780101_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quaf

type of visit: 4p compliance inspection U operation Review V Ntructure juvaluation V Iectmical Assistance
Reason for Visit_ 4P Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: 2' f+ County: Region:
Farm Name: —V6VIIn5 h ���,, ,D��..� _- Owner Email:
Owner Name: 'o �u�q r�S Phone:
Mailing Address:
Physical Address:
Facility Contact: CV P 12�j Title: Phone:
Onsite Representative: 4 Integrator: �;' Ywww/
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
SH He =
Wean to Finish
Design Cnrrent
Capacity Pap.
Wet Poultry
Layer
INon-Layer
D_ . P,oul
Layers
Design
Capacity
I
Design
Ca aci
Current
Pop.
""'
Cnri ent
Por.Non-Dairy
Cattle
Design Current
Capacity Pap.
Dairy Cow
Wean to Feeder
11
Dairy Calf
Feeder to Finish
Farrow to Wean
Dairy Heifer
Dry Cow
Farrow to Feeder
Farrow to Finish
Beef Stocker
Beef Feeder
Gilts
Non -Layers
Boars
Pullets
Beef Brood Cow
Qther .0 V
Turkeys
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
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 F No ❑ NA ❑ NE
❑ Yes [—]No
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes No
❑ Yes No
NA ❑ NE
]NA ❑NE
M NA
❑ NE
❑ NA
❑ NE
❑NA
❑NE
Page I of 3 21412015 Continued

Facili Number: Date of Ins ection:
Waste Offection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: !/
No ❑ NA ❑ NE
No P NA ❑ NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 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 O No [DNA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No 0 NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window, ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): k_&5 {z ju-
13. Soil Type(s): !�
14_ Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
V] No
0 NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
0 NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
10
❑ 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
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 `t j No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22_ Did the facility fail to install and maintain a rain gauge? ❑ Yes �No ❑ NA ❑ NE
23_ If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes `4" No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - Date of Inspection:
2+4. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structures) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes No
[] NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes No
❑ NA ❑ NE
Application Field ❑ Lagoon/Storage Pond ❑ Other:
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
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes :No
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional usees as necessarv).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: q//Jr/1 -7
21412015

I ype of visit: JP Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: & Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: � Arrival Time: 'DG%st_ DepartureTime: O County: O�"Qlvl Region: dC;d
Farm Name: CO ��✓ a�t'i Owner Email:
Owner Name: j(� Gl9�s �17s Phone:
Mailing Address:
Physical Address: �1
Facility Contact: r+ ep Title: Phone:
Onsite Representative: Integrator:�/M�Z%��
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Po!UIMEM-121city
La er
Design
Current
Pop.
Design Gunrent
Cattle Capacity Pap.
DairyCow
Wean to Feeder
Non -La er
I) . P.oul
Layers
Design
Ca aci
Current
P,o .
DairyCalf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
DairyHeifer
D Cow
Non-Dai
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turkey Pouits
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
❑ Yes �No ❑ NA ❑ NE
a. Was the conveyance man-made? ❑ Yes ❑ No NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes [:]No Yq NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes Q�No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes t No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facility Number: - Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
* No ❑ NA ❑ NE
[:]No WNA ❑NE
Structure 6
Spillway?:
Designed Freeboard (in):
�u
Observed Freeboard (in): _
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.) r
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [I No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes CANo DNA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes q No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12_ Crop Type(s): L6i7i7z•`��9� yiJ : �i*t�
13. Soil Type(s): IVIJ� ! Lo
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
® No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[� No
❑ NA
❑ NE
acres determination?
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
[4 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? If yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box.
II
❑ W UP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 1� 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 ® No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

lac' dumber: _01 1 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [P
No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 475
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 Ievels 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
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
(refer to question ft Explain any YES answers and/or any add!
Qs of facility to better explain situations fuse additional oaEes as
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes
❑ Yes
No
❑ NA
❑ NE
No
❑ NA
❑ NE
No
❑ NA
❑ NE
No
❑ NA
❑ NE
❑ Yes F No ❑ NA ❑ NE
❑ Yes r
No ❑ NA ❑ NE
❑ Yes EP
No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
ons or any other comments.
Phone:
Date:
21412015

1 ype of visit: 0 Compliance Inspection U Operation Review U Structure Evaluation U 'Technical Assistance
Reason for Visit: 49 Routine O Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: Arrival Time: / • 'q Departure Time: 2 County: &0jW01 Region:
Farm Name: c! t/ ,,,� Owner Email:
Owner Name: Bi'4cCe C Phone:
Mailing Address:
Physical Address:
Facility Contact: (Zra Title: Phone:
Onsite Representative: u
Integrator: M a"//V—dAk✓AI
Certified Operator: 'j A4-o-, - Certification Number: % Z`J
T !'
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
_
Swine
Wean to Finish
Design Current
I
'Design Current
—it—
VIEPop.
Cattle
Dairy Cow
Design Current
Capacity Pop.
La er
110
Wean to Feeder
iNon-Layer
I
Dairy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
2Q 63
`` W.11" . -. I -
a. ID
D P,unl Ca aci P,o
La ers
Dairy Heifer
Dry Cow
Non -Dairy
Farrow to Finish
Beef Stocker
Beef Feeder
Gilts
Non -La ers
Boars
Pullets
Beef Brood Cow
` `!"
Other
Turkeys
Turkey Poults
Other
Other
Discharges and Stream Imoacts
1. Is any discharge observed from any part of the operation?
❑ Yes
JgNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
® NA
T
❑ NE
C. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
® NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[$�No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
C&No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

FacitiVy Number: ? - Date of Inspection: (,
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ® NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1
Spillway?:
Designed Freeboard (in): _
Observed Freeboard (in): 3 u —
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
❑ Yes ® No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [�q No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes W No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes RN No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes ® No
❑ NA
❑ NE
maintenance or improvement?
1. 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 7 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
in the CAWMP?
15. Does the receiving crop and/or land application site need improvement'?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
® No ❑ NA ❑ NE
®No ❑NA ❑NE
0 No
❑ NA
❑ NE
®No
❑NA
❑NE
[�j No
❑ NA
❑ NE
Reciuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [:]Yes ® No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes ® No
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [�3 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

acili umber: - Zal Date of Inspection: /F
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [P No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of fast survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes [X No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes ® No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes �a No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
D Yes [R 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
0 Yes ® No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[:]Yes ® No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
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 ® No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes FNo ❑ 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).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ` AO-YT-3400
Date: 6/7 ls- _
21412014

type of visit: w t;omptiance inspection CJ uperanon tcevtew V structure Evatuatton V t ecnmcat Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: iArrival Time: Departure Time: County: Poilli Region: P'42�
Farm Name: Owner Email:
Owner Name: �r4tCs( ��..�Slvs Phone:
Mailing Address:
Physical Address:
Facility Contact: ccv'o ylz'l " Title:
Onsite Representative:
Certified Operator: �--
Back-up Operator:
Location of Farm:
Latitude:
Phone: ¢Q��
Integrator: %JR�L✓`'t
Certification Number: /7
Certification Number:
Longitude:
' Design CurrentDesign�Curre�t
Design Current
Swine Capacity . Pop.. Wet Poultty, Capactty`P p
Cattle Capacity Pop.
Wean to Finish Layer
airy Cow
can
Wto Feeder
Non -La er
Dai Calf
Feeder to Finish
� � �
DaiHeifer
)01
Farrow to Wean
7 p
Z m Q
Destgn�Current
D Cow
Farrow to Feeder
Farrow to Finish
D . P,ouIt . Ca aci s P, .,
Non -Dairy
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
ITurkey Puults
Other
Other
Discharims and Stream Impacts
1_Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
[:]Yes ® No ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
[—]No
NA
ONE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes [:]No [O] NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes E� No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes [N No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

FaciffNumber: Date of Inspection: -112EAlf
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No aNA [:)NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: —
Spillway?:
Designed Freeboard (in):
�t
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
Co 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
4 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[9 No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
® No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable, Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
C��[.l
12. Crop Type(s):
( < t1— JR G-OL
13. Soil Type(s): 6LO", C4�tz .-
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
M No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[ No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes © No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [] Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes P
No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

FacUity NuLuber: Date of Inspection: 2 Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
0 Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28_ Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
f�l No
❑ NA
❑ NE
❑ Yes
F�] No
❑ NA
❑ NE
❑ Yes 3 No ❑ NA ❑ NE
❑ Yes [P No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CA WMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34_ Does the facility require a follow-up visit by the same agency'? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question # ): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional oases as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: Q/V'-Yr?- ? :?o0
Date: `7/�Z J`1
21412011

Ii ype of visit: W uompuance inspection V operation tceveew u Ntructure r.vaivanon V t ecnmcai Assistance
Reason for Visit: Routine O Complaint O Follow-up. O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: to- K0. Departure Time: j q County: �OB�
Farm Name cc h Va' Owner Email:
aw c"1
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
l?e%Yv0 /4 4 4, Title:
r�
Onsite Representative:
Certified Operator:��S
Back-up Operator:
Location of Farm:
Phone:
Region:9
Integrator:
Certification Number: 179�
Certification Number:
Latitude: Longitude:
Design Current
r Destgn C ent
�Po
Design Current
Swine
Ca aci,. Po
Wet Poult .
Ca aci
Cattle
Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
I 11-ayer
I INon-Layer
I
Dai Caw
f
airyHeifer
Farrow to Wean
0 Z3o
Design Current
sj
Cow
Farrow to Feeder
11tryG,
act P,o
Non -Dairy
Farrow to Finish
Gilts
Boars
„
Layers
Non -Layers
Pullets
Turkeys
Beef Stocker
Beef Feeder
Beef Brood Cow
Other
;.,:;
Turkey Poults
Other
10ther
Discharizes. and Stream Impact
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [�?No ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes ❑ No
❑ Yes EPNo
❑ Yes to No
NA
❑ NE
❑NA
❑NE
❑ NA
❑ NE
Page I of 3 21412011 Continued

lr_�
Pacili Number: - Date of Ins ecEion: �
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes EP No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No P NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
`� No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
jP No
❑ NA
❑ NE
maintenance or improvement?
TT
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 nn❑ Evidence of ind Drift' ❑% Application Outside of Approved Area
12. Crop Type(s): C� .l s� Sal.,�--
13_ Soil Type(s): "ov
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes]
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
[:]Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
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
-Q No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
t] No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
,E] No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Q No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Pacility Dumber: Date of Inspection: J_
24_ Did the facility fail to calibrate waste application equipment as required by the pennit? ❑ Yes P No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes ® No ❑ NA ❑ NE
the appropriate box(es) below. ii��
❑ 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 T No 0 NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [n No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes No D NA ❑ NE
❑ Yes [P No ❑ NA ❑ NE
❑ Yes 5P No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ff] No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes M No [DNA ❑ NE
34. Does the facility require a follow-up visit by the same agency? [:]Yes V§ No ❑ NA ❑ NE
Comments (refer to question # ): Explain any YES answers and/or any additional recommendations or any other comments.
---1
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 1 le
Date:
21412011

Type of Visit: Getompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: t ►3'1(Zoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 6at Arrival Time: ' 4S A Departure Time: 1.'Qt_Arr1 County: _110 be San Region: FRO
Farm Name: c45A U4X R-- VNS11 Rkop o V"Aittr`S L, .0 Owner Email:
Owner Name: 4tVAPLT Mm\% &!AD VAit+n:�, LLC- Phone:
Mailing Address:
Physical Address:
Facility Contact: GT_fQ0 \�?_mwbiq Title: C�eh SgtC Phone:
Onsite Representative: {�fr'�L R
Integrator: ��i(�t)�Y ow t-1
Certified Operator: � (� , p„a sa , F^i�1f�� _ Certification Number: 1 %!j 5 3T
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current � � '� '"
Design
Current
Design Current
Capaeity Pop.
Finish
La er
Dai Cow
Feeder
Non -La er
Dai Caif
Finish
7,Boars
-'°'
Dai Heifer
Wean
o Feeder
x s #
DPoul
Design
Ca aCi
Current
Po
1#
D Cow
Non-Dairyo
Finish
Layers
, Non -La ers
!
Beef Stocker
Beef Feeder
os
Pullets
Turkeys
Beef Brood Cow
Other
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes [@ No ❑ NA ❑ NE
❑ Yes [:]No
[:]Yes [—]No
® NA ❑ NE
[' NA ❑NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No [4NA ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yes ® No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ® No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility lumber: 1 - ION Date of Inspection: j
'�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
® No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
® NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 30
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
M No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
® No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
R] No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[Z) 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
0 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 W No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): E 4k M A )64 fs G
13. Soil Types):L.,RGtZAt'� �,Ak�11�nUTol,nSc� N _„
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes X No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ 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
❑ No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
[]Other:
21. Does record keeping need improvement? Ifyes, 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 M inute 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 tail to install and maintain rainbreakers on irrigation equipment'?
❑ Yes
❑ No
to NA
❑ NE
Page 2 of 3
21412011 Continued

Facility Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes (91 No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes M No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes [0 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [n No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes ® No ❑ NA ❑ NE
❑ Yes M No [:]NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
[4 No
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
[V No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
M 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).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:\b 3C Cs
Date: _tQ 2k k1 r.), _
21412011

Type of Visit: (!��om iance Inspection —0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: poutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1/ .] Arrival Time: V4C4UI Departure Time: , County:
Farm Name: mail:
Owner Name: _� /ryy� S Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: 1 i�� Phone:
Onsite Representative: Integrator:
Certified Operator: wl I 1pt-Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Region: r &:O
Design Current
Design Current Design Current
Swine Capacity Pop.
Wet Poultry Capacity Pop Cattle Capacity Pop.
7
Wean to Finish
Layer - Dai Cow
Non -Layer Dai Calf
A
Wean to Feeder
Feeder to Finish
;• Dairy Heifer
Farrow to Wean
Farrow to Feeder
f,
Dry Cow
D , P,ouI o Ca "act _ . Po Non -Dairy
Farrow to Finish
La ers " ' Beef Stocker
Non -Layers `v Beef Feeder
Pullets Beef Brood Cow
Turke s Y _
Gilts
Boars
Other
Turkey Poults
Other
L10ther
Discharees 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 fff No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
E7'NA ❑ NE
@D-<A ❑ N E
❑ Yes [:]No E J NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes ��No ❑ NA ❑ NE
Page I of 3 2/412011 Continued

[Facility Number: - Date of Ins ection: (J
Waste Collection &Treatment
4_ Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ffNo
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
[DNA ❑NE
!—"HSC] NE
Structure l 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 ❑'i o ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
❑'1Zo'
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
f N
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Q 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
E 7Vo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance altematives that need
❑ Yes
U 5u
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Q-fvu ❑ 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): �C©� � ` Lf
13. Soil Type(s): c to
i
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o
❑ NA
❑ NE
15. Does the receiving crop andlor land application site need improvement?
❑ Yes
�No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
�No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
E2 <o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Ea-<o
❑ NA
❑ NE
Reuuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes 23`�o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check [] Yes ❑11o`❑ NA ONE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes g21lo ❑ NA 0 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<o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on imgation equipment? [:]Yes [:]No E3- A ❑ NE
Page 2 of 3 21412011 Continued

Facie Number: - Date of lns ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes eNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes <o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes []No ❑ NA
Other Issues /
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes Elio [DNA ❑ 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 [9 1V V ❑ 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 <o ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below. ❑ Yes G�Jo ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes L1.J'I"" ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [g-No NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? [:]Yes o ❑ 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).
Reviewer/Inspector Name: L»'i 4Phone:
Reviewer/Inspector Si re: Date: d
Page 3 of 3 14120 1

Dtvtsion of V1'ater Quality V
IFaciiity Number T --p� O Division of Soil and Water Conservation
% Other Agency
Type of Visit a Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I jild i f V Arrival Time: Departure Time: County: Region: _
Farm Name: c1LW.- ! v �� l i•`CtV F1n S LLC Owner Email:
Owner Name: L l Fcad F`�(.tm C, . l�L Phone:
M.
Mailing Address:
Physical Address:
Facility Contact: _ QfC-VID Title: Phone No:
Onsite Representative: _ `"^-7 5 Integrator: 1 y`� lc�J✓t.li��
Certified Operator: �r� ` t��5 Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: El o ❑ ' 0 « Longitude: E__10 ❑ T E__1 v
Design Current
Desi g n Current'
- Desi n Current
md g
Swine 0pulation
Wetnullry Capacity Population
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
on -Layer
❑ Dairy Calf
❑ Feeder to Finish
_
❑ Dairy Heifer
Farrow to Wean 0
1
Dryooltry
❑ Dry Cow
El Farrow to Feeder
❑ La ers R
ElNon-Dai
[IFarrow to Finish
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cowl I
❑ Turkeys
Other
❑ Other
El Turkey Poults
10 Other
Number of Structures:
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 03 No ❑ NA ❑ NE
❑ Yes
❑ No
" NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
�(] NA
❑ NE
❑ Yes
Wo
❑ NA
❑ NE
❑ Yes
tp No
❑ NA
❑ NE
Page 1 of 3
12128104 Continued

Facility Number: Q Date of Inspection6
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes C�No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No �9 NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
r!
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
0 No ❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
[P No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
�No El NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
Igp%,,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 El Evidence offElf Wind Drift Application Outside of Area
12. Crop type(s) Ct�QS�y natw,}� [rrls�da, 1. S. ,. am,, C[je.
13. Soil type(s) oo c:, . L-J�e I0. (,J
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
;Z No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
(� No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
q9No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ftNo
❑ NA
❑ NE
Comments (refer to question 4): 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 I ! Phone:
Reviewer/Inspector Signature: JIM Date: r _/6��
Page 2 of 3 111-141" Lonnaueu

Facility Number: — Date of Inspection I it L 1/01
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes EA No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes IPNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �9 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
ONo
❑ 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
PNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
VNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
50 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[ANo
❑ 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
��qq
[L`I No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
*No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
"No
❑ NA
❑ NE
Page 3 of 3 12128104

sion of Water Quality
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency J
Type of Visit ,,....��ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Qtcon�utine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: S 07— 0`l Arrival Time: /firr; I� Departure Time: /�� /� County:
Farm Name: C�i0n1 i%ul�e� !'aYWS Owner Email:
Owner Name: _ Pla u Phone: _
Mailing Address:
Phvsical Address:
�c 6:San/
Region: Fio
Facility Contact: Kq+ �2 Title: 1 e_e 4, 5pzd ' Phone No:
Onsite Representative: ear & rkeKFa Sr'"4 f Integrator: ,. �urp"`f `t1rd LJA!
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: = 0 6 = Longitude: 0 o =, =
ig
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
f❑ Non -La et
Dry Poultry
❑ Lavers
❑ Non -Layers
❑ Pullets
❑ Turkevs
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:DI - :
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 El No LTNA El NE
❑ Yes
❑ No
❑ NA
ENE
❑ Yes
❑ No
❑ NA
D<E
NA
ENE
❑ Yes
❑ No
❑ Yes
El No
�❑
LJ NA
❑ NE
❑ Yes ❑ No Lr NA ❑ NE
12128104 Continued

Facility Number: 7e — /Qf
Date of Inspection
Waste Collection Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier_
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 32
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 B No ❑ NA El NE
El Yes El No 31A ❑ NE
Structure 5 Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes 2No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ElE Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑Yes 2rNo ❑ NA [I 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 El Yes No El NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ErNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 2N. ❑ 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) -BGir NAU.CiQ (Ha:,t ) 6,,-, n/ ('4/5)
13. Soil type(s) LJm,9 . Lake-1--Fj J ol1%. 5
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ Yes
El NA
❑ NE
�Er'No
El NA
El NE
,eNNo
ICJ No
❑ NA
❑ NE
No
El NA
El NE
�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):
Gav� l��Cv!C9L.S
ReviewerAnspector Name }Ri 4KC ;Ze_vedS Phone: 510, 1'331333V-
Rei1ewer/Inspector Signature: Date: S d 1- ZUO
12128104 Continued

Facility Number: 7 — %dj Date of Inspection 5 O7-'D
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20.
Does the facility fail to have all components of the CA WMP readily available? If yes, check
❑ Yes
B No
❑ NA
❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps
p El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
El Yes
�,/
2No
❑ 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 El Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
El Yes
PJ No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rambreakers on irrigation equipment?
❑ Yes
G,'No
El NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
l lo
ElNA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
ElE Yes
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
BNo
❑ 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
ONo
❑ 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
�/
E! 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
d 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
0—No
❑ NA
ElNE
33.
Does facility require a follow-up visit by same agency'?
ElYes
2rN.
❑ NA
❑ NE
Comments and/or
12128104

glmS ens 4"wae Y/OZ/0
Division of Water Quality
Facility Number O Division of Soil and Water Conservation
O Other Agency
Type of Visit
Inspection
Q Operation Review O Structure Evaluation
0 Technical Assistance
Reason for Visit
,,c��ommpliance
C�Routine O Complaint
O Follow up Q Referral O Emergency
O Other ❑ Denied Access
Date of Visit: '"07 Q Arrival Time: /s—fflt� Departure Time: Z: 0/ County: �od e- SL1/'f Region:
Farm Name: _e0-1A V rf i'l1yltit S Owner Email:
Owner Name a F��� Phone:
If
Mailing Address:
Physical Address:
Facility Contact: Title: ! le-64- SiOeG`a� 7; Phone No:
Onsite Representative: kQ Dt14,•�/ ��a., I3�-; Integrator: t i� l — rea✓w
7 %'. , qq
Certified Operator: Y� Operator Certification Number: / 9/3
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: 0 a = 4 =,, Longitude: = ° = I = c[
siQ i�.C. ( B Ta►t . , s We 'ZSt 89 PW � p RP�vc aei / iM. G tN f
10
- F� o N -Avw. pa 4' 4, f 5_o ApPr"r. 1-y +h./c (3a4A4)
1 �
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Nan -La ei
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
2-1100
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ 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
❑ DaityCow
❑ Dairy Calf
❑ Daiiyfleifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stockei
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: 111.
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 L7 No ❑ NA ❑ NE
❑ Yes
❑ No
dNA
❑ NE
❑ Yes
❑ No
�NA
❑ NE
L_1 NA
❑ NE
❑ Yes
❑ No
❑ Yes
0 No
❑ NSA
❑ NE
El Yes
El No
D A
❑ NE
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 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z g
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 Q No [I NA ❑ NE
❑ Yes ❑ No BONA ❑ NE
Structure 5 Structure 6
❑ Yes El No ❑ NA ❑ NE
❑ Yes LS NQ ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental) threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes E No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes BNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑Yes No ❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
dNo
❑ 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 types) 3c�1114. 046. ..�... - — _
13.
Soil type(s) S Laa.v� _
14.
04
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
dNo
❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
Ero
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
0"NNNo
❑ NA ElNE
17.
Does the facility lack adequate acreage for land application? ElE Yes
No
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment? ❑ Yes
LN'hlo
❑ 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 ��� eve%S Phone: /O. 5'23,1J3
Reviewer/inspector Signature: Z1jDate: .3 - 07 -240 S
I212&U4 t onanuerd

Facility Number: % S — /0/ Date of Inspection
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [19 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [M No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [14 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
91 No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
[A NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
A No
ElNA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
ElYes
El NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
El Yes
�3"NNo
E3 No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
E(NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CA WMP?
El Yes
�,/
L"J No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
L" No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
[I Yes
�
B No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
u 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
ETNo
❑ NA
❑ NE
Comments and/or Drawings:
Page 3 of 3 12128104

Mks MOD?
® Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit *Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: r�. k, Departure Time- 9: Sg County: �O,bC S0r%1 Region: /'_'eo
Farm Name: C n44 n & t lfokllc<. a ".A Owner Email:
Owner Name: h'- Phone:
Mailing Address:
Physical Address:
Facility Contact: � D th a Q. Al Title: u ' SP t-e- � Phone No: bloj S1 z-3 ` zZ1Z
Onsite Representative: �0.`��.. �u ant i-r Integrator: /'L e`tlta. �/'cTJN
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Back-up Certification Number:
�o
Latitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
-2qoh
Z 3S0
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Longitude: 0 ❑
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non-Dai ry
❑ Beef Stocket
❑ 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)?
Number of Structures: ❑I
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 [9 No ❑ NA ❑ NE
❑ Yes
EINo
❑ NA
❑ NE
❑ Yes
[WNo
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
No
❑ Yes
( No
❑ NA
❑ NE
❑ Yes
ta No
❑ NA
❑ NE
12128104 Continued

Facility Number: %g— /Q/
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: L 1
60,
Spillway?:
Designed Freeboard (in): 19
n
Observed Freeboard (in): Z g
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.)
1
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
L.,ffNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered ves, 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
M 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
IM No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
El Yes
No El NA ❑ NE
maintenance/improvement'?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
V3 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) ,r� Gi'Ks kd L2 an . Sil►1 /-4,;
13.
/ ' f
Soil type(s) tt/4 y,7 f o„Jd �i] 4Iys
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
(VNo
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
P No
❑ NA
❑ NE
I &
Is there a lack of properly operating waste application equipment?
❑ Yes
Lim 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 j L e V C_ S Phone: (9/0 #3.3 —3 3.30
ReviewerAnspector Signature: Date: .3 — Z3 " ZOO-7-
12128104 Continued

Facility Number: y] — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0] No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 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 �+ 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
[A No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
14 No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
(� No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
[:1 NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [] No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
% No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[Z 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
1� No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
[4 No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

December 6, 2006
Ray Britt
Cotton Valley Farm
CO Ten Bridges Farm
P O Box 187
Fairmont, NC 28340-0187
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
RECEIVED
n;c o t 20
�-FAYEiIENLi� �q��irl�
Subject: Sludge Survey Testing Dates
Certificate of Coverage No. AWS780101
Cotton Valley Farm
Animal Waste Management System
Robeson County
Dear Mr. Britt:
The Division of Water Quality (Division) received your sludge survey information on November
13, 2006. On your behalf, Kathy Dugan requested an extension of the sludge survey requirement
for the Iagoon at the Cotton Valley Farm facility not to be required until 2009. Due to the
amounts of treatment volume available, the Division agrees that a sludge survey is not needed
until 2009. The results of the 2009 sludge survey are to be submitted by March 1, 2010. Thank
you for your attention to this matter. if you have any questions, please call me at (919) 715-
693 7.
Sincerely,
7*4AC-�
Miressa D. Garoma
Soil Scientist
cc: Fayetteville-Regional-Ofiice,_A4uifer P-rotection_Section
Kathy Dugan, Gallberry Consulting Services
Central Files
Aquifer Protection Section 1636 Mail Service Center
Internet: www.ncwatergualitv.ore Location: 2728 Capital Boulevard
An Equal Opportunity/Affirmative Action Employer— 50% Regrded140% Post Consumer Paper
WMhCarolina
Aawra!!r#
Raleigh, NC 27699-1636 Telephone: [phone]
Raleigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
Customer Service: [phone]

DI I Uffl- of Water quality .,
iFacility NUmMer l $1 /Q/ O Division of 50i1 anU Water Conservation
- - - Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: g-D%O(v Arrival Time: Departure Time: /2: Z County: 090OAI Region: 10l
Farm Name: t-a f::qy bn Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Ka 41 Ib" d o,J Title: f&C�4 , SDGG , Phone No:
Onsite Representative: Ka-M, � D�tq�.J ! _ AZ- Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [� o [� d [� Al Longitude: = ° = f 0
ti Design Current
Swine Capacity Population
Design, Current
Wei'oultry CapacityrPnpulation
Design
Cattle Capacity
Current
Population
❑ Wean to Finish
❑ Layer
❑Dairy Cow
❑ Wean to Feeder
❑ Non -Laver
❑Dairy Calf
❑ Feeder to Finish
❑Dairy Heifer
Farrow to Wean Q�
Dom, Poultry m
❑ D Cow
❑ Farrow to Feeder
"`
❑ Non-DaiEy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
on -Layers
❑Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cow
Other 5 y
Turkeys
❑ Turkey Poults
-� �;;.�
Y
❑ Other
❑ Other I
Number of -Structures:
Discharges & Stream Impacts
l . Is any discharge observed from any part of the operation?
❑ Yes
JNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
[% No
❑ NA
❑ NE
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
❑ Yes
[4 No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system'? (If yes, notify DWQ)
❑ Yes
PpNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
X No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
R; No
❑ NA
❑ NE
other than from a discharge'?
Page I of
12128104
Continued

Faciliiy Number: -75— IQI Date of Inspection `D!�
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
N No
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
[0 No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
/j
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
9No
❑ NA
❑ NB
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
M 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
(1 No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
0 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
[j Yes
C9 No
❑ NA
❑ NE
maintenance or improvement?
Waste Anolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
C$$ No
❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
ONo
❑ 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 of Area
12.
lOutsjide
Croptype(s) ��ct_ A.,S,ti:��t9` ;y �UV14'.Se�C J
13.
Soil type(s) ',�4 k—'_ oti S
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[)I No
❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
1p No
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
[ No
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
�gNo
❑ NA ❑ NE
Reviewer/Inspector Name i; G�! r=5 " `':.„� Phone 9�0 St33—
Reviewer/Inspector Signature: Date:
Page 2 of 12128104 Continued

Facility Number: 7g —/(�j Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E4 No ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 5d No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
M No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Ep No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
t� No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�j No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[P No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
91 No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
10 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[A No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern'?
❑ Yes
ERNo
❑ 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
P No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ® Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: p Arrival Time: a7 � B� Departure Time: County: 4b Region:
Farm Name:.n 7iri�.. VGt (LQ�1 1C�j ��� _- Owner Email:
Owner Name: fCa.c.f brt 7d— Phone: - r
Mailing Address: _. 80 _� [&a
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator: _ _ ra 1[ Haw, V4 ,
Back-up Operator: Joe p. SGA
Location of Farm:
Phone No: pp
Integrator: &t EpL, -b -
Operator Certification Number: ZZOZ�
Back-up Certification Number: /2Z�
Latitude: = ° 0 . Longitude: ° 0 "
Design Current
Destg[i Current`
"
!DDesign Current
Svvin'e
Capacity Popuiation� �i'et,P�owZltry
-Capacity Populateon
_
Cattle•
Capacity �P.o�pu� lion'
❑ Wean to Finish
❑ La er
❑ DairyCow
❑ Wean to Feeder
❑Non -La et
El Dairy Calf
[IFeeder to Finish
r; ' .
Ej Dairy Heifer
Farrow to Wean
❑ Dry Cow
❑ Farrow to Feeder
El
Farrow to Finish
El La ers
❑ Beef Stoekei
El❑
❑ Gilts
ElNon-Layers
❑ Beef Feeder
❑Boars
❑ Pullets
❑ Beef Brood Co
Other
❑ Turkeys
. y
<,jltsl
❑ Other
� `:' ❑ Turke Pol
❑Other
Number of Structures: ©-
Dischart=es & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
MNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
RNA
❑ NE
b. Did the discharue reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
[9 NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system'? (if yes, notify DWQ)
El Yes
El No
25NA
El NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
�] No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
P No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

I.Favilily Number: -W io% Date of Inspection n 1
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? El ❑ No � NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: i't
Designed Freeboard (in): q
Observed Freeboard (in)_ ?j
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
ER 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
14 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
`d No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
91 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
P No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
JR No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
P No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 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) 5MA at-zt a.t-14
13. Soil type(s) Ul�ae.rzx.wl I -a r�5
v
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
%No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'❑ Yes
® No
❑ NA
❑ NE
IT Does the facility lack adequate acreage for land application?
❑ Yes
&No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[SNo
❑ NA
❑ NE
Comments (refer to question #): Explainf°any YES answers and/or any' recominendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as szecessairy): G
Reviewer/Inspector Name l ?� � Phone: ! 1 71.5- 4,&,z 7�
Reviewer/Inspector Signature: Date: 10yzO.�

Yscilrty Number: 7& — Date of Inspection JU
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes &No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [RNo ❑ NA ❑ NE
the appropriate box. ❑ WUP - ❑ Checklistsr ❑ Desigr( ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EgNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑Yes
Ej No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
6No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[gNo
❑ 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
9[No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[gNo
❑ 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
LgNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
9No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31 _
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[9No
❑ 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
E&No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Y re.Q&e- L,%p)4Lfc— Ei TT y; r tom'` !r- riuy-r'Q,4- 1%wGI n r_C) N .
12128104

} �•e v_
.t
Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit • Routine O Complaint O Follow up O Emergency Notification O Other © Denied Access
Date er Visit: / /� �I aii Tune:
F -Facility Number 8 !o
Q Not Operational C Below Threshold
M Permitted ® Certified © Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name:—s..l�f'!..._r�._ Va/day Fair+. County:. _ /S�,p]
Owner Name: 2 �yc tf _ Phone No:
_U Z .. ., k - . 9.2 zz_
Mailing Address:
Facility Contact: --Title: _. Phone No: . .
Onsite Representative:. 4 ztx 4 Integrator. /%'%cr r b �. -- Br o c.2 ti
Certified Operator: _ Operator Certification Number: 19 i1.3
Location of Farm:
U
%Swine ❑ Pouttry ❑ Cattle ❑ Horse Latitude • 6 " Longitude • � Du
;Desig�t Ct2rrent
.: .
Current t
Wean to Feeder
Feeder to Finish
Farrow to Wean y o 0
Farrow to Feeder
Farrow to Finish
Gilts
-'Poultry -;Po lion. Cattle ''Pblyfillation
❑ Layer Dairy
Non -Layer Non -Dairy
Other
Total Design} Capacity
Total SSLVV
Number oMigogas.
AAldin� Pondc / Saud �'�nc :". 1
Discharges & Stream Inn acts
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 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier --
Freeboard (inches): YCR- —
❑ Yes 10 No
❑ Yes ❑ No
❑ Yes ❑ No
N/.4z
❑ Yes ❑ No
❑ Yes R No
❑ Yes ® No
❑ Yes M No
Structure 6
12112103 Continued

Facility Number: %fr — /O/ Date of Inspection
l ~
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ yes No
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/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 ❑ yes Q No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance improvement? ❑ Yes No
i 1. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12.. Crop type A -* M it L+& / / [iCI / S ^-. i / G r : k n V <_" j C Cs
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes M No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ;0 No
b) Does the facility need a wettable acre determination? ❑ Yes J,j 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 attor below ❑ Yes P 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 L�j 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.
Field Copy ❑ Final Notes
is% /Ylcn �`fo� } i')Af -P... w �c��t L��t{d,.s rsu�� redl��} �wrQ ��e�t~
GL ] rlL4C eLX- .
Reviewerliaspector Name _ _ _ r .,_ _ _.
Reviewer/Inspector Signature:
12112103
Date: /01.21 /
Continued

Facility Number: — /n/ Date of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes We No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie! WUP, checklists, design, maps, etc.) ❑ Yes No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes W No
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes ® No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(it/ discharge, freeboard problems, over application) ❑ Yes (a No
27. Did Reviewer/inspector fail to discuss review/mspection with on -site repnsentative? ❑ Yes 13 No
28. Does facility require a follow-up visit by same agency? ❑ Yes jp No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes El No
NPDES Permitted Facilities
30. is the facility covered under a NPDES Permit? (If no, skip questions 3I-35) ❑ Yes ® No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record creeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

_v
Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: a( Time: C', 1
Facility Number c7 I i 10 Not Operational 0 Below Threshold
E Permitted ®Certified ❑ Conditionally- Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: C > VC —Me'. — ,r/11 County: P
Owner Name: i2C, tf-" Phone No: of I C l io .1 V
Slalline Address: _ L,c �i— Uj h i c
FacilitA Contact: f?, G cn [i ^ rtC" Title:
Onsite Representative:
Certified Operator: 96
Location of Farm:
Phone No:
Integrator: _ Cz'j-n0i f S
Operator Certification number: I q tj k?
® Swine ❑ Poultry ❑ Cattle ❑ Horse l-atitude Lonaitude �' �• ��
Design Current Design Current Design Current
Swine Ca acitf Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder I I 1 10 Lavcr I ❑ Dairy
❑ Feeder to Finish ❑ Non -Laver I I Non-Dair
® Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area IDSprzvField Area
Holding Ponds / Solid Traps [ No Liquid Waste Management Svstem
Discharges & Stream Impacts
1 _ Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Sprav Field ❑ Other
a. I1 discharge is obsen•tzd, was the conveyance man-made?
b_ If discharge is obsen-ed, did it reach Rarer of the State? (if yes, notif}, DWQ)
c. If discharge is observed. what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If ves, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there an%, adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection g Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure
Identifier:
Freeboard (inches): 3
05103101
❑ Yes rZ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes © No
❑ Yes Q No
❑ Yes ® No
Structure 6
Continued

Facility Number: — / CDate of Inspection I II I C
r
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 maintenancelimprovement? ❑ 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 Q) No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes [O No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes IRNo
12. Crop type 13C-rv+n i.1cc,, 4- i i (I`r, i n l r ,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
W No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
UjNo
c) This facility is pended for a wettable acre determination?
❑ Yes
[j] 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
P No
I &
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
[A No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
64No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
V1No
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
[g 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
Wo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
MNo
0 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
Comments (refer to question #): Explain any YES answers andlor any recominen a onsirorilanUittierMomments.
Use drawings of fardity to better explain situations. (use additional pages as necessary): ❑Field Copy ❑Final Notes
G.i' L� s^c.L3 l 4�,v I,a: o�ca �,► MA,
}Irk
f 6­4 &-e, el ( A, t'O- Co r:�AO
6; 64- v3 ,rc cs s c�-S Jt q- )06-d — S'-' M.. j
T
9
Reviewer/Inspector Name `` a,
Reviewer/Inspector Signature: A- LJ ; , Date:
05/03/01 (j y Continued

Facility Number: Date of Inspection 1 2I
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below
liquid level of lagoon or storage pond with no agitation?
27_ Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
OSIO3101
❑ Yes []No
❑ Yes ® No
❑ Yes ® No
❑ Yes tO No
❑ Yes R No
❑ Yes ® No
❑ Yes ❑ No

Type of Visit ® 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
FaciGth- Number 7 d Irate of Visit: l4 �� dZ Time:L rO
Not Olnerational 0 Below Threshold
0 Permitted ® Certified © Conditionally Certified © Registered Date Last Operated or Above Threshold:
Farm Name: !/ �. County: Z,,€,22,)
Owner Name: 1, Phone No: `/�G� G— �� 77
iviailing Address:
Facility Contact: �Tit2i Title: Phone No:
Onsite Representative: integrator:
Certified Operator: Operator Certification Number:
Location of Farm:
[]Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' • K Longitude • 0
Design Current .:. _ Design Current Design." -,..
Swine Ca adty -Po elation Poulryi CaDacitf Povulation Carrie Capacity ` P6qulation
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
60
2d
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons ❑ Subsurface Drains Present ❑ La oon Area 10 Spray Field Area
Holding Po©ds'! Solid Traps 10 No Li uid Waste Management System
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 ves, 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
Identifier:
Freeboard (inches):
05103101
Structure 5
❑ Yes �qNo
❑ Yes n No
❑ Yes WNo
❑Yes MNo
❑ Yes ONo
❑ Yes Wo
❑ Yes X No
Structure 6
Continued

Facility lumber: 7X — JO/
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. .Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered ves, and the situation poses an
immediate public health or environmental threat, notih, 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 anv stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11, Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type7�i�wG�/t.
❑ Yes 5rNo
❑ Yes No
❑ Yes M No
❑ Yes JqNo
❑ Yes ZNo
❑ Yes % No
❑ Yes 4 No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 4No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
sE] No
b) Does the facility need a wettable acre determination?
❑ Yes
gg No
c) This facility is pended for a wettable acre determination?
❑ Yes
ANo
15.
Does the receiving crop need improvement?
❑ Yes
JZ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
O-No
Re aired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
PEFNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP. checsts, des ma maps,etc.)
❑Yes
RNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
N"No
20-
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
E(No
21 _
Did the facility fail to have a actively certified operator in charge?
❑ Yes
PrNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
discharge. freeboard
El Yes
No
Oe/ problems, over application)
23,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
ENo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
PNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
;B No
0 to violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer -to question #): Explata any YES an gers shd/or_ any rieomateodsttons"or srty oth_er-':commeuts
Use drawings of facility to better ezplaw snxtattoas. (else additional pages as nrecessary) 'w: r _ _ .: El Field Copy m0 Final NotesY
.. ,.
/ 7
�,c�-. h,�� /Z/.c��-J -C� ��f7.-� �c{ .s �`" CrG� G•�� dy o �� f��.�
Re-viewerllnspector Name
Reviewer/Inspector Signature: Date:
O5103101 Continued

Facility Number: 79 — / f 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
liquid level of lagoon or storage pond with no agitation?
27, Are there any dead animals not disposed of properly within 24 hours?
28. is there anv evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads. building structure, and!or public property)
29. is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e, broken fan belts, missing or
or broken fan blade(s). inoperable shutters. etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
Additional Comments and/or'Drawings:
05103101
❑ Yes ,� No
❑ Yes `� No
❑ Yes No
❑ Yes KNo
❑ Yes )dNo
❑ Yes P No
❑ Yes �NO

o�oF W ArFRQL
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P. E., Director
.0 Division of Water Quality
January 13, 2003
Ray Britt Facility Number 78 - 101
Cotton Valley Farm
c/o Ten Bridges Farm
PO Box 187
Fairmont NC 28340
Subject: Public Meetings for Draft Renewal of State Non -Discharge Animal Waste Operation General
Permits
Dear Producer:
Your animal waste management facility is scheduled to be issued coverage under the Animal Waste
Operation General Permits in the near future. The Division of Water Quality (Division) staff is currently
in the process of renewing the Animal Waste Operation General Permits and is scheduled to have the
permit reissued by early April 2003. Once the permit is reissued, your facility would be eligible for
coverage under the reissued permit.
The Division has published a public notice regarding these renewed general permits. A copy of .
the draft animal waste operation general permits and fact sheets are available at the website
hftp:/Ih2o.enr.state.nc.us/ndpu/
or by writing or calling:
Non -Discharge Permitting Unit
NC Division of Water Quality
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Telephone number: [phone], ext. 574
The Division will be conducting public meetings regarding these renewed permits. The following is a
list of dates, times, and locations of the public meetings:
February 3, 2003; 7-9 p.m.; Kenansville — James Sprunt Community College
February 4, 2003; 7-9 p.m.; Williamston — Martin Community College (Bldg. 2 Auditorium)
February 6, 2003; 7-9 p.m.; Iredell -- Iredell County Center
Further information can be obtained by reviewing the Fact Sheet available at the website and address
listed above.
Cc: CFayettevilfe-Regional Office, Division of Water -Quality
Robeson Soil and Water Conservation District
Permit Application File 78 - 101 VOW.
Non-Discharge Permitting Unit Internet http://h2o.enr.nc.state.usJndpu
1617 Mail Service Center, Raleigh, NC 27699-1617 Telephone [phone] Fax [phone]
Customer Service Center Telephone [phone]
An Equal Opportunity Action Employer 50% recycled/10% post -consumer paper

F— Facility Number Date of visit:
Permitted [a Certified Conditionally/Certified [3 Registered
Farm Name: a-
QQ
OwnerName:.........................................1........r.........
't'imv: E:::� Printed an: 10/26/2000
Q Not O erational Q Below Threshold
Date Last Operated or E bove Threshold: .........................
County: .... .l�i�.........................
Phone No: Z Z
Facility Contact: ........... Gei/t r..... ... Title: Phone No:..........�~- ..................
..................� .................
Mailing Address: V -{ t"7�!�,C-. �tf...................
P..............W........1-.-..-....?........--.............................--.................... M...�.......
Onsite Representative:.... [�ei.Yi &' ... Integrator :................... . I`r'O / ....................
r- c
Certified Operator:._. ,p. .t,� ......................... ............... Operator Certification Number:
Location of Farm: II
❑ Swine ❑ Poultry ❑ Cattle ❑ horse Latitude 00 ` i Longitude �� �6 "
Swine
Design Current Design Current
Capacity Population Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
60
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy
❑ Non -Dairy
Total Design Capacity 2
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds I Solid Traps 10 No Liquid Waste Management System
Discharges & Stream im-packti
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 fN
o
b. If discharge is observed, did it reach Waterof the State'? (1fyes, notify DWQ) ❑Yeso
c. if dischar�,c is observed. what is the estimated flow in gal/min?
(1, Does discharge bypass a lagoon system'? (li'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? ❑ Ye No
Waste Collection R Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure I 111'tfcture 2 Structure 3 Structure 4 Structure 5 Structure 6
Ident i ficr: ................
Frechoard (inches): 26
5100 Continued on back

Facility Number: — 6 Date of Inspectionyl- Printed on: 10/26/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes KNO
seepage, etc.)
6. Are there structures on -site which are not property addressed and/or managed through a waste management or
closure plan? El Yes KNO
(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 ONO
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes Po
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes A No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes _4No
11. Is there evidence of ver applicatio ? ] ExcessiveZZ
❑ PAN ❑ Hydraulic Overload ❑Yes No
12. Crop type erry11 CL Vl r v; UGr `o
13. Do the receiving crops differ with those designate in Xe Certified Animal Waste Management Plan (CAWMP)? ❑ Yes o
14. a) Does the facility lack adequate acreage for land application? ❑ YesfNo
o
b) Does the facility need a wettable acre determination? ❑ Yes
c) This facility is pended for a wettable acre determination? ❑ Yeso
15. Does the receiving crop need improvement'? ❑ Yes o
16. Is there a lack of adequate waste application equipment? ❑ Yes No
_Required_ Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes ANo
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
ANo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
o
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
o
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
o
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
Qi�qo
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
o
24.
Does facility require a follow-up visit by same agency?
❑ YesTNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
IVo
��10 yiQlatidfis:or i lit itrig 4his;visit: - Y:oo will •receive do furtboe • , •
orresportdence ah' ' au is visit.. . . • . • . •
Comments (refeir to question ##): Explain any YES answers aitd/or.any recommendations or any
Llse drawings of facility to better explain situations. (use additional pages as necessary):
A X-5- good i�" 4J4,
6er3�*t ,s ems; .-7 ct.-le-"
�ther.co>rninents.r -�- -
A.
Reviewer/Inspector Name J
Reviewer/Inspector Signature: - Date: 7 /6 '0
5100

Facility Number: _ O Date of Isyspection
Printed on: 1/4/2001
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
32. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
33. Do the animals feed storage bins fail to have appropriate cover?
34. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes No
❑ Yes a
❑ Yes PO
ElYes
❑ Yes ❑ No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
Reviewer/InspectorName
_.. ..` . s ' -_•`: ..�,- �� ,�.. ..-. Nib_;..-...,_ ��_„
Reviewer/Inspector Signature: Date:
01/01/01

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
Ray Britt
Cotton Valley Farm
c/o Ten Bridges Farm
PO Box 187
Fairmont NC 28340
Dear Ray Britt:
�A&,Tk?W,j
IT 0 0
41 )
NCDENR
NORTH CAROI_INA DEPARTMENT OF
ENVIRONMENT ANo NATURAL RESOURCES
December 30, 1999
RECEIVED
Eta
5 2000
FAY :TTEl19LLE
riEG. O -FiCE
Subject: Fertilizer Application Recordkeeping
Animal Waste Management System
Facility Number 78-101
Robeson County
This letter is being sent to clarify the recordkeeping requirement for Plant Available Nitrogen (PAN)
application on fields that are part of your Certified Animal Waste Management Plan.
In order to show that the agronomic loading rates for the crops being grown are not being exceeded, you
must keep records of all sources of nitrogen that are being added to these sites. This would include nitrogen
from all types of animal waste as well as municipal and industrial sludgestresiduals, and commercial fertilizers.
Beginning January 1, 2000, all nitrogen sources applied to land receiving animal waste are required to
be kept on the appropriate recordkeeping forms (i-e. IRR1, IRR2, DRY], DRY2, DRYS, SLUR1, SLUR2,
SLD1, and SLD2) and maintained in the facility records for review. The Division of Water Quality (DWQ)
compliance inspectors and Division of Soil and Water operation reviewers will review all recordkeeping during
routine inspections. Facilities not documenting all sources of nitrogen application will be subject to an
appropriate enforcement action.
Please be advised that nothing in this letter should be taken as removing from you the responsibility or
liability for failure to comply with any State Rule, State Statute, Local County Ordinance, or permitting
requirement.
If you have any questions regarding this letter, please do not hesitate to contact Ms. Sonya Avant of the
DWQ staff at [phone] ext. 571.
Sincerel
Kerr T. Stevens,/Director
Division of Water Quality
cc: Fayetteville Regional Office
Robeson County Soil and Water Conservation District
Facility File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper

Drvision of Soil and Water Conservation - Operation Review
.._ _ e
0 Drvision of Soil'and Water Conservation -Compliance Inspectron {
rvrsion of. Water Quality - Compliance Inspection
D Other'Agericy - Operation Review
Routine 0 Complaint O Follow-up of DNVQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of Inspection
Time of Inspection ! eS� 24 hr. (hh:mm)
Permitted 13 Certified [] Conditiona€Iv Certified © Registered [3 Not O crational Date Last Operated:
Farm Name: (I 1?J4
iJr0. cirvl ....................... ...........
County ......... ���5
.....-1...........f ...
Owner Name:....-. r .. - Phone No: rP Z �� z 7 7
k. T...�I.l....r .......................... ..................... ..................�...........-....-..........................
Facility Contact: 'et-i t e t� Title: �- Phone No:
......................................................................---........----...........-- ...................... ................................................
~failing Address:... ..Q...... .Q UG .l...V.....(... ..-----�....`"..�rT..�.... ..l .!...-�..................
..................... /1
Onsite Representatwe: d G_h...'e. �.. ..... Integrator .....................r'r r�k5................................
Certified Operator:... `��/. ............. .r'... r' Operator Certification Number:..........................................
Location of Farm:
t-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
y t ;
Latitude Longitude
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder 10 Layer ❑ Dairy
❑ Feeder to Finish ❑ Non -Layer ❑ Non -Dairy
Farrow to Wean 2 6V .
❑ Farrow to Feeder JE1 Other
❑ Farrow to Finish Total Design Capacity 2— �]
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons f ❑ Subsurt'ace Drains Present ❑ 1 agoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps JE3 No Liquid Waste Management System
Discharges & Stream Impact~
I. 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 convcyanre man-made?
h, it- discharge is observed. did it reach: ❑ Surface Waters ❑ Waters of the State
c. li discharge is observed. what is the estimated fogs' in galhnin?
d. Dries discharge bypass a lagoon system?
2. Is there evidence of past discharge from any part of the operation'?
3. Were there any adverse impacts to the waters of the State other than from a discharge?
waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
M.
❑ Yes �No
❑ Yes &A, o
ITtI
❑ Yes IgNo
❑ Yes [0 No
❑ Yes -K`No
❑ Yes P5_No
Structure I Structure ? Structure 3 Structure 4 Structure 5 Structure 6
Idenfiif[cr: 7�
Frechoard (inches):
L '
..............................................................................................................................................................................................................
l /6/99 Continued on back

Facility Number: — Q Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste manauement 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?
L Does any patt of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings?
Waste A lication
10. Are there any buffers that need maintenance/improvement?
11. is there evidence of over application'?
❑ Ponding ❑ Nitrotten
`
12. Crop type ( s!! t !mil a
f I
11'tIl...
4 ti
a.......................................
L----=f'
❑ Yes �No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. Does the facility lack wettable acreage for land application! (footprint)
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
❑ Yes ANo
❑ Yes gNo
❑ Yes 92'No
❑ Yes kNo
❑ Yes KNo
❑ Yes Wo
❑ Yes ANo
❑ Yes )P�No
❑ Yes KNo
❑ Yes ANo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes RNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes No
19. Does record keeping need improvement'? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes No
0
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 O�No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
tr
(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 EY-No
1VA.vialattons-or. deficiencies .were noted during Ais.visit.. Y.ou will.reueive nog further
c-orresPgridei ice' abut; this visit ; ; .............
Coments (refer to question #): Explain any YES answers and/or any recommendations or any other. comments. "w ;
Use. drawings drawings of facility to better explain situations. (use additional pages as necessary)
l R.r»1 f S Jrti trCl-�jdpC� Jr/iG� G��L'\ �.UC�1 it�tGC.�rt�cteK�p� • -
U� r Qcod rcc&4_51 _ I
�v W e"[Q O_0e_ rL7e ��F��-v►1� tti2t7avt n�e�s -�, �je de,,.- Cr J-�; s
IS-4A"5 odrecjy
Reviewer/Inspector Name a 4c,_5
Reviewer/]nspector Signature: Date: 2 - 2q --`7
1 /6/99

Division of Soil and Water Conservation ❑ Other Agency
f'Division of Water Quality
10 Routine O Complaint O Follow-un of DWO inspection O Follow-up of DSWC review O Other
Date of Inspection lo ,� d`
Facility Number f7
Time of Inspection : � 24 hr. (hh:mrn)
13 Registered Certified 0 Applied for Permit © Permitted [3 Not O erational Date Last Operated: ..........................
Farm Name: ..........0176 ?......V 3 &ris-1....................................... County: ................... e P.1............. ...............
Owner Name: ...........
.......... .............. sfl.......................................... Phone No: .........1..-....-...`�.'1....................
t
Facility Contact: .. .................•V- .... �1°� ... Title Phone No: ...................................................
.....
Mailing Address: tU l .- � ��4{�
.. ........ x..........................................................................��r...... t. ...C.....I.-........... .fir„
,� f
Onsite Repre, :.............. „�ri Int rator•.....,.-...-.rl..f�.(../ ....._ .....C. p ..... ......... ......-----'---...........--'--..........-----..._..... eg r .........
Certified Operator ................... t t o Z
p ._ X.....- ' ------'........................'-----................ Operator Certification Number;....................-- -
Location of Farm:
................................................................................................................... _ _ _
Latitude Longitude '
N Desrgn Current nx Design" F Current `
. R,
Capacity` Population' ' Poultry Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
a3a
0A3P
❑ Farrow to Feeder
c
❑ Farrow to Finish
❑ Gilts
❑ Boars
- IU Non -Layer
I
'-�
U Non-
' ❑ Other
g
Total.R&ign,,Capai
-
� � :Total SSI
'Nrtmber„of Lagoons / Holdung Ponds ❑ Subsurface Drains Present ❑Lagoon Area ❑Spray Feld Area
•- ti.
No Liouid Waste
General
I . Are there any buffers that need maintenance/improvement? ❑ Yes f KNo
2. 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 Surface Water? (If yes. notify DWQ) ❑ Yes J'No
c. If discharge is observed, what is the estimated flow in gal/min? /V
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes KNo
3. Is there evidence of past discharge from any part of the operation? ❑ Yes JXNo
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes J9 No
5. Does any part of the waste management system (other than lagoons holding ponds) require ❑ Yes No
maintenance/improvement?
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 on back

Facility Nunther:
8. Are there la,00ns or storage ponds on site which need to be properly closed?
Structures (I,ag000ns.Hoiding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Strvaure 1 Stnicture 2
Identifier:
......................................................................
Freeboard (ft): ............ R
10. Is seepage observed front any of the structures?
Structure 3 Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed'?
12. , Do any of the structures need maintenance/improvement'?
❑ Yes %No
❑ Yes No
Structure 5 Structure 6
El Yes ONso
XYes ❑ No
,K Yes ❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DIVQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers'
❑ Yes
XNo
Waste Application
14.
Is there physical evidence of over application'!
❑ Yes
k!js 'o
(If in excess of WMP, ur runoff entering waters of the State, notify DW )
15.
Crop type ...................•-- S ...........................................
'..............................
16.
Do the receiving crops differ with those designated in the Animal Waste Mana,ement Plan (AWMP)?
❑ Yes
Jff\To
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
O`No
20. Does facility require a follow-up visit by same agency?
❑ Yes
XNo
21. Did ReviewerAnspector fail to discuss review/inspection with on -site representative?
❑ Yes
,A No
22. Does record keeping need improvement? r
❑ Yes
RNo
For Certified or Permitted Facilities Only.
,
23. Does the facility fail to have a copy of the Animal Waste Manaec:ment 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
0 No.violations or deficiencies were: noted during this visit. You *ill receive no further
correspondence about this.visit. .
Commepts.(refer to question #): Explain any YES answertn s andlor any recontendations or any, oilier calthments w to
Use drawings of facility to better explain situations. (use additional pages as nccess:in):
1-4 VW
V_K S
ax. amerce t- cam-. G~ t,...,..
5;"_
arr� yes . /'-
w
Reviewer/Inspector 'samee'r-tt gnX041-1
Reviewer/Inspector Signature:_ . � _-Z Date: