820003_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qua

Type of Visit: COCompliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: 0-1 routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: , �D County: Region:
Farm Name: 4 ` -, 17 ;Z C�— / jv Owner Email:
Owner Name: ��,,�fi;�f ; L Phone:
Mailing Address:
Physical Address:
Facility Contact: �Y Title: Ow"I Yr Phone:
Onsite Representative: Integrator:���„
Certified Operator: ��..� Certification Number: At7/�%
Back-up Operator:
Location of Farm:
Certification Number:
Latitude: Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.ZI
Wet Poaltry
La er
Design
Capacity
Current
Pop.
C►attle
Dai Cow
Design Current
Capacity Pap.
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
FarrowtoFinish
(3 Oz7
D , Puul
Layers
Design
Ca aci
Current
P,a
Dai Heifer
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
keys
Turkey Pouets
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? (Ifyes, 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 Eallo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[] Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes Ea No
❑ Yes [�-No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

�) V
[Facility Number: - Q Date of Ins ection:
° Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Ej 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): �7
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
f' 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
allo
❑ 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
(INo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
RNo
❑ 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
[HNo
❑ NA
❑ NE
maintenance or improvement?
_Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[R.No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes CEI-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) �•��/l�u�cZ _ - - — - - — - --
13. Soil Type(s):,AJa
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E[No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
2,No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[allo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
allo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[3No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes allo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [] Yes allo ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes [allo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ,� No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [-]Yes No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

r .y.
f Facility Number: - Date of Inspection:
. 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [SjNo ❑ 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 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
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 allo ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes 'No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
0 No
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
E[No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
CNo
❑ NA
❑ NE
Comments(refer to gi estionjg#) Ezplain a©y YES answers and/or ahy.addihonal recommenda`tioos or any "other cor�iments:
[3se dravmgs offacilt- -
ty to better ez iaiq;situati©ns use additional ,
P_. Pages as necessary) i. _ ..
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
Phone:
Date: U — ;2_9L j/Z
21412015

Division of Water Resonrces
Facility NHE Division of Soil and Water Conservation
OO Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ® Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Departure Time: =Qp County: Region: rjf0
Farm Name: _ j' 4 A f ,' f 1.+a t,LT C Owner Email:
Owner Name: [nbrs4 a I 1 - Pti "`� Phone:
Mailing Address:
Physical Address:
FacilityContact: _ L11 " r 4 AIL t/„ /&es Title: Phone:
Onsite Representative: 5A 0/_ Integrator: �j�a1o�p 4 1ll4
Certified Operator: MCtrs4al1 rh���,�s Certification Number: ag7/y
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude: -
Design Current
Swine Capacity Pop.
Wean to Finish
Design C«urrent
Wet Poultry C►apacity Pop. Cattle
Layer Dairy Cow
Design Current
Capacity Pop.
Wean to Feeder
I
INon-Layer
I
El Dairy Calf
Feeder to Finish
_67ko
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
'Layers
Design Current Cow
D , P,oult , Ciiaci P,o , Non-Dal
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turke Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
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 [a-1Qo ❑ NA ❑ NE
❑ Yes
[] No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No
[-]Yes [✓]'No
❑ Yes [r No
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
Page I of 3 21412015 Continued

Facility Number: jDate of Inspection: (p d
Waste Collection & Treatment or
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes F1 No
a. If yes, is waste level into the structural freeboard? ❑ Yes [J No
Identifier:
❑ NA ❑ NE
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Spillway?:
Designed Freeboard (in): _ICl
Observed Freeboard (in): -3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 2No ❑ NA [] NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[2 o
❑ NA
D 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
[31N'o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[q'1`lo
❑ 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+ r o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�To
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [2"No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): e1^ U Oven ee
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ErNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [✓rNo [] NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [l"No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
RrNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ff'Ro
❑ NA
❑ NE
Reguired 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
Q'No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes E?(No
❑ 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? 0 Yes dNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
[+ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - 003 Date of Inspection: jd7 /
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
CDII�o
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
E30'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
[3"No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[>J'No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[:]Yes
dNo
❑ NA ONE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
�No
❑ NA D 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
[DNo
❑ 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
0No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAVRAP?
❑ Yes
[✓rNo
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[✓rNo
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
0No
❑ NA ❑ NE
Comments (refer to question #f): 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 Signatm
Page 3 of 3
Phone:
Date: /P 11 jl G
21412015

ivis`ioa of Water Resources
Facility Number ®- 03 1 1
Division of Soil and Water Conservation
5t Other Agency
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 9-1 utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: La
Arrival Time: ; � Departure Time: s County;
Farm Name 0 Owner Email: Owner Name: 74 ; I%; �S �L G Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title: Phone:
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Swine C+apacity Pop.
Wean to Finish
Design CurrentM Design ourrent
Wet Poultry Capacity Pvp. Cattle Capacity Pop.
Layer DairyCow
Da Calf
Wean to Feeder
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design Current Cow
1] , P,oult . Ca aci P,o , Non -Dairy
ILayers Beef Stocker
Non -Layers Beef Feeder
Beef Brood Cow
Turkeys
Turkey Poults
Other
Farrow to Feeder
Farrow to Finish
Gilts
Boars 4—Pullets
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 0,No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No [] NA ❑ NE
[:]Yes [—]No
❑ Yes SLNo
❑ Yes Z, No
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
Page 1 of 3 21412014 Contdnued

' Facility Number: XE p' 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: 3 1
Spillway?:
Designed Freeboard (in): - 1
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
®,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
[2 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Eg 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 Cgi-No ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): 5r'/M UA
13. Soil Type(s): GC/G?A/1?� / ��i! o/ k /CAD I k)n /
❑ NE
14. Do the receiving crops 'ffer from those designated in the CAWMP?
❑ Yes
�No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
allo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
allo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
allo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
0,No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[a No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
M No
❑ NA
❑ NE
the appropriate box.
❑WUP El Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [S No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 8 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 V4/2014 Continued

4
Facility Number: o jDate of Inspection:
-�
s,24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Dg_No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
[—]Yes
ELNo
❑ 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
Dallo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
21 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:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes JM No [3 NA ❑ NE
[]Yes 5,No [DNA ❑ NE
❑ Yes [2.No ❑ NA ❑ NE
[:]Yes fallo ❑ NA ❑ NE
[—]Yes RNo
❑ Yes J&No
❑ Yes E!�No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #I): Explain any YES answers and/or any:additional::recommendations:or. any other, romin eim
Use drawings of facility to better explain situations (use -additional pages as necessary).:.
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412014

i ype ut visit: %,-7 v.ampuance inspecuuu v vperauun review V atructure r,vatuauun %_J 1 CCRII1Cal Assistance
Reason for Visit: &,routine O Complaint O Follow-up O Referral O Emergency O Other . O Denied Access
Date of Visit: Arrival Time: ; pV Departure Time: ; 3 p County: Region: F?l0
100,
Farm NameOwner Email:
Owner Name: Z" 6 F,4 14 U Phone:
Mailing Address:
Physical Address: ,
Facility Contact: j .`r�` 3 Title: 'Phone:
1. 1.
Onsite Representative: Integrator:
a
Certified Operator: �_ Certification Number: ,
Back-up Operator: Certification Number:
.ocation of Farm: Latitude: Longitude:
Swine
Design
Capacity
Current
Pop.
Wet Poaltry
Design
Capacity
C*urrent
Pop.
Design Current
Cattie Capacity Pop.
Wean to Finish
Layer
ow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
�D
Dai Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dr P,oul
Layers
Design
Ca aei.
Current
$o
D Cow
Non-D '
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
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 C5KNo 0 NA ❑ NE
❑ Yes [:]No
[:]Yes ❑ No
❑NA ❑NE
❑ NA ❑ NE
❑ Yes
[] No
❑ NA
❑ NE
❑ Yes
5J, No
❑ NA
❑ NE
❑ Yes
Eg No
❑ NA
❑ NE
Page 1 of 3
21412014 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
KNo
❑ 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: t� 3
Spillway?:
Designed Freeboard (in): L
Observed Freeboard (in): __
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 DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
[Z No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
El 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
[DNA
❑ NE
maintenance or improvement?
Waste Aaolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
CR No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[:]Yes
R No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Approved
Area
12. Crop Type(s): _l1Cr`�nJd_L_�.✓—"e`er' I-
13. Soil Type(s): r{7} kC 601J � ac,`~n
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
allo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
IQ 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
X 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
Z,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.
[]Wi-IP ❑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 ❑ l20 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes IB,No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes P4 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

[Facility Number: - Date of Inspection: /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes JZLNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [Z 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 allo ❑ 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?
24. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
f,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
allo
❑ 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
J&No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWW?
❑ 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
allo
❑ 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: /10,q33r-3>D0
Date: 4 �/
21412014

MS Z1V_f 09113
• Division of Water Quality
Mcialuiumber a - •O Division of Soil and Water Conservation
•O Other Age,�cy
Type of Visit: 1$1 Compliance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: ($� Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Q� Departure Time: County: SOMP Sit Region: EM
Farm Name: Iona
Owner Name: �t A f h i 1 j j0 S LLG11
Mailing Address:
Owner Email:
Phone:
Physical Address: _% &�n P�/t Lou -e—
Facility Contact: Nmhah phO l rnS Title: Phone:
Onsite Representative: $ah+ Mi (�j�jdf6g�] _ Integrator: 6462,0 +q ;irm
Certified Operator: Mo sho(l Pb IS Certification Number: 313 1 y
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Design Current
Wet Pou1try Capacity op.
La er
Design Current
Cattle Capacity Pop.
Daity Cow
Wean to Feeder
Non -La er El
Dairy Calf
Feeder to Finish
S'j
Design
Dr. P,oul Ca aci P,o ,
Layers
Da' Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dry Cow
Non -Da'
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
TurkeX Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
[] NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
[] NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
H No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
g No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 121412011 Continued

Facili Number: - Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [RNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: k_3 _
Spillway?:
Designed Freeboard (in): _ 19 �--1-�
Observed Freeboard (in): 5A '
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 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 I. 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):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
LJ Yes
U Jc No
LJ NA
LJ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
2] No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
� No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes
(a No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[:]Yes
& 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
13 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
Pg No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
ED NA
❑ NE
Page 2 of 3 21412011 Continued

acili Number: -3 1 1 Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes 0 No NA [] NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes CR 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 C-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
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 file drains exist at the facility? If yes, check the appropriate box below.
5q Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
Yes � No ❑ NA ❑ NE
Yes � No NA NE
Yes N No NA NE
[0 Yes No E] NA [] NE
❑ Yes No
Yes No
❑ Yes No
NA NE
NA NE
0 NA NE
Comments (refer to question tf): Explain any YES answers andlor any additional recommendations or any other comments —
Use drawings of facility to better explain situations (use additional pages as necessary).
�, Pk, keq wer" 0, 6e V f M5 OA bob
a0% vvilt inafi Crq �veU *m
Cody ifs I �dy�e Bey `�a�, l�f-,
Reviewer/Inspector Name:
Reviewerllnspector Signature:
Page 3 of 3
Ne.u_ makecoff�� 4 fill ii
Phone: q Q—t03,jL J
Date: 0 Q
Z/4/2011

C11 D te
fli 113
Fat:
PLAT.'i.Annual
Permit -OIC NPDES (Rainbreaker: Ceit: biity Oipe
j
PIP
B Drops 7.1
MEM
mm
0 R, rM
MIT I m0a
M1. Ev, Mom=
MIMMM—Alamll
rl=rp
M
A
-7v
Lagociri Naryi 9 fors A ak 3 -4 5 -6
Design'j''Free and.1s Recorded.(in)
Observed, *.w
Slud a Surve
IM x
Sludg6-De"PtH.::(ft)",f?".,-,- z
Liquid 7
Ratio.SlUd ' to-,T AeblUO&if> 0.45
Date'OUC [a PTIT7
Al I. I!
Soil Test Dat j: Crop Yield Transfer Sheets
J1,
PH Fields ;- -Wettable Acres ✓ RAIN GAUGE
Lime Needed WUP Dead box or incinerator
Lime-AOpk,d �j Weekly Freeboard Mortality Records
iw�
1 in Inspections; Cu-I ­z ''I, Check Lists
Storm Water 120 min Insp. VO Needs 1, �25
Needs Pt es Weather Cod
FUMNSM I M-
MiMIN
MiMIN
IMMIMP
I Taw
Im
Im
Verify P,
Date las
Date'las
App.: H6
I ffiliations
''FRO or Fdrai Records
Lagoon #
Top Dike
Stop Pump
Start Pump
3000= 213 lb/ac

Type of Visit: [Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: tKRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: SC1M d50_ 1 Region: Fft
Farm Name: J1 la q j1 2 Owner Email:
Owner Name: _ H4A Phone:
Mailing Address:
Physical Address:
Facility Contact: Higahal j p 1 11 I'r
d Title: Now- Phone:
Onsite Representative; 'Macho I I Integrator: 6j 1 b&DgfjJli7
Certified Operator: M af$ W) i"h 1111 bJ Certification Number: ;�S 7 / Li
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Cerrrent
Design
Current
Design Current
Swine Capacity Pop.
Wet Pouttry
Capacity
Pap.
Cattle Capacity Pap.
Wean to Finish
La er
Da Cow
Wean to Feeder
Non -La erEli
Da' Calf
Feeder to Finish
Da' Heifer
Farrow to Wean
Design
Current
Cow
Farrow to Feeder
D , P7u-I
Ca aci_
P,o ,
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
LBeef Brood Cow
Turkeys
Other
Turkey Poults
Other
Other
Discharees and Stream Imuacts
I . Is any discharge observed from any part of the operation? ❑ Yes [S No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters []Yes [allo ❑ NA ❑ NE _
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: -0003 Date of Inspection: q IA
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 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Ef No ❑ NA ❑ NE
❑No ❑NA ❑NE
Structure 6
Spillway?:
Designed Freeboard (in):_
Observed Freeboard (in): 3_
5. Are there any immediate threats to the integrity of any of the structures observed?
[—]Yes
rallo
❑ 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
�R No
[Y] 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
S No
❑ NA
❑ NE
8. Do any of the structures 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
❑ Yes
CR No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
U No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �TNo ❑ 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
in�
12, Crop Types}: C 1� ha V S
13. Soil Type(s): Q
14. Do the receiving crops di er from those designated in the CAWMP?
❑ Yes
rR No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Vq No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
rKNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
0 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
to No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
M No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[R No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[E No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
CRNo
❑ 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
21412011 Continued

Facili Number: $a. - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes CR No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [gNo ❑ 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 RNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No PS NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
[:]Yes U No ❑ NA ❑ NE
❑ Yes ER No ❑ NA ❑ NE
❑ Yes [SNo ❑ NA ❑ NE
® Yes ❑ No ❑ NA ❑ NE
❑ Yes RNo
❑ Yes 6 No
❑ Yes ® No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #::Explain any YES answers add/or any additional recontinendations or any`other. comments: ' , '.
Use drawings of facility to better explain situations (use. additional pages as necessary).
3f, braf11-rile_ L4de­-�e(d (- �99ed U
W6,✓ wot� 01 b" spas on 10 04 lc 3, Som-,e_ so& war pu* d owl la3-ty,6a,
wire seiafPd, ', �ol' a lea Wl<s ado. �firr a�0�1 I aj_�year.
a 5 P �Pge d n Sj vo* S viva Fore end ofy �a� or a�� �x t a` a�, Pa Ap A.
1N�� ma �n�ail�r-aim 9 ° re( ords,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 911 0-4---Z 3'3' 6 p
Date: f ', a
21412011

Facility No. $Farm Name _ �`1 CH Date
Permit COC OIC_ NPDES (Rainbreaker PLAT Annual Cert Daily Pipe }
FB Drops
Lagoon Name, S forspillway
1
3
4
5
6
7
Design Freeboard I Last Recorded in
Observed freeboard
Sludge Survey Date
Sludge Depth (ft),
6
,
Liquid Trt. Zone ft
Ratio Sludge to Treatment Volume if> 0.45
Date out of compliance/ POA?
•
_icy.'
-----�-
Actual Flow
Soil Test Date
pH Fields
Lime Needed
Lime Applied
Cu-I Zn-I
Needs S (S-1<25)
Naarlc P 1-4
Crop Yield
Wettable Acres
WUP
Weekly Freeboard
1 in Inspections
120 min Insp.
Waathar rndpc
Transfer Sheets
RAIN GAUGE
Dead box or incinerator
Mortality Records
Check Lists
Storm Water
• 1 ! 1 Gal)
PullfFietd
Soil
Crop
Acres
PAN
Window
Max Rate
Max Amt
YVa
Cg
a-7s--
Verify PHONE NUMBERS and affiliations
Date last WUP FRO FRO or Farm Records '
Date last WUP at farm Lagoon #.
App. Hardware Top Dike
Stop Pump
Start Pump
Conversion- Cu-I 3000= 108 Ib/ac; Zn-I 3000= 213 Ib/ac

Type of Visit: 12FCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: &Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: rCjq � Departure Time: County: _S06? — Region:
Farm Name: n1 — I Owner Email:
Owner Name: 4 A L U Phone:
Mailing Address:
Physical Address:
Facility Contact: M&JrlQL1 Phil l I ins Title: (Owner Phone:
Onsite Representative: hr f1 r� Ike Integrator: 6oldibovo-im
Certified Operator: Hfta 11 Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Design
Current
Design Current
Swine
Capacity Pop.
Wet Poultry
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
Layer
Dai Cow
Wean to Feeder
Non -Layer
Da' Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
Design
@urrent
Dry Cow
Farrow to Feeder
i
P,o
Non-Dai
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
Turkey Poults
Otlter
Other
Dischar2es 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 W No ❑ NA ❑ NE
❑Yes ❑No ❑NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation?] Yes R No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes IF<[ No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

lFacHily Number: S1 - 3 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 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Spillway?:
Designed Freeboard (in): �1L�
Observed Freeboard (in):
5. Are th"ere any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
[U-No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 6
[:]Yes [5R�No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
C�'No
D 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
C' No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
UNo
❑ 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
2"No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
N 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): elm Vdtq ` Smq11 0V
13. Soil Type(s): Qdibotok6 RCL.1. 1'Vd I t'
14. Do the receiving crops differ from those desi t d 1 the CAWMP?
❑ Yes
to 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
P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
10 No
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
t5jNo
❑ 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
❑ 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
EffNo
❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
N NA ❑ NE
Page 2 of 3
21412011 Continued

Facility Number: IDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 153'No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes
C*No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes
❑ No
[51 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 file drains exist at the facility? If yes, check the appropriate box below.
YW
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?
0 Yes [&No ❑ NA ❑ NE
❑ Yes CR No ❑ NA ❑ WE
❑ Yes R No ❑ NA ❑ NE
0 Yes ❑ No ❑ NA ❑ NE
[] Yes
C`No
❑ Yes
(R No
❑ Yes
EWNo
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Comments (refer to'question ft Explain any YES answers and/or any'additionai recommendations or, any other comments..
Use: drawings of facility to better explain situations (use additional pages -as necessary). a p
me_--()elds as naede , SoWvr or*ii�1 have- heIf A c%
peVi -Fbc a ®11.
of Pro IV -forS1V S te ve eXe,,00 mo14ed)to Pa�°1 �7
-Oek 1!
n 9 �
arrnl �iQ ldi � sec& d_j a-e r' pdAye- Qjrce#4 of n aW a ba,,
Nof'o, hos bPfj s�(Pmy /of Virft1b Noun,.
Reviewer/Inspector Name: �sScj noA
Reviewer/Inspector Signature:
Page 3 of 3
Phone: }
Date: Qf
412011

Type of Visit 0 Compliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit P Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: ����.. , Arrival Time: .' Departure Time: County: `S� Region:
Farm Name: 1<1l 1 t q--I fe Owner Email:
Owner Name: H4 /T All i (! ns L L C Phone:
Mailing Address:
Physical Address:
' I ago-ofi1
Facility Contact: ulshal �h l 11� Title: ��►`�79' Phone No:
Onsite Representative:
Certified Operator:
Integrator:
Operator Certification Number: oilt�
Back-up Operator: Back-up Certification Number:
Location of Farm:
Latitude: [= o = 4 = H Longitude: = ° = 6 = IL
Design Current Design Current
Design
Current
Swine Capacity Populatian Wet Poultry Capacity Population
Cattle Capacity
Population
❑ We;; to Finish
❑ La er
❑ Dai Cow
❑ Wean to feeder
I I
Non -Layer I
❑ DaLrySalf i
Feeder to Finish
-1 0 MQQ
❑ Dairy Heifer
❑ Farrow to Wean Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
ElNon-Dairy
El Farrow to Finish ❑ Layers
❑ Beef Stocker
❑ Gilts ❑ Non -Layers
El Beef Feeder
❑ Boars El Pullets
❑ Beef Brood Co
❑ Turkeys
Other ❑ Turke PouIts
❑ Other ❑ Other
Number of Structu€es:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes §-No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
2 No
❑ NA
❑ NE
❑ Yes
RNo
❑ NA
❑ NE
12128104 Continued

• Facility Number: IS — pM3 Date of Inspection d �
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [SNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 14 14
Observed Freeboard (in): 7 ��-
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ®No ❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes [SNo ❑ 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 [2 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [S 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 CA No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes MNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes tijNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ES No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
RNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
0 No ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
allo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E -No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/,or any recommendations or.,any ether comments
Use drawingsof facility to better explain situations. (use "additional pages, as necessary.). ..
AL
Reviewerlinspector Name 0 Sc PJLo, Phone:
Reviewerlinspector Signature: Date: NPV
Page 2 of 3 " 12128104 Continued

Facility Number:S-6, —Cj Date of Inspection j T ic1 I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 1}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 ❑ Desig
n El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes S No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 ° Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
P No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
® NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
F�jNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[,RNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
RNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
[RNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
B No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
® No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
B No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[g 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
BNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
❑'No
❑ NA
❑ NE
Addition'a1 Comments and/or DiraWmgs:' a
} � .
... �f
p vt m (r b-ailt>, ` & 07e is - cW,04 `1 7us 1� aen*at -fir a I t s�oayr?y
sw�e � ,P Qt~ C�l�r Or- a r /�x��,
cad reca-ds
�[Mdv4aiaj n01e06e1nth-o),3(Dw# Cjrj
Page 3 of 3 12128104

• Facility No. 15'd\r'OD3 Farm Name lo-A q � h Date I 1(
v IL
Permit COC OIC� NPDES (Rainbreaker PLAT Annual Cert )
M-MM
mL M .71Tlwan aN-
ININ0R.M"''ram
Lagoon
mL M .71Tlwan aN-
ININ0R.M"''ram
Lagoon
2
3
4
5
6
7
Spillway
Design freeboard
Observed freeboard in
Sludge Survey Date
10
Sludge Depth (ft)
Li uid Trt. Zone ft
<
<
Ratio Sludge to Treatment Volume
Calibration
-Date
ActualWidth
--------
Soil Test Date S�Ub a0(0 Wettable Acres RAIN GAUGE
pH Fields WUP Dead box or incinerator
Lime Needed Weekly Freeboard Mortality Records
Lime Applied 1 in Inspections
Cu-I �Zn-I `-� 120 min Insp.
Needs P ¢ (�G�- Weather Codes 1
r.mn Yielrl t / Transfer Sheets
- -
all _
.1 r.
111 _
/ / /
.,
�.
f
All F4 ISG 360 T04 IUD
Verify PHONE NUMBERS and affiliations
Date last WUP FRO 'afajpq Date last WUP at farm
FRO or Farm Records
Lagoon #
Top Dike
Stop Pump
Start Pump
Conversion- Cu-I 3000= 108 lb/ac; Zn-I 3000= 213 Ib/ac
3 tp il*,
App. Hardware

Type of Visit ?Zr Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: 3o Departure Time: County: SO,% jMhRegion: M
Farm Name: 1[ ha i� j�! Owner Email:
V F
Owner Name: M4 phi ! I ITnS L L G Phone:
Mailing Address:
Physical Address:
r F 1 0
Facility Contact: `V Title: �� ! 1Phone No:
Onsite Representative: SrI'1 9hilii Integrator: 6oldsh o _
Certified Operator: 1 fars� [ 1 I QS Operator Certification Number: &WA a S7I 9%
Back-up Operator: Back-up Certification Number:
Location of Farm:
Latitude: = o = & = Longitude: = ° =
Design Current
Design C►urrent
Design
Current
Swine Capacity Population
Wet Poultry C►apacity Population
Cattle Capacity
Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
❑ Non -Layer
❑ Daia Calf
® Feeder to Finish
❑ Daia Heifer
❑ Farrow to Wean ,9D
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
El Layers
❑ Beef Stocker
❑ Gilts
❑Non -La Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
J
❑ Turke s
1Other
❑Turke Poults
Number of Structures: n�
1FE1 Other ❑ Other
Discharees & 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 E No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
CKNo
❑ NA
❑ NE
❑ Yes
fTNo
❑ NA
❑ NE
12128104 Continued
\I

Facility Number: a — OQj Date of Inspection f
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes RNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): Q
Observed Freeboard (in): JS
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes I'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 5;�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? Ryes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes lij 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 IR No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes E,;�Oo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
El
ER No
❑ NA
❑ NE
�29
15. Does the receiving crop and/or land application site need improvement?
Yes
JE No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination
? ❑ Yes
N' No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
ERNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
fg�No
❑ NA
❑ NE
s
g y recommendations or anyeothe11AW" cents. may, Comments (refer to question #): Explain any YES answers andlor an
Use drawings of facility to better explain situationi: (use additi inal,pages as necessaryd)
.. .. .. _
Reviewer/Inspector Name MUZS l E Phone 1U`[3Qd /�''3.j
Reviewer/Inspector Signature: p ! Date: 4L� a3 Q00q
12128104 Continued

Facility Number: g a — s Date of Inspectiond3
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes El No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 5;-No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
IRNo
❑ NA
❑ NE
❑ Yes
❑ No
C9 NA
❑ NE
❑ Yes
IR No
❑ NA
❑ NE
❑ Yes
®'No
❑ NA
❑ NE
❑ Yes &No ❑ NA ❑ NE
❑ Yes ❑ No [27NA ❑ NE
❑ Yes Ej� No ❑ NA ❑ NE
❑ Yes (SNo ❑ NA ❑ NE
❑ Yes Rwo ❑ NA ❑ NE
❑ Yes
ErNo
❑ NA
❑ NE
❑ Yes
f No
❑ NA
❑ NE
❑ Yes
Q-RO
❑ NA
❑ NE
7. So� laid o, inside. s 1or o'f- lajO&Lr. C ocd K&4-1 Vx rbae aevj rvoat
GY 6r-�e sad« �a have IorkB►�^
,, er roil 4mvlch f y
15, S'o d ll.r he''e Qid o�rw, SAS»-e -e;-efdr neeO (1�ne,
Fe1di 7 4 g ore a btu~ hi h on cod '-r,��,,,�C op c u -34ex.
'al � -� � . ° a,.r --b r e_rr bye _rf
©u
ll}/1 tih v(,�Q I f) -S r } A
�S o d e sl,trv-e n b �-, o� ��t
cool -" vecods.
12/2VO4

Facility No. m Name ti'�t9 itn* _ Date
Permit ✓/ COC OIC NPDES (Rainbreaker
Pop.
Type
Design
Current
FB
Dr(
PLAT Annual Cert )
Lagoon'
31
3
4
5
6
7
Spillway
Design freeboard
Observed freeboard in
Sludge Survey Date
Sludge Depth ft
Liquid Trt. Zone ft
0
Ratio Sludge to Treatment Volume
1�1�1!1f��4iTrl=�[[t�T�r'1
Design Flow
Actual Flow
Design Width
Actual Width
Soil Test Date gbaa Wettable Acres RAIN GAUGE
pH Fields WUP Dead box or incinerator
Lime Needed Weekly Freeboard Mortality Records
Lime Applied 7 7} 1 in Inspections
Cu-I ✓ Zn-Ir 120 min Insp.
Needs P �Weather Codes
Cron Yield Transfer Sheets
ste Analysis
Ar—
rMITIRern!
•-�
In T
Verify PHONE NUMBERS and affiliations
Date last WUP FRO aIA4�
A'[ qk IiVate last WUP at farm
FRO or Farm Records
Lagoon #
50.0
�1
Top Dike
Stop Pump
Start PumpV 1
Conversion- Cu-1 3000= 108
Ib/ac; Zn-1 3000= 213 Ib/ac
M"ae s6 bj 4I-7
App. Hardware
��/

&Ujs �C,'A'4Z O/loe{lzooS
Facility Number
® Division of Water Quality
Q Division of Soil and Water Conservation
O 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 0 Referral 0 Emergency 0 Other [IDenied Access
Date of Visit: Arrival Time: Departure Time: �2 = i�o M County: SreN Region:
Farm Name: _ K"At A Owner Email:
LIP
Owner Name: AA o G l Fv ads . £ice C- . Phone:
Mailing Address:
Physical Address:
Facility Contact: G eor�5 <.. Pc-7'Tu S _ Title: Phone No:
OnsiteRepresentative: Integrator: WOA'wal /CoCds
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: [_—] o =' = Longitude: 0 ° =' =
Design Current Design Current
Swine Capacity `PopulationWet Poultry Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish S7(Or7
ElFarrow to Wean
ElFarrow to Feeder
❑ Farrow to Finish
❑ Gilts
Other
❑ Other
EEO]La er
ElNon-Layer
Dry Poultry
Non-L;
Pullets
Poults
Discharges &Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑Structure El Application Field El Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population ly
❑ Dal Cow
❑ Dairy Calf
❑ Dal Heife[
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes [4 No ❑ NA ❑ NE
❑ Yes
� No
❑ NA
❑ NE
❑ Yes
� No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
� No
❑ Yes
[� No
❑ NA
❑ NE
❑ Yes
O Na
❑ NA
❑ NE
71/18/04 Continued

Facility Number: 82 — 003
Date of Inspection /z-28 D7
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: 03 'V #
❑ Yes q No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): #to 293
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
(A 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
Ep No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
® No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
[3No
❑ 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
[�j No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[P No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes F No ❑ NA [I NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ] 0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) a'V1ds `n kn 9ALVS , 1,JG. gWA-1
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [g No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
RNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
[�JNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for ]and application? ❑ Yes
W No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
® No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
AL
Reviewer/Inspector Name iG Phone: 910, eI33. 336 a
Reviewer/Inspector Signature: ,r0� Date: / Z — Z ir— z6a 7
12128104 Continued

Facility Number: gZ —Oo Date of Inspection �Z'zY`p7
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 CAWMP readily available? If yes, check ❑ Yes ( No ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ 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 [h No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes WNo ❑ 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
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ N _
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
1� No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fait to notify the regional office of emergency situations as required by
❑ Yes
P No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
W No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
W No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

Up d n k-j- SrS �"r. /e<N�+ ✓� d ,ZP— t Oho -D %
WLDivision of Water Quality
Facility Number Division of Soil and; Water Conservation
- D 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: d- -(f Arrival Time: /Z ij Departure Time: County: 9�' Sd7✓ Region:
Farm Name: Owner Email:
Owner Name: A&-5ew"- 1� 145600.5 �1VL r Phone:
Mailing Address:
Physical Address: �] �
Facility Contact: (_eC25� toe_4` .2 Title:
Onsite Representative:. 4;C0Y4.[r 5 -_
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
Integrator: &,ff)We,11 ,5aglS G.
Operator Certification Number:
Back-up Certification Number:
Latitude: = o a t = u Longitude: 0°= I=
Design Current Design Current „.. Design.
Currentp
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
ZZ
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other.
Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
discharge observed from any part of the operation?
Discharge originated at: ❑ Str!%Ke
❑Application Field ❑Other
a. Was the conveyance mamade?
b. Did the discharge reach waters of the State? (I y"�3 notif -w
c. What is the estimated volume that reached waters of the State
Cy ow
Calf
alf
y Heifer
Cow
U Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
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?
Page I of 3
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
59 No
❑ NA
❑ NE
❑ Yes
[�PNo
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
1� No
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
53 No
❑ NA
❑ NE
12128104 Continued

Facility Number: Z — O 3
Date of Inspection it 9-
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?
Structurq] Structure Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes M No ❑ NA ❑ NE
❑ Yes V No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes R1 No ❑ NA ❑ NE
❑ Yes WNo ❑ 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 M No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes IN 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 [XNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [5 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes Eff No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) Ee"wu dc� AN Sf�IL ",: /
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [ffNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ONo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes 0 No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes [5 No ❑ NA ❑ NE
❑ Yes 14 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
Phone: it��33- 330 O
Reviewer/Inspector Signature:
Date: &i -25F—ZOO
Page 2 of 3 12128104 Continued

Facility Number: Z — O3 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [X No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 0 No ❑ NA ❑ NE
the appropriate box.
❑ WiTP ❑Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [X No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[FNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
1 No
9
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
OpNo
❑ 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
[9No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Cl Yes
DjNo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
VNo
❑ 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
5'No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[?No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
�3 No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
Pa?No
❑ NA
❑ NE
Additional Comments and/or Drawings:
T
Page 3 of 3 12128104

1�c4d-ew e_ + h7 RJL- Ir-06 -0 f
tV Division of Wafer Quality
Facility umber--Z �� o 0 Division of Sail and Water Consen anon
Other Agency
Type of Visit 6Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 01=ollow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: ? 2 o Arrival Time: Departure Time: County: Region: 7:= S�
Farm Name: L4="_ _ §,= �j — 14. Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: Cs -a 2-G9- (3
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other .
❑ Other
Latitude:
Phone:
Phone No:
Integrator: G o LflS &4 :-
Operator Certification Number: 12 'T L
Back-up Certification Number:
= " Longitude: 0 o E--] , = "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
,OG — --
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ 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 Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Col
i
Number of Structures:
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes !Z No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Facility Number: 2�— °3 Date of Inspection L o
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P 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: 10,
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes VNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes [ rNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 46 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 El NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? El!rJ 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 LI No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes 91No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ZNo ❑ 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 ElEviderkeeofWbadDrift ❑ Application Outside of Area
3z2 27 S
12. Crop type(s) C. gam{" W oAr-- 4�%A ` fs
13. Soil type(s) G n
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
A No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ZNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination:
❑ Yes
ON.
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
;3 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
EJ No
❑ NA
❑ NE
��'
Reviewer/Inspector Name 1 Phone:
�WM
Reviewer/Inspector Signature: Date: 'a
7 9/7Rinl rA"0;"rjed

Facility Number: gZ — 83 Date of Inspection z 3
Required
Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes 9No
❑ NA
❑ NE
20.
ggI a_Z_
Does the facility fail to have all components of the e P readily available? If yes, check
❑ Yes No
❑ NA
❑ NE
the appropirate box. ❑ W-Up ❑ Checklists ❑ Design
g El Maps [I Other
21.
Does record keeping need improvement? if yes, check the appropri to box below.
L6 Z Z.3 a ZS' Z•1V �j Z, Z-� fl
El Yes El No
El NA
[I NE
n
El Waste Application ElWeekl Freeboard Waste Analysis ❑ Soil Analysis Waste
y
Transfers ❑Annual
( rti
�
fication
❑ 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 1 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes No
❑ NA
❑ NE
25.
6.
Did the facility fail to conduct a sludge survey as required by the permit? I�tcroY 3�
❑Yes No
El NA
El NE
26.
Did the facility fait to have an actively certified operator in charge?
❑ Yes No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes V(No
❑ NA
ElNE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El �( No
❑ NA
ElNE
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
A
❑ 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 4No
❑ 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 Q No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes 4 No
❑ NA
❑ NE
Z 'BJE, c dD t C-aq-F_ c, g Fes•,) oA 4-T er sT c�oP G 9 ,JCOA So; L TES rX
car _ w Its TP,64aUrr V€." -r/V(.C_ 914k5
� " "JA _ l YE C��r4hr`ca p o� s el aci'
l2/2V0d

Type of Visit • Compliance Inspection O Operation Review O Lagoon Evaluation I
(Reason far Visit • Routine O Complaint O Follow up O Emergency Notification O Other © Denied Access
Facility Number � 3 Date of visit: � / � Time: : 2 a
� Not rational Q Below Threshold
GkOermitted [certified E3 Conditionally Cerdfied 13 Registered Date�Last Operated or Above Threshold:
Farm Name: —Lag �I -/li County:
1
Owner Name: /7 X. a f F; /s -r«� � _ 'Phone No: 9 ! 4----7 7 8 313 D
Mauling Address: _�• d. Box 109 12 2 Got NL ?7
Facility Contacts 44- --------------------- Title:
Onsite Representative: e r11P u
Certified Operator: TT ,� —444& 64, 2 C-C-1
Location of Farm:
Phone No:
Integrator- H�9 /5r-a1
Operator Certification Number.
❑� ^Swine ❑ Poultry ❑ Cattle ❑ Horse
�de �• �" Longitude �• �u
Discharses & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑'iqo,
Discharge originated at~ ❑ Lagoon ❑ Spray Field ❑ Other
a If discharge is observed, was the conveyance man-made? ❑ Yes C--Ko'
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑Yes 91Qo
c. If discharge is observed, what is the estimated flow in gal/min? �-
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes M-Nii
2. Is there evidence of past discharge from any part of the operation? ❑ Yes Q�Ke
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State outer than from a discharge? ❑ Yes 9NO
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes Eallo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier. I
Freeboard (inches): y �' yy `
IM2103 Continued

Facility Number_ —
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? Cie/ trees, severe erosion, ❑ Yes U-N-0
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes &Wo
(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 smicdues need maintenancefrmprovement? ❑ Yes Ei-
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes Q>K'
9. Do any stucmres lack adequate, gauged markers with required maximum and minimum liquid level ❑ yes ❑,per
elevation markings?
Waste AnWiration
10. Are there any buffers that need maintenanm/improvement? ❑ Yes 63M
11. Is there evidence of over application? If yes, check the appropriate boa below. ❑ Yes ❑.NU—
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
hod r9�a'7f
12. Crop type , // �..,.:. l9vpr«.J .
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes [.ENO
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) M is facility is pended for a wettable acne determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes UNo
16. Is there a lack of adequate waste application equipment? ❑ Yes [t KO
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes B No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes EgNo
roads, building structrue, 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 [Wo
Air Quality representative immediately.
srtfer to � YI�Saassrns-aadlar- orr, # - �--
��' - �:!) D•F�e1d Copy ❑Final Notes
Reviewer/InspectorNgme ' M
-Z
Reviewer/Inspector Signature: Date: Ll -3 D -o y
.1"Z" 7 W"A"U M

Facility Number. $ 2 — j Date of Inspection L/j-,70-,OzjI
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all co nents of the Certified Animal Waste Management Plan readily available?
(ie! J , chec deft, c.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ tiea ❑-F�+xba ❑ WWWAaiysie- ❑saffsampftng ,G /. 7 /, G
-7 02 � ". 8� /, 17 33 � -7, `f 2. 3 S ,
24. Is facility not in compliance with any applicable setback criteria in egect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did ReviewerAuspector fail to discuss reviewimspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
ZG. Were any additional problems noted which cause noncompliance of the Certified AWMP?
!`'FOES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (if no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement) If yes, check the appropriate box below.
Gpep -yield Pon&—❑ 1 Gf6-M ion After I " Rain
❑ ❑
❑ Yes Leo
❑Yes UNI
❑ Yes Eg-No'
❑ Yes B<o
❑ Yes [�o
❑ Yes [314o
❑ Yes 0' 0
❑ Yes Q-No
❑ Yes RING
Fifes
El No
❑ Yes
Ep o
❑ Yes
Ohio
❑ Yes
0#G
❑ Yes
}
[moo
!/ bob es
M*icr—
12/12M

Site Requires Immediate Attention: 3A.R..
Facility No. .1 - 3
zIt
-
DIVISION OF ENVIRON11+fENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 1995
Time: li : 05 kM
Farm Name/Owner: '; r r i u e n�
Mailing Address: Z{ q E rf� Sire e, [� a t a w N G 'LS 3 9 B
.County:
Integrator. bjcnn Fo.rr►►s _ Phone: a93- 3SL14
On Site Representative: Phone:
Physical Address/Location: - i � a & 2 4 Ea s 4- +a 4vv kt- /eF4-
a+` K'n W1 Lfle ! r..r.n o ri-qkt qo 3
Type of Operation: Yv6e _&- Poultry Cattle
Design Capacity: See below Number of Animals on Site: 5e� f3e1 cw
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude• Longitude•
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) Yes or No be , Actual Freeboard:'e�law Ft. =g Inches
Was any seepage observed from the Ia oon(s)? Yes or&Was any erosion observed? Yes orN
Is adequate land available for spray? �or No Is the cover crop adequate? �or No
Crop(s) being utilized: Cara -
Does the facility meet SCS minimum setback criteria? 2G6 Feet from Dwellings? �s or No
100 Feet from Wells? & or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or 0
Is animal waste land applied or spray irrigated within 25 Feet of a USGS. Map Blue Line: Yes or 10
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or C _0 if Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)?' . or No
Additional Comments: F&l 4% _ kad •}+., o s c.10.+� ooer�-i a �+ s Boffit+ �'��u` Lot
F I FZ J G 1= AA r d aa. ` C I c A- 7
fr"bou,CA Z = �.1 •`
L = 141- L 3 % 2 �1- Fs.G� opera++
L:L - I Ly- _ 50rM ';% reefs
L I s Ls pen Cral i 'e
LZ � I.►Se.h Z remote
Inspector Name
,`Rk ewe
t�ZQ .4
Signature
s x
ages v..q b/j-
cc: Facility Assessment Unit Use Attachments if Needed.
0'so ^Aeds _"f% _
k- & a /OAS

State of North Carolina
Department of Environment,
a Health and Natural Resources 4 • •
Fayetteville Regional Office
James B. Hunt, Jr., Governor ID E H N F�
Jonathan B. Howes, Secretary
Andrew McCall, Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
November 15, 1995
Circle Q Farms
Attn: Mr. Craig Quinn
214 Elm 'Street
Warsaw, NC 28398
Dear Mr. Quinn:
I would like to extend my sincere thanks for allowing to ` visit your farm on
November 13, 1995. As per our conversation Monday, It Is of extreme importance that the,
lagoons serving Cole Quinn's facility are pumped immediately as they are above the 19" of
recommended freeboard levels. We also discussed the removal of the hay bails present in
your spray fields before land application is Initiated. As I am familiar with your company's
tradition of excellence and legal compliance, I am confident that the above mentioned
items will be addressed as soon as possible. Also, please contact me at [phone]
when you begin spraying:
If you should have any questions concerning these matters, please do not hesitate
to call me. Once again, thank you for your time and consideration.
Sincerely,
Ed Buchan
Environmental Engineer I
Wachovia Bolding. Suite 714. Fayetteville, North Carotirwa 28301-5W Telephone [phone] FAX [phone]
An Equal Opportu-ity Affnmarme Action Employer 50% recycled/ 10% post -consumer paper

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Facility No. —3 Farm Name Date
Permit COC OIC NPDES {Rainbreaker PLAT Annual Cert
WA
Rammr=��
Lagoon
1 3
2k—kj
3
4
- 5
6
7
Spillway
Design freeboard
Observed freeboard in
Sludge Survey Date
Sludge Depth ft)
3 o
Liquid Trt. Zone (ft)�
Ratio Sludge to Treatment Volume
Actual Width
--�---
Soil Test Date
i ?
pH Fields
�-
Lime Needed
Lime Applied
Cu-I %.,Zn-I
Needs P
D-10o
Wettable Acres
WUP ✓
Weekly Freeboard�-
1 in Inspections
120 min Insp.
Weather Codes
.. Yield TransferSheets
Waste Analysis Date
RAInboxU(r
E
e incinerator
Mortality Records
MA
HD SG T ��
Verify PHONE NUMBERS and affiliations
Date last WUP FRO a0 Date last WUP at farm
L FRO or Farm Records
Lagoon #
Top Dike 5a 0 ���'�M a0,151-°/
Stop Pump 1- 513 1
Start Pump qb, (
Conversion- Cu-I 3000= 108 Iblac; Zn-I 3000= 213 lb/ac
see-Ha--
App. Hardware
Aq-wa7
qY(
jq q
r