780098_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qua'
II

Type of Visit ® Compliance Inspection 0 Operation }review 0 Lagoon Evaluation
Reason for Visit (D Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
i Facilit}- Number I Date of Visit: ab o Time:
i - JOLN7at Operational 0 Below Threshold
® Permitted ® Certified M Conditionally Certified © Registered Date Last Operated or Above Threshold
Farm Name: County:_
Owner Name: Cee, 1,ec7 ��S - O Phone No: _ O AZ t'J 6.Z 7
Mailing address: o,X \ �o _ _ C + 0$AW
Facilit-3- Contact: h8c,-1j: M4_. . (act, Phone No:
Onsite Representative:_Integrator: a f'
Certified Operator: .�1X.P.e : [� Operator Certification Number: 1� a
Location of Farm:
9 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 0 " Longitude ' �•
Design Current
Swine ('anari/t pronnlatinn
❑ Wean to Feeder
® Feeder tc Finish S a D
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ -Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Cariacitv Population
Laver ❑ Dain
❑Non -Laver ❑Nor -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons I S _ I ILI Subsurface Drains Present IL Lagoon area IL Spra} Field Area' 'I
Holding Ponds / Solid Traps ❑ No Liquid Waste Management Svstem
Discharges S Stream impacts
1. Is anv discharge observed from any par of the operation?
Dischame originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (if yes, notifi- DWQ)
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge by-pass a lagoon system? (If ves. notify DWQ)
2. Is there evidence of past discharge from any par 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 CollLction 8- Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103/01
34
3(�,
❑ Yes Imo" No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ YesNo
FU
❑ Yes 19 No
Structure 6
Continued

Facility Number: Ij — q f' Date of inspection �o 0
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste_ Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes �INo
❑ Yes [�[No
❑ Yes [ No
❑ Yes �] No
❑ Yes No
❑ Yes No
❑ Yes [� No
12. Crop type _ .__R e C nA t t a IZ -�_ S" CWvC_r r�, (_") L .S , , —
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA WMP)? ❑ YesNo
14. a) Does the facility lack adequate acreage for land application? ElYes gNo
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?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, 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?
❑ Yes PNo
❑ Yes P No
❑ Yes QNo
❑ Yes [:No
❑ Yes PNo
❑ Yes QjNo
❑ Yes [& No
❑ Yes No
❑ Yes ® No
24. Does facility require a follow-up visit by same agency? ❑ Yes P No
25. Were any additional problems noted which cause noncompliance of the Certified A WMP? ❑ Yes [!XTVo
Q No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.

Facility Number: '�— �j� Date of inspection O
Odor Issue
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. is there any evidence of wind drift during land application? (i -e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanenthemporary cover?
❑ Yes ❑ No
❑ Yes ES No
❑ Yes allo
❑ Yes 51 No
El Yes IM— No
10
❑ Yes 5 No
❑ Yes ❑ No
Additional Comments and/or Drawings:
Ak
05/03/01

r
1W
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit ® Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other
❑ Denied Access
L -- Facility Number _ }
Date of Visit: � Time: ��
Ero ?got Operational 0 Below Threshold
Qj Permitted Certified 13Conditionally Certified © Registered Date Last Operated or above Threshold:
Farm Name: U'rr-p(I Fc r , .5 Zn County: 2��eSsn i-2
Owner Name: n , LAS' i9t 70 .1 2 _ Phone No: 9 10�-
'Mailing Address: G
Facility Contact: Title: 1--+\1 M Phone No: 4w a
Onsite Representative: G Integrator: Carr e t l S
Certified Operator: Ax e'v% ill ; ne- Operator Certification Number:_ 1�� .5 n
Location of Farm:
OS41 of S< I I Ri t�sr- Li g ut._ c� �,,5� 13 a r SK (i8 r
Ea Swine ❑ Poultry ❑ Cattle ❑ horse Latitude ' 1 " Longitude ` • -
Design Current
Swine C nnarity Pnnnlatinn
❑ Wean to Feeder
® Feeder to Finish a
❑ Farrow to ' V can
❑ Forma to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Laver I 1 10 Dairy
❑ Non -Laver 1 10 Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons Ir I ILI Subsurface Drains Preseat fIL1 Lagoon Area IL Spray Field Area
Bolding Ponds / Solid Traps JEI No Liquid Waste Management'Svstem
Discharges & Stream Impacts
1. Is anv discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Snrav 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 D WQ)
c. If discharge is observed. what is the estimated flow in eal/rnin?
d. Does discharge bNTass 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 1 Structure 2 Structure 3 Structure 4 Structure
Identifier:
❑ Yes Q No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
5� No
❑ Yes
®No
❑ Yes [�No
Structure 6
Freeboard (inches): 23
05/03101 Continued

I
M
Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes [P No
seepage, etc.)
6_ Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6was 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 M 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/improvcment? ❑ Yes MNo
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 (CA WMP)?
❑ Yes
M No
14, a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
R3 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
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
0 No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
P No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
q No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
M No
21-
Did the facility fai I to have a actively certified operator in charge?
❑ Yes
O No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes O No
23. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative? ❑ Yes Lai
"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 [e No
Q No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Field Copy ❑ Final Notes
Mo am pi" �r "ate- G,'A--'1

Facility Number- Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or la�,00n fail to discharge atior below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. is there anv evidence of wind drift during land application? (i.e. residue on neighboring vegetation. asphalt.
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. l ere any major maintenance problems With the ventilation fan(s) noted? (i -c. broken fan belts, missing or
or broken fan blade(s)• inoperable shutters. etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
3-. Do the flush tanks lack a submerged fill pipe or a permanentltemporart' cover?
Additional Comments and/or Drawia2s:
05103101
❑ Yes 0 No
❑ Yes p No
❑Yes ®No
❑ Yes [RNo
❑ Yes ®,No
❑ Yes ( No
❑ Yes v No

Type of Visit • Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facilih- Number Date of Visit: dz Time: 6 -
Not erational SeloK- Threshold
■ Permitted E Certified O Conditionally Certified ❑ Registered Date Last Operated or Above Threshold:
Farm Name: X, w, 06(— 70 72 County
Owner Name: .Si_'7 �� SPhone No: 1 _/10
Mailing Address: . 6), Los- zo_vx
Facility Contact: S L 4..} Title: Phone No:
Onsite Representative* P, 1/4 L�4l�iJ� Integrator: Sa—,ZZ '1�
Certified Operator:�7i. _a « � � Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude a " Longitude 0' �'-
Design Current Design Current Dese;tr Current "^
Swine capacity 'Papulation P.ouMry Capacity Po ulatxoii
. Cattle : 'Ca acit�:�`Po ulataon . -
❑ Wean to Feeder -= ❑ La er' ❑ DaI
® Feeder to Finish)?,VOZ� I JC1 Non -Laver I Non -Dairy
:c
❑ Farrow to Wean ` - -
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design'Capacih°
❑ Gilts
❑ Boars ,Total WSSLW
'Number. of Lagoons 0
❑ Subsurface Drains Present
:Holding Ponds'i Solid Traps ❑ No Liquid Waste Managen
Discharges R Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon Cl 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 Collertion & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3
Identifier:
Freeboard (inches):
05/03/01
ray Fieid Area
❑ Yes No
❑ Yes 5 'No
❑ Yes XNo
❑ Yes �;No
❑ Yes �KNo
❑ Yes ffNo
❑ Spillway ❑ Yes i— No
Structure 4 Structure 5 Structure 6
Continued

Facifi Number: -ZZ Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage. etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes �No
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
T Do any of the structures need maintenance/improvement? ❑ Yes No
S. Does any part of the waste management system other than waste structures require maintenancelimprovement? El Yes RNo
9. Do any sructures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes XNO
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes StNo
I I.
Is there evidenceofover application? El Excessive Ponding El PAN El Hydraulic Overload
El Yes
�No
12.
Crop type cc 'sC4i
!J
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA A MP)?
❑ Yes
No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
No
Reviewer/Inspector Signature: Date: a�
b) Does the facility need a wettable acre determination?
❑ Yes
NO
c) This facility is pended for a wettable acre determination?
❑Yes
No
i�
15.
Does the receiving crop need improvement?
❑ Yes
kNo
16.
Is there a lack of adequate waste application equipment?
❑ Yes
;KNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes $rNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ✓ f ❑ Yes ,®'No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes WNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes PNo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes (RNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes FNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative? ❑ Yes FNo
24. Does facility require a follow-up visit by same agency? ❑ Yes 0�40
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes KNo
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comnn6nts;(refer'to question # Expl" anybYES i3eswers aud/on"any retommendsttons"or snv other comments.
Use dra_7rigs Of facilrty to better cYplsua sttuahOnS: (nse addrtlaAal pages: as ntcessary3 _ ❑Field Conv ❑Final Nates
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: a�
05/03/01 Continued

Facility Number: — 9
y I Date of Inspection 8 DZ
dor issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/orbelow ❑ Yes 4�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 )�-No
28. 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)
29. Is the land application spray system intake not located new the liquid surface of the lagoon? ❑ Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes No
Additional'Comments and/or Drawings:
�-t' _-4i;0 .�4 VIA R
I
A.
05/03/01

r }
Division of Water Quality x,
ik
_ _ - Q Divt on of:Siiil and Water Conseiwatron ,
Q Other Agency'v - -
IType of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit f5LRoutine O Complaint O Follow up O Emergency Notification O Other
❑ Denied Access
Facility Number Date of Visit: Time: E:::= Printed on: 7/21/2000
Q =Not Operational Q Below Threshold
Permitted ❑ CertMed [3 Conditionally Certified ❑ Registered Date Last Operated 2,bove Threshold. ....................Farm Name 7D 77i County:.....,(�..0.....................................I.......
...................................... ...................................................................
Owner Name: era rptia
f ... .. ......&
S.. s ...................... Phone No.....................................................................................
Facility Contact: .... �2.......�.. ......�/..! ?......................... Title:.... ��.� :..../ .!.. .:.......................... Phone No:................................................
Mailing Address:
OnsiteRepresentative:......................................................................................................
Certified Operator: �A i A y..-._.... ! 'i �n- e
Location 'of Farm: I
Integrator:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ cattle ❑ Horse Latitude �' 0` ��� Longitude
Desigiu Current
Gana©tv. . Population
Design Current Desigq 'Carrent'-.
Poultry Capadty Population Cattle -Cipidtj 0olliuMtllion,
❑ Layer ❑ Dairy
❑ Non -Layer I 1 10 Non -Dairy
Other
Total Design Capacity
TOWS"
_ Nr;of Lagotiittis Subsurface Drains Present ❑ Lag�xw Area ❑Spray Field Area
Haiditag'PDtts % Solid Traps❑ No Liquid Waste Management System
Discharges & Stream Imeacts
1. is any discharge observed from any part of the operation? ❑ Yes KNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made! ❑ Yes 0 No
b. If discharge is observed. did it reach Water of the State'? (if yes, notify DWQ) ❑ Yes V�,No
c. If dischar2c is observed. what is the estimated flow in gallinin?
d. Does discharge bypass a lagoon system) (If yes, notify DWQ) ❑ Yes KNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes CA No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes VNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes #No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
5100 Continued on back
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Y
Boars
Design Current Desigq 'Carrent'-.
Poultry Capadty Population Cattle -Cipidtj 0olliuMtllion,
❑ Layer ❑ Dairy
❑ Non -Layer I 1 10 Non -Dairy
Other
Total Design Capacity
TOWS"
_ Nr;of Lagotiittis Subsurface Drains Present ❑ Lag�xw Area ❑Spray Field Area
Haiditag'PDtts % Solid Traps❑ No Liquid Waste Management System
Discharges & Stream Imeacts
1. is any discharge observed from any part of the operation? ❑ Yes KNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made! ❑ Yes 0 No
b. If discharge is observed. did it reach Water of the State'? (if yes, notify DWQ) ❑ Yes V�,No
c. If dischar2c is observed. what is the estimated flow in gallinin?
d. Does discharge bypass a lagoon system) (If yes, notify DWQ) ❑ Yes KNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes CA No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes VNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes #No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
5100 Continued on back

Facility Number: '7 — 8' Date of Inspection printed on: 1/9/2001
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 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 maintenance/improvement?
11. Is there evidencAe4-w,,�a/-ZI.4
f over application?? ❑ Excessive Ponding [I PAN []Hydraulic Overload
12. Crop type evidence
/ C i -o -s Q 6C-'_SCCeJ/
13. Do the receiving crops differ with thosevignated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & GeneraI 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? (ic/ 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?
❑ Yes �No
❑ Yes PNo
❑ Yes )I�No
❑ Yes �o
❑ Yes qNo
❑ Yes )?fNo
❑ Yes INo
❑ Yes Mf No
❑ Yes ,C;rNo
❑ Yes WNO
❑ Yes ONO
[]Yes AfNo
❑ Yes 9io
❑ Yes ONO
❑ Yes ONO
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes ($No
❑ Yes No
❑ Yes No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes VNo
-001)ktiOris'oir d+rrjcj6nk es -**re note# d&tng fhis:visit.'- Yoitt will dee iYe Ad further
corresPa Bence' abouti this visit`
Comments {refer to ques#ton #} Eatplajn-any YES answers an�Vor any. rocoanuendatlons or any othercommeals:�. �'�
Ise di^a of fachli #o.better Iain sltiva4ons use addrtaonal es asp.,
�e�d S rel Wt T+ti `76 73 N ePd S to ar k of - co)-- e- 4; ca. &-c-k C;e d I -J Q� oj.
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: SZ�-or' S/f1Q

X
Facility Number: 7S — S Date of Inspection Z _e Printed on: 7/21/2000
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 P(NO
28. 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)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ((No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes j2chio
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes R No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
AdditionW Comments'an orDrawings:.
J
5100

~~---77 ffJJ
Farm Name: .......... .........................��....l.......... ........... County:.......1SQ.....?r.
Z . ........................I................
Owner Name:..�q.rrQl.�.IS.......... r��s ..... Phone No: .......Z76..p6.ll........................... ....... _.....
Facility Contact: ... `. �r....... r ............................ Title: .... y s..................... Phone No: ............................................. .....
Mailing Address: � � ' .!'ai ?l ................................................. ....... G4 t S�... L iC.................. .. z �5 l
j.._.
Onsite Representative: ....... Integrator: ...................... . . .
Certified Operator: ............................. ...................... ........ ............... ............................ I......... Operator Certification Number:..........................................
Location of Farm:
Latitude 0 9 64 Longitude lam• 4 11
Design ` -Current Design GurreQt Design :Current
wine Ca ac�ty.::Po ulahon; .Poultry Ca act - Po`ulatian Cattle _.- =. Ca acr `Po uiatzon,
❑ Wean to Feeder ❑ Layer Y ❑ Dairy
Feeder to Finish ❑Non -Layer ❑Nan -Dairy
❑ Farrow to Wean W N..: M>,_ _. • r
❑Farrow to Feeder ❑ Other
Farrow to FinishTotal Desi Ca act W
❑ Gilts P
E] Boars Totai'SSLW
Nninber of Lagoons : ❑Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area gi,
Holden Ponds /-Solyd 'Traps ❑ No Liquid Waste Management System b
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 KNo
❑ Yes 06 No
❑ Yes [ No
❑ Yes ji No
[]Yes ONO
❑ Yes KNO
Structure 6
Identifier: A
Freeboard (inches} : .............�.
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, [] Yes �-No
seepage, etc.)
3/23/99 Continued on back

Facility Number:-) — Date of Inspection
❑ Yes
No
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
--�� T T V T Wim,
Use drawings of fac�Lty to betterexplain sttuatrons�(use addibonalxpages aslnecessary} .
'3'sc_f..
closure plan?
❑ Yes
KNo
(If any of questions 4-6 was answered yes, and the situation poses an
No
19.
immediate public health or environmental threat, notify DWQ)
❑ Yes
No
7. Do any of the structures need maintenancetimprovement?
❑ Yes
RNo
8. Does any part of the waste management system other than waste structures require maintenancetimprovement?
❑ Yes
yl No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
No
22.
elevation markings?
❑ Yes
M No
Waste Application
(ie/ discharge, freeboard problems, over application)
❑ Yes
10. Are there any buffers that need maintenance/improvement?
❑ Yes
NNo
'a Ponding ❑ PAN
11. Is there evidence of over application? ❑ Exc75;
❑ Yes
IQ No
12. Crop type— 6 2L ► er-S
❑ Yes
No
13. Do the receiving crops differ with those designat in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
NNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
EO 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
0 No
16. Is there -a lack of adequate waste application equipment?
❑ Yes
CO No
Reauired 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?
--�� T T V T Wim,
Use drawings of fac�Lty to betterexplain sttuatrons�(use addibonalxpages aslnecessary} .
'3'sc_f..
iajjs 7"Ad iJe-1'e f fi a re C i aloe pre -4 well
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
No
23,
Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑ Yes
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?
❑ YesNo
�'V[i yiolatiQris:or defciezic3e5 vt=ere noted d4rrit�g �fijs.visit'.-:Y:ou Wdj,teeeive rio' #ui-th�r
- Tories' Henke_ aboult_ this :visit:... . .......... .
Curetments (refer to questzon #} Eacpiam a y YES answers and/or ani recommendat<ons ar.any other comments _....
--�� T T V T Wim,
Use drawings of fac�Lty to betterexplain sttuatrons�(use addibonalxpages aslnecessary} .
'3'sc_f..
iajjs 7"Ad iJe-1'e f fi a re C i aloe pre -4 well
4-6 lvork a-.--- we S,
Reviewer/Inspector Name
Reviewer/Inspector Signature` Date: 6/2 _ Z C5__dV
f F

Facility Number: 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 0Yes ❑ 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 qNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ,EgNo
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 ONO
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 WNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 7k`To
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? Yes ❑ No
-Addifionagl& is and/or-'DrawingA.

Y
Water Conservation - Opefi on Revrew
© Divtslon of:Soil and Wates Conservation - Co[riphance Inspection
Drvision of Soil and
�wrsron of Water Qualrty -'Compliance Inspection _ = t
Othci,Agency`- Opera tion;Revrew.: M
Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number 6 Date of Inspection
Time of Inspection 1 24 hr. (hh:mm)
Wermilted © Certified [] Conditionally Certified © Registered [3 Not Operational Date Last Operated:
Farm dame: 74�,! County:.......�e.sOn--..................................
I........................................
Owner Name: .....+ .5......... 4' ..... ......yF .................... Phone No:..........2. tv..l.f i`T
. + .............................................
Facility Contact: ...Le..�........... T .......................... Title:... G�tl V ,.....q•.... Phone No:
ltlailingaddress: .... .•.a....( .................................................................................,......h!�a:r.��}....`.C......................... �.;..
Onsite Representative:.... {......... . .... .................................................... Integrator:.........................,............................................................
Certified Operator: ... ............................. /a-CC� Operator Certification Number: ..........................................
..................................................................
Location of Farm:
.......................... .............._........... ............................................................................................. ...................................................................................................� .tom
Latitude E=:, Longitude • ° C cc
Design Current Design Current 'Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer ❑ Dairy
Feeder to Finish ❑ Non -Layer Irl Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity �QQ
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑Subsurface Drains Present 110 Lagoon Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
DischaMU & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance lnan-made'.'
h. 11' discharge is observed, did it reach: ❑ Surface Waters ❑ Waters of the State
c. II-dischas-e is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon syMC111?
2. is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts to the waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier;
Freeboard(inches): ........--� ................... ................... ................................... ... ............. ................................
.......................
Spray Field Area
❑ Yes �No
❑ Yes OINo
❑ Yes tiNo
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes �LNo
Structure 6
1/6/99 Continued on back

Facility Number: 7 — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
El Yes No
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan? � ❑Yes �] No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement'? ❑ Yes 10 No
8. Does any pact of the waste management system other than waste structures require maintenance/improvement? ❑ Yes EA No
9.
Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
..-or
etirr.... detZ .. about: this ;visit.; :: ; ; : ; ; : ; ; ; ; ; ; ; ; ; ; ; , ; , ; ; , ; ,, ; ,,,, ; ,
liquid level elevation markings?
❑ Yes
® No
7�
Waste Application
eti s 11 ti 'C/��rrz ed.
ilib ! rr; ka
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
J No
11.
Is there evidence of over application? ❑ Ponding ❑ Nitrogen
❑ Yes
Q No
12.
1 C
Crop ll......r4!.«.--.........
type......r/it�C�q.....f4..................(..f�
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14.
Does the facility lack wettable acreage for land application'? (footprint)
❑ Yes
No
15.
Does the receiving crop need improvement'?
❑ Yes
No
SN
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
1
Re uired Records & Documents
17.
Fail to have Certificate of Coveratle & General Permit readily available?
❑ Yes
No
I&
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(icl WUP, checklists, design, maps, etc.)
❑ Yes
No
19.
Does record keeping need improvement`? (lel irrigation. freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
�No
21.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
q No
22-
Fail to notify regional DWQ of emergency situations as required by General Permit'?
(ie/ discharge, freeboard problems, over application)
❑ Yes
No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
No
10- No.violattons deficiencies .were rioted. during this -visit.. ;You �iviyl.reeeive nv r6riiier . ;
..-or
etirr.... detZ .. about: this ;visit.; :: ; ; : ; ; : ; ; ; ; ; ; ; ; ; ; ; , ; , ; ; , ; ,, ; ,,,, ; ,
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) :-
1k.5' I`s a nej :!i .
eti s 11 ti 'C/��rrz ed.
ilib ! rr; ka
��;
I 1
rctr 1 tr�K� C ��c� 4-
Reviewer/Inspector
Reviewer/Inspector Name 3c,
Reviewer/Inspector Signature: Date:
1/6/99

Division of Soil and Water Conservation ❑ Other Agency
jf'Division of Water Quality
I! Routine O Complaint 0 Follow-up sif DWQ inspection 0 Follow -ug of DSWC review 0 Other
Date of Inspection
Facility Number p 24 hr. (hh:mm)
Time of Inspection �%' 3
0 Registered Certified © Applied for Permit J'Permitted 0 Not Operational I Date Last Operated: „•....
�ar•ro' 5 9 % Count.- [i�.
FarmName: 1. ..............................
��&Owner Name: � lI .s ....... f..-.�'C............................... Phone No: ........... .fl0.—'n-33-....�'3 i. F.T.....................
Facility Contact: -� fi Title: .... Phone No:.................. .........
MaiUmg Address' ..........FQ.........0.t !diet ..............�J.... .......... .........!!V4 r i!v.,,e.....N(.�....................... a�./..G......
Onsite Representative:........... C j../........... fA �t Z. ... . integrator: ............. 6ZLfro..11s..........1.-�...-�.
Certified Operator, ...............C..'.il
............................ �:.............................. Operator Certification Number:.------------.....
Location of Farm:
Latitude 0• 1 ig Longitude ° 66
me " '{
Current A Design "Current:
V: Pgpulatson -' Poultry :=,Capacity �Popirlation-" {Cattle,,,,
�.,; ❑ Wean to Feeder
Feeder to Finish pp
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
F�
'I❑ Non -Layer
❑ Yes
}
ELI Non -Dairy
27.
"Z ❑ Other
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
Yes
;U No
f, �
Total Design CapacityG<
Dd No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
Total SSLW
No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
Subsurface Drains Present jjU Lagoon Area
`❑ No Liquid Waste Management
4 ;fir" Cbrrent � 7
tcrtyPopiflatipn' '
QUO
Spray Field Area
General
I. Are there any buffers that need maintenancelimprovement? ❑ Yes [fNo
2. Is any discharge observed from any part of the operation? ❑ Yes 0 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the convevance man-made? ❑ Yes 18 No
b. if discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
[K N, o
c. if discharge is ohserved, what is the estimated flow in gal/min?
� '`
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
Yes
;U No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
Dd 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 lagoons/holding ponds) require
❑ Yes
No
maintenancelimprovement?
6. is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
No
7125/97
Continued on back

Facility \umber: ' Gl
8. Are there lagoons or storage ponds on site which need to be properly closed'!
Structures (LaPoonsflolding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes [�INo
❑ Yes J[No
Structure t Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (ft): ..................../
...............................................................................................................................................................................................
1^�t<
10. Is seepage observed from any of the structures? ❑ Yes A No
IL Is erosion, or any other threats to the integrity of any of the structures observed'? Yes ❑ No
12. Do any of the structures need maintenance/improvement? ($1 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 tack adequate minimum or maximum liquid level markers'? ❑ Yes 0 No
Waste :application
14. Is there physical evidence of over application? ❑ Yes ;,No
([f in excess of WMP, o�runftf erin waters of the State, notify DW )
15. Crop type ............................. ..................... f......... s................ ... d1"tti........_...._............................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMPP ❑ 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 C4 No
19. Is there a lack of available waste application equipment? RYes ❑ 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 f 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 VNo
24, Were any additional problems noted which cause noncompliance of the Certified AW,MP? ❑ Yes JR No
25. Were any additional problems noted which cause noncompliance of the Permit'? ❑ Yes JM No
Q No.violations or deficiencies were noted, during' this. visit. .You.will receive no further
correspondence about this visit'.-
Comiinents;(refer`to,question #.): Explain `any VES answeirs and/oranv rec6nki endations Oran, other co=nents
.
Use'di^ -wings of facility O better°explain situations. (use,additianal pages as ne6es,,46r "AL
ff /a, &•w'I �utt 010 COmr04A 0 0-h
se e Wo a - a tM _(LO alvwc
6 U
;3PAA�
S.7I25197
Reviewer/IjectorName
Reviewer/Inspector Signature: Date:
a / f ��

❑ Division of Soil and Water Conservation ❑ Other Agency
[Division of Water Quality
Routine O Complaint O Follow -u of DAVQ inspection O Follow-uof DSWC review O Other
Dale of Inspection
Facility Number -] Time of Inspection ; 3a 24 hr. (hh:tnm)
13 Registered Certified © Applied for Permit © Permitted JE3 Not Operational Date Last Operated: „•
Farm Name: CA p .* 70 7 Z Countv:.......RO ................ 6,0-................................................
rr
Owner Name: C n r`ajloE. ' S....Fa.%a...s... Phone No 2 74 ....-0(- 41
............. ...........................................
`
Facility Contact: .4e4 5&76 ..... Title:..6.V..t....x......................... Phone No:....- . .......................
Mailing Address:.... r.O.�ra�,�er SSL .........................W,.q r'v ►vC 293 cV
Onsite Representative: --baa ..........................................................,.--,4 ►k5 Integrator: --....0 rrn- IA...........
Certified Operator, ................................................ ................... Operator Certification Number;
Location of Farm:
........................ _................................. ......... .......................... .-..................................................... I.................... ,.
Latitude • =' <G Longitude 0 ° 44
" : ' Design ° w , s-; # Design Current DesrgnkCurrett .
_Curren#
Capacity Pla a try Po Mahan Cattle... act Poulatian
„Srwtne « , .
N opufton Pauitry FCap pct w
MW
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non-Dairys
;r :r
❑ Other n M..
back
_
Total Design Capacity.
�= _
Total" SSLW
.,... _.. ,. ._....
K•:: ...,. ivry ,wa '?'.. ,.s: N.. �-r, .4 flhbn �' 0 .iu .{ko .',
* MNutnber of Lagoons /Holding Ponds ' ❑ Subsurface Drains Present Lagoon Spray Field ©L n
r
� Yrs `��
r
, ❑ No Liyuid Waste Management System
Fes,
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
Farrow to Finish
❑ Gilts
❑ Boars
❑ Yes �No
!r!r
ElkNo
General
1. Are there any buffers that need maintenancelimprovement?
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 conveyance man-made?
b. If discharge is observed, did it reach Surface. Water'? (11 ves. notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
A. Does discharge bypass a lagoon systein'? (If ye;, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
mai ntenance/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?
7125197
Yes
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
[I Yes ANo
❑ Yes O(No
❑ Yes � No
❑Yes �No
❑ Yes �'(No
Continued on
back

Facility Number: 771L If
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (La oons,tioldint' Ponds, Flush Pits, etc.►
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure ? Structure 3 Structure 4
Identifier:
... .......... ........ r........... .................
Freeboard (ft)- ............ !................. ......... :..,
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenancelimprovement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
a
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes # No
❑ Yes XNO
Structure 5 Structure 6
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering aters of the State, notify DWQ)
��
15. Crop type .................. .._................................ ._
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on-site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities On]
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.violitio'ns,or deficiencies were noted during this" visit. - You'.wiH receive -no f&iher :
correspondence about this'visif.
❑ Yes P(No
❑ Yes 0 No
❑ Yes N�No
❑ Yes .l�No
❑ Yes )<No
❑ Yes �No
❑ Yes 4No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes 4No
❑ Yes 1�No
❑ Yes ANO
❑ Yes gNo
❑ Yes ❑ No
3 ¢:5b "S"va. -fi-�• G -- rs:� '-: axs- ..•, i k .vPGYC'H. 'AtkT3 W§: 1�'> 3
Camrnents (refer,to question #):; Explain any Yl S{answers and/or any,recOn�meutlations orany ether eoffir& ats;
; ,c w N, : - : axe�u}ei. --" +ti. ;'y. ` uZ k.o •a'R�F j"y .�: m ,a' 2
Useydrawings of faethty`to be#ter exptaiit satuations (use addrtionat gages as necsairy� IS,b �r
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Revicwerllnspector \ame A ,f !,RR
Reviewer/InspectorSignature: Date: l—Z/� 97