No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No 5Z 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
El -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 [5No
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
E[ NA ❑ NE
Page 2 of 3 21412014 Continued

rl .(v
Faeili 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? n Yes ❑ No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[—]Yes
® No
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[R No
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
[allo
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
�o
❑ 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
EFNo
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
EgNo
O NA ❑ NE
EC NA ❑ NE
® NA ❑ NE
® NA ❑ NE
DNA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
r
r�S _5 -7i
4J-,- V r o't'-4 �—j v L 9
Reviewer/Inspector Name:
Phone: '/O -Y 33-3,3 U c�
Reviewer/Inspector Signature:
Page 3 of 3
Date: % --/2:— /4�
V412014

f
I Type or visit: t 7Routine
Hance inspection U Uperanon xeview U btructure :valuation U t ecnntcal Assistance
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: L�IQ K Owner Email:
Owner Name: _Q �/ 0�64-49,1�_ L Phone:
Mailing Address:
Physical Address: (i 9�j 0
Facility Contact: �' Gay Title: 3 I V Phone:
Onsite Representative: t Integrator: /t _
Certified Operator: r( Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Currentmom,Design
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Wet Poultry
La er
Non -La er
Capacity
@urret►t
Pop.
Design Current
Cattle Capacity Pop.
DairyCow
DairyCalf
DairyHeifer
Feeder to Finish
= D , ;Foul
Layers
I
Design
Ca aci
Current
Farrow to Wean
D Cow
Farrow to Feeder
Farrow to Finish
Non -Da'
Beef Stocker
Beef Feeder
Beef Brood Cow
Gilts
Non -Layers
Boars
Pullets
Other
Other
Turke s
Turkey Pouets
Other
Discharges and Stream ImDaetS
1. Is any discharge observed from any part of the operation?
❑ Yes
` 'L'j ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
[Y] NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ NoF3'_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
i6NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
P-34o
❑ 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 21412014 Continued

Facitity Number: - late of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [� A" I❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 2-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 P>er— ❑ 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 NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes o ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes QF�� ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [E' iqo ❑ NA ❑ NE
maintenance or improvement? \
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [21go ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Co k
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[g1Qo'❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
L215" ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
0 ' "' ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
io ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No ❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[3—N ❑ 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 E& 10 ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑Waste Transfers ❑ Weather Code
❑G `f�mfall locking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes o ❑ NA ❑ NE
IV -
Page 2 of 3 21412014 Continued

LID
IF —acuity Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes HKO ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes [frNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes E2*1Vo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [ . o ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No ❑ NA ❑ NE
D Yes �No ❑ NA ❑ NE
❑ Yes Dfilo ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
No ❑ NA ❑ NE
rNo
❑ NA ❑ NE
❑ NA ❑ NE
(Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name: UAA Phonet / b
Reviewer/Inspector Signature: 1! L20L Date:
Page 3 of 3 21417014

I ype at visit: tV.C'ompliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: (Dogo—utine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region����
Farm Name: i (V O�( CAidAJ_c f Ty� Owner Email:
Owner Name: Phone:
Mailing Address: d Lf
Physical Address: 7 8 7
Facility Contact: Len, a� 1�-i Title: A.4�6ev/ Phone: 3
J-
Onsite Representative: l Integrator: d
Certified Operator: i Certification Number: / A —
Back -up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design
Current Design Current Design Current
Swine Capacity
Pop. Wet Poultry Capacity Pop. Cale .: = Capacity Pop.
t.
Wean to Finish
La er
Dairy Cow
DairyCalf
Wean to Feeder
Non -La er
Feeder to Finish
0
U
n- "-
Dairy Heifer
Farrow to Wean
Design Current
Dry Cow
Farrow to Feeder
t , Ca aei ` P,o
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Points
Other
Other�yv
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
[:]Yes
[—]No
lid l"A
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
Ep"'NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
E]54A
❑ 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
F71AA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑ No
Me ,
ElNE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
❑ No
I "A
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Faciti Number: -tZ jDate of inspection:
Waste Collection & Treatment
4. is storage capacity (structural plus stone storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No J[ff'-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): hit
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ❑ No [ l TA ❑ 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 ®/lqA ❑ 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 [0.NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ No [3-I A ❑ 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 gj"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 [5 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 Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment'?
Required Records &_Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20_ Does the facility fail to have all components of the CAWMP readily available? if yes, check
the appropriate box.
❑ NE
❑ Yes
[gNo
❑ NA
❑ NE
❑ Yes
[frNo
❑ NA
❑ NE
❑ Yes
❑ No
[Z'-NA
❑ NE
❑ Yes [IN0
❑ Yes ❑ No
❑ Yes [R'N10
❑ Yes E!5"No
❑ NA ❑ NE
[!'NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑WUP []Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Eg`�o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard [:]Waste Analysis ❑ Soil Analysis ❑ Waste Transfers [] Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ENo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes W(No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

lFarility Number: - Date of Ins ection: Nou
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No [!r-I A ❑ 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 [BINA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No �A ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[jj
❑ 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
[Z1,15o
❑ 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
❑(, ,K—o
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
❑moo
❑ 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 Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
Off"No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[Gio
❑ NA ❑ NE
mments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
r
e drawings of facility to better explain situations (use additional pages as necessary).
V JJJ 1� G , c+v V__'k 4Y -L�{ r 0Vct t C"o Jt
Reviewer/]nspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phoneft(o- T3 1 333
Dater . ftUU — �0 V
21412011

lrr'�
Wla.6ltia
Type of Visit: 0 Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: (Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: a1 Arrival Time: O to0 Departure Time: County: Ra �F.Tan Region: FRd
Farm Name: L`,�r�y��y� '� AS�:�jS Owner Email:
Owner Name:Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: LAt�0.� AXE K�yE
Certified Operator: gT'n' Z_
Phone:
Integrator:
Certification Number:
Back-up Operator: 5 ,p4� t_ Certification Number:
Location of Farm:
Latitude:
Longitude:
Design
Current
Design
Current
Design Current
Swine
Capacity:
Pop.
Wet Poultry
@apacity
. Pop..
Cattle Capacity P.
Wean to Finish
La er
airy Cow
Wean to Feeder
-Layer
airy Calf
Feeder to Finish
0 O
o D
"' W ..
Dai Heifer
Farrow to Wean
Dry Cow
Farrow to Feeder
a aci
P,a
Non -Dairy
X Farrow to Finish
o
p
La ers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
O#her
Turkey Pouets
Other
Other
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [:]No n7NA ❑ NE
❑ Yes [—]No tgNA ❑ NE
❑ Yes [] No gNA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 2No
[g NA
❑ NE
dNA
❑ NE
❑ NA
❑ NE
Page I of 3
214.12011 Continued

Facili Number: - Date of Inspection: a
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No Ef NA ❑ NE
a. If yes, is waste level into the structural freeboard? [:]Yes ❑ No [YNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
g 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
[2' 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
ENo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[fNo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
E�No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[O No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No dNA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evid`ence of Wind Drift ❑ Application Outside of Approved Area
12. Crop TYpe(s): '_QZIkM"0a. f WA'..4 'Sn .kov"L.S_
13_ Soil Type(s):
l4. Do the receiving crops differ from those designated in the CAWMP? [:]Yes [gNo [] NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? 0 Yes YNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [] Yes ❑ No RNA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
[gNA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[] No
ff NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[] Yes
Q'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 E?(No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [:)Yes B/No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No [�iVA ❑ NE
Page 2 of 3 21412011 Continued

Y facility Number: 1 - 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 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? ❑ Yes erNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [qNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes &No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better exDlain situations (use additional na2es as necessarv).
21'�A ❑ NE
OR'NA ❑ NE
B"NA ❑ NE
BINA ❑ NE
Reviewer/Inspector Name:
Revi ewerA nspector Signature:
Page 3 of 3
[-]Yes E3"No ❑ NA ❑ NE
❑ Yes [D**No ❑ NA ❑ NE
❑ Yes ❑ No (Erf,4A ❑ NE
❑ Yes [V'No ❑ NA ❑ NE
0 Phone: Cj /O- �U- (s J
_ o Date: A 2
/4/201

type of visit: QLJ�ompIlanee Inspection V Operation Review t,,,) Structure Evaluation U Technical Assistance
Reason for Visit: t9 Loutine 0 Complaint Q Follow-up 0 Referral 0 Emergency Q Other 0 Denied Access
Date of Visit: //� //j� Arrival Time: Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: u u��tie, Phone:
Mailing Address:
Physical Address:
Facility Contact: t1ry 00&JkA e, Title:
Onsite Representative: L6L_i k:W DAC.-okqV_
Certified Operator: 6
Back-up Operator:
Location of Farm:
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
a
Farrow to Finish
Gilts
Boars
Discharges and Stream Impacts
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
1. Is any discharge observed from any part of the operation?
❑ Yes
❑ No
[]30<A
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
er A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
Eall.'
❑ 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
A
❑ NE
2_ Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑ No
FL.'��A
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
❑ No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facilit y Number: jDate of Ins ect'UfjVC
01
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No B'IgA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No UJ-<C ❑ 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 2Io ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes Io ❑ NA ❑ NE
waste management or closure plan'?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes �o ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes FCrNo [] NA ❑ NE
maintenance or improvement'?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0 . ❑ NA ❑ NE
maintenance or improvement'?
11. Is there evidence of incorrect land application'? If yes, check the appropriate box below. ❑ Yes ❑ No TA ❑ 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'WindDrift [] Application Outside
o-fApproved
,Area
12. Crop TYPe(s): �/V1f Ia_ i t f v , 6 6-a , C-o
13. Soil Type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [ Vo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes to ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No IA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
IAA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
EaXA
❑ NE
Required Records & Documents
19_ Did the facility fail to have the Certificate of Coverage & Permit readily available'?
❑ Yes
l.J o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
❑ No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other.
21 _ Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes EKo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes o VNA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [—]No ❑ NE
Page 2 of 3 21412011 Continued

Facilit Number: f7l- Date of inspection:
24. Laid the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes ❑ No [a1 A ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No W.?�❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [] No Q'NAA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [3No Q-NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ED< ❑ 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 �'N0 ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge. freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes ❑ No [2,< ❑ NE
❑ Yes [Z;'K'o ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes Q'Ko ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes Ea "'o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes Ed ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility, to better explain situations (use additional pages as necessary).
1
Reviewer/Inspector Name:
Reviewer/Inspector
Page 3 of 3
Phone: gIU 43
Date:
21412011

Type of Visit &C—ompliance inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit outine O Complaint O Follow up Q Referral O Emergency O Other ❑ Denied Access
Date of Visit: — -/f7 Arrival Time: /• .... Departure Time: Z: Jos' County: Region: F
Farm Name: Owner Email:
Owner Name:%/� f��t'�d� �t Phone:
Mailing Address:
Physical Address:
Facility Contact: 4ayriz /Title: - af� 4)&J"jc'--�/�� _ Phone No:
OnsiteRepresentative: Llleky C- integrator: S;uck1-r.-
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: [=1 e E__1 I 1--] it Longitude: = ° = I = u
Design Current Design Current Design Current
Swine C►apacity Population Wet Poultry Capacity Population Cattle Capacity Population
❑ Wean to Finish 10 Layer I
❑ Dairy Cow
❑ Wean to Feeder
Cr? ❑ Non -Layer
❑ Dairy Calf
® Feeder to Finish
960
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Layers
❑ D Cow
❑ Non -Dairy
❑ Farrow to Feeder
❑ Farrow to Finish
150
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
❑ Beef Feeder
❑ Beef Brood Co
❑ Boars
❑ Pullets
❑ Turkeys
Qther El Turkey POults
Number of Structures:
❑ Other 7 ❑ Other
Discharges & 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
El No
�,�
B NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
01�'A
❑ 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
E] N
,Noo � tvA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
B oo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
I No r
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number: 70 — cj 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 I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
❑ Yes ❑ No BINA ❑ NE
❑ Yes ❑ No NA ❑ NE
Structure 5 Structure 6
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
Ej NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
❑ No
E
N/
❑ NE
8. Do any of the stuctures lack adequate markers as required by the pen -nit? Yes
❑ No
,
L� ErNA
-N
El 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
0
❑ NE
maintenance or improvement?
Waste Application
10- Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
❑ No
A
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes
ElNo
�
ETI A
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn. etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) q
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
2<. ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
2rNNo ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
LJ, NNoo El NA
ElNE
17. Does the facility lack adequate acreage for land application?
El Yes
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment'?
❑ Yes
,L�(`<
I'110 ❑ NA
❑ NE
Comments (refer to question #}: Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name F-9f`LK +fie ve_t S Phone:
Reviewer/Inspector Signature: z+-� Date: .3-14,` 2010
12128104 Continued

f �
Facility Number: % —67 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes B No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes L'1No ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists El Design ❑Maps ❑Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
[:]Yes
L;vo ❑ 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 E] Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
BIo NA
El NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
,❑_,
El No L`7<
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
ElYes
[INo 6N'A
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
/
No NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
,❑,,
L' hq_o ❑❑ NA
❑ NE
27.
Did the facility Fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ElNo BSSA
❑ NE
Otherlssues
29.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[] Yes
L7 ivo
❑ 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
Bivo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
Yes
ElT
,� ,�16v _
LE,
El NA
El32. NE
33.
Does facility require a follow-up visit by same agency?
El Yes
U44 ❑ NA
❑ NE
12128104

-5 5--`/ S - e `r
Type of Visit &fo-mpiiance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 01(outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time:! 9.'�O Departure Time: %0:30 County:6�SQ� Region: f� `
Farm Name: i 4 OJT e- Af d i�N C _ F� �''�� Owner Email:
Owner Name: t)4c.A/ e(%A1 t
1 p� Phone:
Mailing Address: 21A'-ile r- c c-1 Cyt u. r� 0Gry,�rc N G ZY-37Z
Physical Address:
Facility Contact: _�/llu �if�uv �iw _ Title: OL',Iv e_a Phone No:
Onsite Representative: _Lary � K't^'dr%✓C_ Integrator: _Z�1410 t& t.. :24
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o = ' = Longitude: = O = ' ❑ "
4
Design Current Design Current Design Current
Swine Ca aci Po ulation Wet Poult @a aci P;a ulaHon Cattle Ca aci Po ulation
P t" �_ p h P P h P
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
Non -Layer
❑ Dairy Calf
eeder to Finish
4
x,`bD'ry�Pdultry
❑ La ers
❑ Non -Layers
El Pullets
ElTurkeys
❑Turkey Poults
❑ Other
&. Dai Heifer
' ❑D Cow
❑ Non -Dairy
❑ Beef Stocker
❑Beef Feeder
❑ Beef Broad Cowl
Number of Structures:
ElFarrow to Wean
' Farrow to Feeder
El Farrow to Finish
❑ Gilts
❑ Boars
r..:-...,
Other'w'X'
:;...
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
BNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
El Yes
❑ No
ET'
NN�A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
,E
B<
❑ 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)
El Yes
NNo
,�__,��
[B A
❑ NE
2. Is there evidence of a past discharge from any part of the operation'?
❑ Yes
,❑,,
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
,'L_TNo
ETNo
❑ NA
❑ NE
other than from a discharge?
Page 1 of
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 I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): /v
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 CrNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 0<6 ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmentalthreat, notify DWQ
7. Do any of the structures need maintenance or improvement? El, Yes �No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? [--]Yes I- ivo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require [] Yes [_ 10 ❑ NA ❑ NE
maintenance or improvement?
Waste Annlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 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__01-Al C J11,1L f �✓ , �✓
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
TNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
EfNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment'?
❑ Yes
EYNo
❑ 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):
Crt,,�,`�.U4 4���tss Gc__ /20;NkQ/ a
Reviewer/Inspector Name
Phone:
Reviewer/Inspector Signature:
c�
Date:
12128104 Continued

Facility Number: 'j $ —F9 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ETNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ErNo ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps [I Other
21.
Does record keeping need improvement? If yes, check the appropriate box below,
❑ Yes
3-5"o-_ ❑ 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
N�o ❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
,�,
LTNo ❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
0< NA
El NE
25_
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
�❑
[R o ❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No ❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
B No ❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
N
[:I�o NA
El NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
E,
!_Io
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
Did Reviewerfinspector fail to discuss review/inspection with an on -site representative?
El Yes
go
El ivo
El -
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ NA
❑ NE
Comments and/or Drawings:
11/28/04

SDI,Cs Wd z/a 0
--—."-----. _,.Orfivision of Water Quality
Facility Number -] $ g q O Division of Soil and Water Conservation
Q Other Agency
I
Type of VisitCommp�pliance
Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
Q-I outine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: 0/- ®-O $ Arrival Time: Departure Time: OSf .3Q County: '10es1,1 Region: AA9
Farm Name: 81144 Owner Email:
Owner Name: B��/y �%1�t.v`ram Phone:
Mailing Address: Z �� C✓u�Greey CL.-chi. 2d_ �cyet,�o�'e� /yc Z 8.3 7Z
Physical Address:
Facility Contact: i a u DKem do l e- Title: V W aoU- Phone No:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 0 0 ' = Longitude: = ° a
Design Current Design Current
Capacity, Population Wet Poultry Capacity Population
❑ Laver
a 1 ❑ Non -La et
Dry Poultry
❑ La crs
❑ Non -Layers
❑ Pacts
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stockei
❑ Beef Feeder
❑ Beef Brood Col
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)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [6 No ❑ NA ❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
[7 No
❑ Yes
R No
❑ NA
❑ NE
❑ Yes 0No ❑ NA ❑ NE
12128104 Continued

& 91-30-Z&69
Facility Number: % $— $�9 Date of Inspection 0
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 [jJ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): /V ZA
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
M 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
W 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
0 No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
[A No
❑ 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 [I Yes
� No
❑ NA El NE
maintenance/improvement'?
11, Is there evidence of incorrect 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 ❑ Evidence of Wind Drift ❑ Application Outside of Area
12_ Crop type(s) AoJ Nu 4j 5 CXo 3 CW t u >~ Sli",.= �'�
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[3 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
ONo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[3 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[RNo
❑ NA
❑ NE
j Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
IUse drawings of facility to better explain situations. (use additional pages as necessary):
Fri ►- P (r,,, s cv u�ti.,-��
t7� yta C 0 Vw c "P5 .
Reviewer/inspector Name ��L �w�P_15 Phone: WO,V-73, 3300
Reviewer/Inspector Signature: Date:
12128104 Continued

` 0l -3o-zoos
Facility Number: -7 $ — 89 Date of Inspection - cr
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [O No [I NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soi ]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
0 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[N No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[M No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
® No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
7J
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
( No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[0 No
❑ NA
❑ NE
al Comments and/or Drawings:
12128104

j31MS f161o�
® Division of Water Quality
Facility Number g S 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit *Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 3'2z ` 01 Arrival Time: 1 :40 Departure Time: County: RQkX50AI Region: 14—P-0
Farm Name: c_ ELL, sw Owner Email:
Owner Name: 13 i wj,'a�L Phone: (` / 0) S Z/ —
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: Ayyb 0 X�eAjd 0`k/<- Integrator:
Certified Operator:
Back-up Operator -
Phone No:
Operator Certification Number:
B
ack -up Certification Number:
Location of Farm: Latitude: = o =' E-1 Longitude: = ° =1 I = "
S%ine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non-Layet
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
50
❑ Farrow to Wean
® Farrow to Feeder
Q
S�
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turke Poults
❑ Other
Discharges. & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ C
a Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
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)
?. 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?
F F
21
Soo ❑ NA ❑ NE
❑NA
El NE
❑ Yes
® No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
® No
❑ Yes
[MNo
❑ NA
❑ NE
❑ Yes
[$No
❑ NA
❑ NE
12128104 Continued

i Facility Number: 7 1 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 [A NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: At &1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): /1JI14 1yM
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ No CS 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 QINA ❑ 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
[A No ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[8 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 [I NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes. check the appropriate box below.
❑ Yes
[9 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ] O lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s) 5.4 cis Coyne 5 l� �r-z%N S
13.
Soil type(s) UOrj(�l , �Abar
14.
Do the receiving crops differ from those designated in the CA WMP?
❑ Yes
[9 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
IT
Does the facility lack adequate acreage for land application'?
❑ Yes
No
❑ NA
❑ NE
18.
Is there a Iack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name Ri L gLv C-S Phone: (WO) 133 -3330
Reviewer/Inspector Signature: Date: 3 -- z 7- - zo o 3
12128104 Continued

Facility Number: -7 Date of Inspection 3-2z-07
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [�l No ❑ NA ❑ NE
20_ Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 2fNo ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
'No
[I NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
® 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
ONA
❑ NE
X-M_
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
SNA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
[DNA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes m No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ElNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
��yy,,
[n No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[� No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[M No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency'?
❑ Yes
P No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

i
W Division of Water Quality
Facility,Number �] I g 9 O Division of Soil and Water Conservation
i >�
O Qtheril,gency
Type of Visit g Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit O Routine O Complaint Q Follow up O Referral O Emergency O Other ❑ Denied Access
Date of,* isit: 7-Z d (o Arrival Time: �f , Departure Time: County:
Farm Fame: Q l�g 0;cz ,d A, L )C;if- Owner Email:
Owner Name: 8; l /u _— — 0 .., Phone:
Mailing Address:
Physical Address:
Facilih• Contact:
Title:
Onsite Representative: 9A 0 t 1gk�& e_
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
AL c 5-, Region:
Phone No:
Integrator: -zy !! Lrcw,L7L�-
Operator Certification Number:
Back-up Certification Number:
Latitude: ❑ o = Longitude: ❑ o ❑ , = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
❑ Non -Laves
Dry Poultry
❑ Lavers
❑ Non -Lavers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Disc^ harees & Stream Impacts
1. Is any discharge observed from any pan of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cou
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 W No ❑ NA ❑ NE
❑ Yes
N No
❑ NA
❑ NE
❑ Yes
[ff No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
rV1 No
❑ Yes
RrNo
❑ NA
❑ NE
❑ Yes
[�INo
❑ NA
❑ NE
12128104 Continued

Facility Number: `T $ — $ Date of Inspection 2-2$- D
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes EgNo ❑ 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): alA
Observed Freeboard (in):
5_ Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
(Z 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
WNo
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
[�No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
[;'No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
[;]'No
❑ NA ❑ NE
maintenance or improvement?
Waste_ Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
[PrNo
❑ NA ❑ NE
maintenance/improvement'?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
[PNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn.. etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) V -n/
13. Soil type(s)
I4. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[9No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
2fNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'
❑ Yes
X 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
$6 No
❑ NA
❑ NE
Comments (refer to question #):. Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as.necessary):
Reviewer/inspector Name �� L � Gf S Phone: t! 9/0) 4tg—i5e
Reviewer/Inspector Signature: Date: Z - �8— ZOa 49
I2/2X/U4 Conttnuea

Facility Number: — q Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Pen -nit readily available? ❑ Yes ;K No ❑ NA ❑ NE
20_ Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑yes X 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 ['0 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
[]Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge'? ❑ Yes 09 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes R9 No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
R No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
E[ No
❑ NA
❑ NE
26, Did the facility fail to have an actively certified operator in charge?
❑ Yes
[9 No
❑ NA
❑ NE
27, Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[51No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[)FNo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[XNo
❑ 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
N No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[�No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32, Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[XNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
XNo
❑ NA
❑ NE
Addtttonal Comments and/or Drawingsc`:
72128104

Type of Visit Q Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 4SRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: Time: � ' �"
Facility Number 7 8 8
Q Not O erational Q Below Threshold
Permitted M Certified © Conditionally Certified [3 Registered Date Last Operated or Above Threshold- ----- ---------- ----------
Farm Name: .._.__.I..`. y. ,lf .z_ln._ i ems.... F'a. r.-. County: P e 10 cs a Ir1 ..........
Owner Name:..... 1.. �..�..i.,�.... ......Q.Y..t.xti ±,?—*�, _................. Phone No:
_._. _.......
Mailing Address:..__ � - - P� knAax ..t .. .... N - .E 7.2.
Facility Contact:
Title:
Phone No:
Onsite Representative: .. - ..!..f! `f....._.0_V �"k4s-'"1-�----...---....................... Integrator:.... �"�v aP��o.t. �.nt'f`..... �..._......
Certified Operator:._._._......._........ ._...._ ..
Location of Farm:
Operator Certification Number:
14 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 66 Longitude • �� �Cf,
Design Current Design.
Cuirrent _Cui,=
nt
CSwine Ca acPopulation Ca ci Po utation Cattla Po Wean to Feeder ❑ Layer [] Dairy
Feeder to Finish S ❑ Non -Layer I I[] Nan -Dairy
Farrow to Wean w
Other
Farrow to Feeder
Farrow to Finish Total Design :Capacity
Gilts
Boars Total SSIW
Number of -Lagoons /� /� _ `
J� r'£C'
jjol
Discharges & Stream Impacts
l . Is any discharge observed from any part of the operation?
❑ Yes ®No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min? fy I
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes P No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ........................... .....----...__....._..... ..._..-----_---._ -----------
Freeboard (inches):
12112103 Continued

Facility Number: 8 — g Date of Inspection N a
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes ❑ No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance!unprovement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes ❑ No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancehmprovement? ❑ Yes ❑ No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Excessive Ponding [I PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWNIP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes ❑ No
Odor issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑ No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ❑ No
Air Quality representative immediately.
'araw^a�:rsa�ty to.oettrr sti.�{use's P t91 w [] Feld Copy ❑ Final Notes
Fe, r-• 1 S g '., 1 O f -P4 P. r, t'j 144, r% a 1'. q O d'J s,
14 c 1 a a y S '� d -k .. 4-G Ct 1' S, x r'_O ,I-L- "J' �S .
o ekOs '_' aLfi' a oc. .A p��,r.�� 1%4ve_ m.4,b w-t0. re-e C-1V b cA�
CA Pa r. o6 ,. r ► v o ( p 1 C.R" c- p l.4 `a. �.� -' a-,...,,. r C. La �.d .
Reviewerlinspector Namea'-'-
Reviewer/Inspector Signature: Date:
»i»mi
rA,.hl,"d

FaciIity Number: Date of Inspection
RRe uirel Records & l}ocument_s
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Gel WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ 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?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
3I. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did.the facility fail to conduct an annual sludge survey?
❑ Yet 111,
El No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes R No
❑ Yes ® No
❑ Yes P No
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ 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 Foam ❑ Crop Yield Form ❑ Rainfall ❑ inspection After I " Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

Type of Visit t7 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number ']$ 89 Date of Visit: 09-2a-21103 Time: 9:OOam
Q Not Operational Q Below Threshold
D Permitted ® Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: 0iI1x.Q_XcQ lime.Fazm................ County: Robum --------------------------------- FRQ ---------
Owner Name: BilikSJact utfin�------------------------- Phone No: 41QI�94`1-- --------------------------
Mailing Address: t 4.Ewer. eeq. lturebt.�aad....................................................... ftmhr.ukP...NC ...................................................... 183.72 ............
Facility Contact: ............ Title: ................................... ----------- Phone No:
Onsite Representative: Integrator:
Certified Operator: .. Operator Certification Number:
Location of Farm:
)n the south side of SR 1318 approx..1 mile east of its intersection with SR 1338, northwest of Philadelphus, NC.
® Swine ❑ Pouttry ❑ Cattle ❑ Horse Latitude 34 ' 46 52 u Longitude 79 ' 13 22 K
Design Current `Design Current- - Destgn Current
_ Swine Ca act Poplation Poult 3
ry. -Ca aci Po- ulation Cattle Caac itV Po
uula6on _
❑ Wean to Feederf��
❑Layer ❑Dairy
s
® Feeder to Finish 800 ❑ Non -Layer ❑ Non -Dairy art;
❑ Farrow to Wean - v�
,.
® Farrow to Feeder 150 ❑ Other
Farrow to Finish -Total;Design Capacity 950
❑ Gilts
❑ Boars Total SSLW 186,300
umber of,Lagoons -� ❑ Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area
T Holdtpg Ponds /,Soltd Traps ®No Liquid Waste Management System ` F
Discharges & Stream Impacts
1. Is any discharge observed from any part of -the operation?
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 Water of the State? (if yes, notify DWQ)
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes []No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
Identifier: ....................
Freeboard (inches): ............._.._.._.._.
0si0.3/01 Continued

FacilityNumber: 78-89 Date of Inspection 09-24-2003
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes ❑ No
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
❑ No
12.
Crop type
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application'?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination'?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17,
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19,
Does record keeping need improvement? (ic/ irrigation, heeboard, 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?
❑ Yes
❑ No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24.
Does facility require a follow-up visit by same agency'?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of -the Certified AWMP?
❑ Yes
❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
Comments (refer to.quesiion #): Explain any YESsansrvers andlon=any recommendations or any o#her. comments.
Use drawings of facility to;tietter explain a add oval as accessary,}:
sitaatiori's: (u pages ®Field Copy ❑Final Notes
Visit conducted as part of Mr. Oxendines Non -Discharge application review process. Reviewed his practices with him. Current hog
pulation is three to four hundred animals.
er/Inspector Name °LarrySaxleyer/Inspector
E
Signature: Date:

IV
Facility Number Date of, Visit: 2 -O 'ime: 0 ��
Not Operational Below Threshold
©Permitted O Certified [3Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: 6 1/fi 6.9 Ire" , M-,- 1�Gk v e..1_ Counh':
Owner Name: A. �K _ - Pho No:
Mailing Address: Z /' `-- �C.(r 6 n� /J C z �� %
Facility Contact: Title: Phone No:
Onsite Representative: _ _ Integrator:
Certified Operator:
Location of Farm:
Operator Certification Number:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' " Longitude 0' 0 0"
.Design Current -,Design Current' -Design. CUrieat
Swine Capacity Population Poiil Ca achy Population, Cattle Ca acity IP6 elation "
❑ Wean to Feeder ❑ Laver Dairy
ElFeeder to Finish ❑ Non -Laver ❑Non-Dairy
❑ Farrow to Wean =
❑ Farrow to Feeder ' - ❑ Other
Farrow to Finish �! Total Design Capacity
Gilts
❑ soars _ Total SSLW
Number of Lagoons = ❑ Subsurface Drains Present ❑ Lagoon Area .._ _ ❑ Spray Field Area
lWitin0oods / Solid Traps No Liquid Waste Management System
Discharves R Stream Impacts
1. Is any discharge observed from any pan of the operation?
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 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 ves. notify DWQ)
2. Is there evidence of past discharge from any pan 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:
Frceboard (inches):
05103101
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
Continued

r - ,
Facility lumber: 1g — S
Date of Inspection 1 �O
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
I0. Are there anv buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type rrry. I-- AL
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes to
o
❑ Yes
01
13_ Do the receiving crops diffVwith those desated in the Certified Animal Waste Management Plan (CAWMP)?
El Yes
�No
14.
a) Does the facility lack adequate acreage f application?
❑ Yes
No
b) Does the facility need a wettable acre determination?
El Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
No
I5.
Does the receiving crop need improvement?
❑ Yes
No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
P�No
Re wired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
o
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP. checklists, design. maps, etc.)
El Yeso
19_
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
El Yeso
jNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yeso
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
0 No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
gNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Certified A) MP?
❑ Yes
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refeuto question #): Expt* any YES;aoswers jiii :B i.i'eCOmmendations or anv.Uther comgnenti -
Use draRzngS of fact7ity to better ezplain'sittsatwas. (etst adtfttwnal page; as accessary) ❑Field Cot+v ❑Final Notes K
D � u • ct1aS Sty S
rlVt 16rb
Reviewer/Inspector Name p.�<r
Reviewer/Inspector Signature: Date: r0�
05103101 Continued

Facility Number Date of Visit: GJ Time: ; 3a
�= - -] Q Not Operational Q Below Threshold
fi(Permitted [Certified E3Conditionally Certified 13Registered Date Last Operated r ve Threshold:
Farm It Name: t.Ll ....Li 4 .1.. C..�� .5..r!!h..W............� County: . ..� e5,412
Owner Name:.....!!ij...I.......................... Phone No: ........ •........�
FacilityContact: ........................................ ...Title: .................................... ................... Phone No: .................. ..................._.......
Mailing Address: 2 % z1. a r. rzet ,....... .......... ..�t C .......� . -Z 3?Z
........... .�................... j.._... .. f
Onsite Representative. ejr,@.... ha Integrator: -
Certified Operator: ................................................... ....... .................... ... . ....... . . ...... Operator Certification Number:................ . .
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • Lam... /` « Longitude �• �4 �K
Swine
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
arrow to Finish
Gilts
Boars
Design: Current Design Ctrrertt Design .;
_.
a aClty Population Poultry CapacityCipacity Population Cattle • Ca _
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
Other
D Total Destgn Capacity
Total SS.LW C
Nunber of Lagooins Subsurface Drains Present ield Area
❑ Lagoon Area ❑ Spray F
Holding Ponds / Sa6d Traps .. No Liquid Waste Management System r
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes�No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes El -No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ..................................-------------- ................. ..................
Freeboard (inches):
5100 0 Continued on hack

•e
Facility Number:'7=S? Date of Inspection �d
5_ Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there'structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimprovement?
11. Is there evidence of over application? ❑ Excessiye Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
13. Do the receiving crops differ with those deli ed in the Certi
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?
(ie/ 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?
31; * ttjs ;ejr• iie#}ciepcs •were potedditrizig �hls:v��t,•><eceiye too ftt��r .
correspondence about this visit_ : . : .: :..:: ..:: :.:.:
. . . . . . . . . ....... .
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes.
❑ No
❑ Yes
VNo
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes KNO
❑ Yes JKNo
❑ Yes ECNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
A.
.L� *'Or/e X q Jr d- /nL-7 ' ue7
r
71
i_
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 5/00

Facility Number:'/IF —JF7 1 Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below []Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 0
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 0
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 0
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
31. Do the animals feed storage bins fail to have appropriate . cover? 0 Yes �zo-
32. Do the flush tanks lack a submerged fill pipe or a permanenthemporary cover? El Yes [] No
5/00

® Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of Inspection
Time of Inspection : ao ?A hr. (hh:mm}
13 Permitted ® Certified © Conditionally Certified E3 Registered 10 Not Operational Date Last Operated: .........
,��Cf � ✓ C'/�cQ✓"` --..._ .................... County: •/5o�� �o-!J..........
Farm Name: ........... .............. _ __........ ........... ...........................................
/ .
Owner Name:............ 1
......... phone No:...a-z�'. ....t.....
............................................... —.YAP.
Facility Contact:..... % !.. ......�„� - ... Title Phone No:...................................
,J
Mailing Address: ---- zi yY!!��PrP-{!!�1« rl=l+`rrEyc.t�_..Z.r.7Z...... ..........................
....... ....
Onsite Representative:.... l ... �� �! d_....................._............ Integrator....... fr....Y!`J._.. _
Certified Operator: ................................................... ........................... . ................................ Operator Certification Number: .---........... ........ ..................
Location of Farm:
Latitude =' ' 44 Longitude =a & "
"
Desagn _ Ciirrerif
- <,
Design Current'.° _ Destgn Curirent
Swine -
Ca "acio °Po iilatiori
Poultry
Cattle -
Ca acit _ Po"eilation ,. _ tiCa'ac�ty -Po ulat,on K
ry<: ❑ Wean to Feeder
❑ Layer
"❑ Dairy:
-: ®Feeder to Finish
(]
❑ Non -Layer
.': ❑Non -Dairy
❑ Farrow to Wean
r
Farrow to Feeder
❑ Other
s
Farrow to Finish
Total Diz§ig Capacity
-' ❑ Gilts
❑Boars
Utal'SSLW -.
Number of Lagoons '.� .T , ❑Subsurface Drains Present ❑Lagoon Area ❑ Spray Field Area
� Holdtng_Ponds./:SoLdxTraps _�µ . ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation? ❑ Yes A No
Discharge originated at_ ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes JRNo
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) []Yes No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes ,� No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ,Q No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes I'No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 1, No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches) . .............
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes Q+fo
seepage, etc.)
3/23/99 Continued on back

)Facility Number: % f — Date 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 maintenancelimprovement?
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 maintenancetimprovement?
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 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
IT. 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?
(ie/ 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?
(iel discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
3: No yiQiatignjs:oi dtrf ciencies were itQted• ilut< iitg this:visit; • You will •i eeeiye ijri futther
corresb6fidence: abouti this visit::::::..::: - . • .:: . ::::........::.::.:: .
-// ; �,.—. � �uoC1s� chi' A �� ���1 � �•.�:
❑ Yes P'No
❑ Yes No
❑ Yes ® No
❑ Yes ANo
❑ Yes PNo
❑ Yes J&No
❑ Yes tWNo
❑ Yes ® No
❑ Yes] No
❑ Yes ® No
❑ Yes )UNo
❑ Yes M'No
❑ Yes PtNo
❑ Yes ;M No
❑ Yes J4 No
❑ Yes 10 No
❑ Yes ANo
❑ Yes P'No
❑ Yes [e No
❑ Yes ® No
❑ Yes M'No
Reviewer/Inspector Name - - ,
= ai ,.7> A
Reviewer/Inspector Signature % Date: - z �a�a

Q Division of Soiland=Water i
[j_Division of Soil and Water t
Division of Water Qah uty
Other Agency :Operation-]
ration -- Operation Revkr
Mahon=rCompliance Inspi
fiance inspectron
L9 Routine 0 Complaint Q Follow-up of DWQ inspection O Follow-up of DSWC review Q Other
L - Facility Number Date of Inspection
Time of Inspection .'3a 24 hr. (hh:mm)
0 Permitted M Certified [3 Conditionally Certified [3Registered [3 Not Operational Date Last Operated: .....
Farm Name: --.... �.11.......6,re,�.ash. ...��r ............................ C�un#y:.......... 0. eso7.-.......................................
Owner Name: ...... M.-df ......................... Phone No:.....,, .."...1... I. .
Facility Contact: ....... _ ------ ® ...Title: .. Phone No: 7�...............................
Mailing Address: -.._. 7...-1.1..... G�..... .9.z_-:.................................. ..l..U..e....................... ........
Onsitc Representative: ........................4I.D.W. i✓ Integrator:
Certified Operator:...... .............................................
Location of Farm:
................. Operator Certification Number:...........................
I&
E..........................................................................................................................................................................................................................................................................1
Latitude 0 Longitude.i
• �. 0 • 1 C�«
Design Current Design-"' Current
1.Swine Capacity Po ulation Poultry: C acity Population Cattle
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
4 a
❑ Gilts,
❑ Boars
❑ Layer ❑ Dairy
❑ Non -Layer ❑Nan -Dais
' ❑ Other
Total Design Capacity
Total SSLW
-'Number-of-Lagoons Q _ ❑ Subsurface Drains Present © Lagoon Area
Holding Ponds / Solid Traps No Liquid Waste Management System
Design Current
.apacity Population
`l
Spray Field Area ,
Discharges & Stream impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
h. if discharge is observed, did it reach Water of the State? (Il'yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/inin?
d. Dees discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4- Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes KNa
❑ Yes fiR No
❑ Yes E�No
❑ Yes
K_No
❑ Yes
kTNo
❑ Yes
JR No
❑ Yes K No
Structure I Structure 2 Structure 3 Structure 4 Strucaure 5 Structure 6
Identifier:
Freeboard(inches): ............................................... ................................... ...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 00o
seepage, etc.)
3/23/99 Continued on hack

Facility Number: 7 Date of Inspvction
6. Are there structures on -site which are.not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
XNO
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
T 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
.No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
KKNo
Waste Application
10. Are there any buffers that need maintenance improvement`?
❑ Yes
RNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
KNo
12- Crop type elqtn-63�jc't k r::S�'4
13. Do the receiving crops differ with those desi bated in the Certified Animal Waste Management Plan (CAWMP)?
' ❑ Yes
No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
EfNo
b) Does the facility need a wettable acre determination?
❑ Yes
PdNo
c) This facility is pended for a wettable,acre determination?
❑ Yes
WNo
15. Does the receiving crop need improvement?
❑ Yes
gkNo
16. Is there a lack of adequate waste application equipment?
❑ Yes
Mo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
�No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
KNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
j"No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
XNo
21- Did the facility fail to have a actively certified operator in charge?
❑ Yes
WNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
KNo
(ie/ discharge, freeboard problems, over application)
23, Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
ZNo
24. Does facility require a follow-up visit by same agency?
❑ Yes
VNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
5�No
0: No•yUhtidns:or• deficiencies were noted• dt:tlririg Obis:visit; • Y:oit W-111-reeeiye ii6 #'arthe.
............... ...
correspoiideittce: abauf this visit
Alps are- r'a,ise j
/ 4 �1Cex� r' lot e i 5
eF as
Bn 7 ►t a
W L
&-r IC ^j A I C 5 j3 le - a
P
Reviewer/Inspector Name
Reviewer/Inspector Signature: _ Date: / 2 — 2-3
q
3/23/99

Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other J
nu�r urn n i ,��^■ —� ru
Facility Number Date of Inspection
Time of Inspection ,'� 24 hr. (hh:mm)
0 Registered 0j Certified 13 Applied for Permit © Permitted 113 Not Operational Date Last Operated:
Farm Name:Oxt°rc �i.t �e�r Count .................................
Owner Name: .5 Il. 1C� .........................
.... ..r... ........................... ................. L..in..�.............................. Phone No:..�1.��..�Z.� ...�1.�:.T
FacilityContact: h ems ~ Phone No: .ter
5�................................................................... Title•............................................I...................................................................
�......�,U3�Ma' ' Address•....-...................j...................... z7
Onsite Representative: ............................ ........ Integrator:........................
Certified Operator, .................................................. ... Operator Certification Number, ................ -.........
Location of Farm:
Latitude Longitude 0• ��
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars 4
Current, Design,, 3 :'.'Current
Poprilatton,w .: Popitry,Y, Capacity Population w: Cai
❑ Layer ❑ Dairy
❑Non -Layer ❑ Non -Dairy
❑ Other 17.
Q ;
Total Design Capacity-
`Tata1 SSLWF�
❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
❑ No Ligtttd Waste Management System Y}
General
I. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
2. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon [ISpray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Surface Water? (If yes. notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gaUmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
4. Were 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 lagoonsiholding ponds) require ❑ Yes ❑ No
mainten anceli mprovement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes ❑ No
7/25/97
Continued an back

Facility Number• � --
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
❑ No
Structures La oons foldin Ponds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
fSkNo
Structure I Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier:
Freeboard(ft):
.......... .............. ................................. ....................................
.................................... ....................................
10. Is seepage observed from any of the structures?
❑ Yes
❑ No
11, Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
❑ No
12. Do any of the structures need maintenancelimprovement?
❑ 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 maximum liquid level markers?
❑ Yes
❑ No
Waste Application
14. Is there physical evidence of over application?
❑ Yes
❑ No
(If in excess of WNW, or runoff entering waters of the State, notify DWQ)
15. Crop type
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
❑ No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
❑ No
18. Does the receiving crop need improvement?
❑ Yes
❑ No
19. Is there a lack of available waste application equipment?
❑ Yes
❑ No
20. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
22. Does record keeping need improvement?
❑ 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?
❑ Yes
❑ No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
❑ No
[]-No.vitilatioils_or. de'ficiencies.wer'eittited,during this.visit.- You,will receive:rto f i Cher
correspondek6 ti oid this:visit:. "
Air, Qxe,, ;,ae ka5 Ja+eQ�ed +Ae 'iQc' 1;� die c�5 re k t.�.
(47S r_!'e Pei"'j J41D:)+eU -0 C"dr j laf �T t i5 / erne. /4 !S
C�t►r!'��c-��
u►�er- --f'jtO �re5ko1 . 14wever he euill Pnjoba-bl Gee 6re�r I-Ae
�hre5ko1c1 J`n 1qC1q IV .SQOi.e Coar-a-r- e__� -f-Ae_
AObt'50-)';_ c, A9, a, j, d a drj /Oijlait Aoto
beet" d e U 4b19e 4r n i 44 ' 7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: 17 Y -

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
February 24, 1999
CERTIFIED MAIL
TURN C IPT REQUESTED
Billy-0xen�ine
Billy Oxendine Farm
Rt 1 Box 292-A
Pembroke NC 28372
Farm Number: 78 - 89
Dear Billy Oxendine:
4 0IT •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
-C
1999
r_AYI�_ _V_1LLt
i7IM' --. i .,JL�
You are hereby notified that Billy Oxendine Farm, in accordance with G.S. 143-215.1OC, must
apply for coverage under an Animal Waste Operation General Permit. Upon receipt of this letter, your
farm has sixty (60) clays to submit the attached application and all supporting documentation. In
accordance with Chapter 626 of 1995 Session Laws (Regular Session 1996), Section 19(c)(2); any
owner or operator who fails to submit an application by the date specified by the Department
SHALL NOT OPERATE the animal waste system after the specified date. Your application must
be returned within sixty (60) days of receipt of this letter. Failure to submit the application as required
may also subject your facility to a civil penalty and other enforcement actions for each day the facility is
operated following the due date of the application.
The attached application has been partially completed using information listed in your Animal
Waste Management Plan Certification Form. If any of the general or operation information listed is
incorrect please make corrections as noted on the application before returning the application package.
The signed original application, one copy of the signed application, two copies of a general location
map, and two copies of the Certified Animal Waste Management Plan must be returned to complete the
application package. The completed package should be sent to the following address:
North Carolina Division of Water Quality
Water Quality Section
Non -Discharge Permitting Unit
Post Office Box 29535
Raleigh, NC 27626-0535
If you have any questions concerning this letter, please call Susan Cauley at [phone]
extension 546 or Jeffery Brown with the Fayetteville Regional Office at [phone].
Sincerely, /
for A. Preston Howard, Jr., .E.
cc: Permit File (w/o encl.)
F.ayettevillc_Regional,Office:(.w/o-enciv)
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

❑ Division of Soil and Water Conservation ❑ Other Agency
('Division of Water Quality
112PRoutine O Com taint O Folio"--u 2 ol'DW'Q ins ection O Follow-u of I}.S%VC rc%,iew O Other
Date of Inspection
Facility Number
Time of Inspection C10 24 hr. (hh:mm)
VRegistered 0 Certified © Applied for Permit © Permitted JE3NotOperatittnal�J Date Last Operated:
Farm Name: /�..1........
County j i n 2 t•-Ylrt✓ . • ....l .D. ,S4.+............................................ .
t 1 ?.J�4.....s......................................................................
Ownern.......................................................... Phone No:,Z �. `...........................................
........... ....
Facility Contact: ...c.l. ..0 Xe n d� �1 Title: r�1 •ti e Phone No: .
�.. Q `j....
Mailing Address : 1�• 1 D Z�� -�. AfNtf�...... .. L�— .............................. ZS3]z_
Onsite Representative: ......................... ........................... ..... Integrator: ...... ........._. 2.�.................. _..
Certified Operator:............................................................................................................... Operator Certification Number:.........................................
Location of Farm.
Latitude •1 44 Longitude 4 "
« -'Design -,.Cunt
the a " :Capacityx Papula
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder f a
Farrow to Finish
Gilts
Boars
Design .Z.Curreent"
a'x Potittry Ca actty ; Population C
I❑ N on -Layer
I
y.�
❑ Other
;¢
T©tal Destgn Cal
4 ?
atal"S
0
Number of Lagoons / ft lding)P6ii&ij ❑Subsurface Drains Present 113 Lagoon Area I❑ Spray Field Area
❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement?
2. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a_ If discharge is observed, was the convevance man-made`'
b, if discharge V, observed, did it reach Surface Water? (If yes. notify. DWQ)
c. If dischai-e is observed, what is the estimated flow in Ual/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 mana;ement system (other than Iagoonslholding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes V,No
❑ Yes l�0
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes tNo
o
❑ Yes
❑ Yes P(No
❑ Yes i No
❑ Yes �No
Continued on hack

Facility Number: 7f —
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (LaQoons.Ilolding Ponds. Flush Pits. etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
❑ Yes/�No
❑ Yes [ o
Structure 5 Structure 6
Identifier:
Freeboard (fty ...... ..........
10. Is seepage observed from any of the structures? ❑ Yes XNo
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes A�No
12. Do any of the structures need maintenance/improvement? ❑ Yes XNo
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type C d.M AJ�(ra-f s� s• .�f� .....
15. Do the receiving crops dif er with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19, Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
No.violations or deficieneies.were noted -during this:visit..:You'rvill recei've-nti further::
cdrrespondence ii out this.visit:
Mr. &)ei dive (`s GIaY`�C�y� Bti C���C��'u+� Gv,`�L. N%1CS�
IUe0.4 + C 1 ea , 4-O_ - 4" I
ReviewertInspector Name
❑ Yes '0 No
❑ Yes JKNo
❑ Ye10
❑ Yes %No
❑ Yes WNo
❑ Yes RNo
❑ Yes O'No
0 Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
7/25/97
Reviewer/Inspector Signature:
Date: -12-T9_