820008_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

k fi1 S � >
ivision of Water Resources
Facility Number - O Division of Soil and Water Conservation
O Other Agency
Type of Visit: O'Compliance Inspection Q Operation Review O Structure Evaluation Q Technical Assistance I
Reason for Visit: OrCutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access 11
Date of Visit: i�1� �, / U Arrival Time: D Departure Time: County: s/4V50lf Region: ( (Z�V
Farm Name: `�—' F,c» Owner Email:
Owner Name: -S Rg 3 �� Jj�d�' �s Phone:
r-
Mailing Address:
Physical Address:
- Facility Contact: C-L"` ' 1 S &&`Q &It Title:
Onsite Representative: ! I
Certified Operator: Ti k-t
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: 13-5
Certification Number: Z�g
Certification Number:
Longitude:
Design Current Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish
Wean to Feeder 5 (9 WTI
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Layer
Non -La er
Pullets
Other
Poults
Design Current
DLX Cow
Dairy Calf
Dairy Heifer
Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges Stream
and Impacts,
1. Is any discharge observed from any part of the operation?
❑ Yes
1 +J- -<
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
Q�;,,NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
i
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
[—]Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
M.
7No
0 NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[:]Yes
IJ
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facilit3o Number: Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure I Structure 2 Structure 3
l_o ❑ NA ❑ NE
❑ No ❑ NE
Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): r
Observed Freeboard (in): d S J 1 3 17 (O
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �oo ❑ 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 0 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 environ e 1 at, W notify DR
77o any of the structures need maintenance or improvement? es 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 12 0 ❑ NA ❑ NE
maintenance or improvement?
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): C 0 H!! y 5 , 0 C_W,5 _
13. Soil Type(s): /)%p Qo °�- _ 13 C am
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Rio ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑- o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes l9'ro ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Renuired Records & Documents
❑ Yes 10
[:]Yes [:;,i�o
❑ NA ❑ NE
❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
l ]Xo
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Eb'
❑ 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
❑'Nlo
❑ 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
E5'1�o
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facilitf Number: 0.2 IDate of Inspection: %1
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Egl o ❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check
❑ Yes
To ❑ 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
[g<o ❑ NA
<
0 NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[] Yes
❑ 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 [ o ❑ NA ❑ NE
❑ Yes []� �o❑ NA ❑ NE
❑ Yes [! o ❑ NA ❑ NE
❑ Yes =eNo ❑ NA ❑ NE
❑ Yes [B o ❑ NA ❑ NE
[:)Yes To ❑ NA ❑ NE
[:]Yes No ❑ NA ❑ NE
Comments.(refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
D r `o
2 �, 3 34t u3
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4-7 yvv,,, u'X I
C( 0(10-
Reviewer/Inspector Name: t ``
Reviewer/Inspector Signature:
Page 3 of 3
Phone: `0` t V 3-33 J
Date: ki 16
2141201

t 5 rvl 16 u
ivi`sion of Wat--MResource
Fraciility Number ®- O Division of Soil and Water Conservation
DQ Other Agency
Type of Visit: ompliance 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: 411
rrival Time: 4 t!O Departure Time: c County: sw
Farm Name: Owner Email:
Owner Name: E" Phone:
Mailing Address:
Physical Address:
Region:
Facility Contact: [� �� Title: Phone:
Onsite Representative: tc Integrator: _
Certified Operator: Certification Number: Z Zf p i(
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Swine
Wean to Finish
Desigu Current
C►apacity Pop.
Wet Poultry
La er
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
I INon-Layer
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
D P P,oaltr,
Layers
Non -Layers
Pullets
Design
Ca aci
C►urgent
P,o
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Turkeys
Turkey Poults
her
Discharnes and Stream Imnacts
1. is any discharge observed from any part of the operation?
[::]Yes
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
E'RE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
aNA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
Q No
[' NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
❑ Yes
E!No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
E�'�o
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facili Number: jDate of Inspection:
Waste Collection & Treatment
. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes B No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No hTA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): J, (0_-
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [ l� o ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [� 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
dNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[2*No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[:]Yes
[ N' o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
E]�No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [7f 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): o
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes J201�o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes E2"�o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes �to ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
[:]Yes �No ❑ NA ❑ NE
❑ Yes P�Mo [DNA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [Er 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 l
❑ 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 [3'oko
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ff7rNo
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection: ,fr67
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑Yes [Z<o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [:k5o ❑ 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 [2"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 dNo ❑ NA ❑ NE
[:]Yes 0No ❑ NA ❑ NE
❑ Yes dNo ❑ NA ❑ NE
[:]Yes allo [DNA ❑ NE
[:]Yes [ rNo
❑ Yes �FNO
o
❑Yes
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question # ): Explain any YES answers and/or'any additional recommendations or auyother :66mments: 'r
Use drawings of facility to better explain situations (use additional pages as necessary).
('%V14'9' Or J
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Reviewer/Inspector Name:
Reviewer/Inspector Signatw
Page 3 of 3
Phone: To —03
Date:d7L
ir
21412015

i ype or visit: rd.c:ompnance inspection v operation tceview V Ntructure r,vatuatnon V t ecnmcai Assistance
Reason for Visit: CKoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: jjO Arrival Time: Departure Time: County: �—
Farm Name _�� ��'Tj ��- � Owner Email:
,4 i
Owner Name: e "'4r Phone:
Mailing Address:
Physical Address:
Regiou��_Ll�
Facility Contact: �F I `5 ��rttNt Title: Phone:
Onsite Representative: (t Integrator: r .7
Certified Operator: �nl wtl Certification Number:
Back-up Operator:
Certification Number:
Location of Farm: Latitude: Longitude:
IA,A C.&44 Za is 6 t 3g A Pa 0 "r6 tFc-- 61
Design Current Design
Swine Capacity Pop. FRRZ7U�Capacity
Wean to Finish La er
Current Design Current
Pop. Cattle11111��Pgcirymrop.
Da Cow
Wean to Feeder Non -La er
Da' Calf
Da' Heifer
Current Cow
Po Non -Dairy
Beef Stocker
Beef Feeder
Feeder to Finish
Farrow to Wean Design
Farrow to Feeder I)rJ P�oultr. Ca aci
Farrow to Finish Layers
Gilts
Non -La ers
Boars Pullets Beef Brood Cow
Turke s t
Other Turkey Poults 1
Other Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes Q.Ai NA ❑ NE
❑ Yes
[:]No
[ A
❑ NE
❑ Yes
[:]No
[]�>K
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) [:]Yes [:]No [514A ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [:]Yes [2'No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes eNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

1 _ G
+acili Number: yr, jDate of Ins ection: d '°'i
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [a N-a—D NA ❑ NE
a. 1f yes, is waste level into the structural freeboard?
Identifier:
Spillway?:
Designed Freeboard (in):
❑ Yes ❑ No ❑SiA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Observed Freeboard (in): �� lga_ 7— V _ H
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
(i.e., large trees, severe erosion, seepage, etc.)
Structure 6
1
9da ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
❑. No
[DNA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
T Do any of the structures need maintenance or improvement?
❑ Yes
[ *I o
❑ NA -
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E4eWo
❑ 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
Q�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
C h10
❑ 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 ❑ Applicatioon Outside of Approved Area
12. Crop Type(s): R-
13. Soil Type(s): A) (2 12
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
R'Ro
❑ 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 �o ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes [�No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes [�No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [n No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [:]Yes [D 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 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 dNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [—]Yes ZNo ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

racility Number: - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
ge<o
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
[BIG
❑ 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
�o
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[2lo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
[3"go
❑ NA
ONE
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
[30NO"o
❑ 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
[T�No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[ ]'No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
Yes
[2'1`l0
❑ NA
❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[3"No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[2roN' o
❑ NA
❑ NE
Comments (refer to question #i): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of.facility to better explain situations -(use additonal,pages as necessary). w m
0
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VOID
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 3
Date:
2/4/20 4

(Type of Visit: Oo70utine
Hance Inspection Q Operation Review Q Structure Evaluation O Technical Assistance I
Reason for Visit: v^d 0 Complaint 0 Follow-up 0 Referral 0 Emergency Q Other 0 Denied Access 11
Date of Visit: k
Arrival Time: r�0 Departure Time: ] County: Region: F
Farm Name: L(G tut t"A-t l � Owner Email:
Owner Name:
Mailing Address:
Physical Address:
'1L &4"`Pr Phone:
Facility Contact: Title:
Onsite Representative: - I " L` A
Certified Operator: rrt,,,,�
Back-up Operator: T trt Wl `4.ck, y
Location of Farm:
Latitude:
Phone:
Integrator:�[��
Certification Number:
Certification Number: a Z? S(/
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
La er
Non -La er
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Wean to Feeder 156
I
Feeder to Finish
Farrow to Wean
Layers
Pullets
Turkeys
Turkey Poults
Dry Cow
Non -Dairy
113cef Stocker
113cef Feeder
Beef Brood Cow
Farrow to Feeder
Farrow to Finish
Gilts
—.Non-Layers
Boars
Other
Other
_jIOther
Discharges and Stream Impact
Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes MNW_ ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No Q'11A ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
LJNA
❑ 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
[21No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
dNo
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility Dumber: jDate of Inspection: u 7-5
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[:]Yes
[D-Ne❑ NSA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No - Q'NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 131 _ 3 '36
31
7 d
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[U>e` ❑ 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
E-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 eat, 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) 4
9. Does any part of the waste management system other than the waste structures require [:]Yes [L]"'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 R(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
(j ❑ Evidence off'Wind
)/Drrift ❑ Application Outside of Approved Area
Gl'�d� 12. Crop Type(s): 6 s�n 0 C�-`�`�1�
13. Soil Type(s):
O W
❑ NE
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E0,N°
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[3,
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[3 o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
E3<
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ffNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[—]Yes
E3 o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
F:rNo
❑ 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 Inspecti Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
allo
❑ 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

I+acili.Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes (n-No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes IT i"o ❑ 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 E9,Wo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [3'No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
Q'No
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No
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
to
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[3"N'o
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[ No
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
El No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to -question.# ): Explain any YES answers and/or, any additional recommendations; or:agy.other ;comments.
Use drawings of facility to better:explain situations (use additional pages as necessary).
I
3LI
4t�
3 . Z,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: j b
21412014

tWkS
Type of Visit: t9'Com ance Inspection U Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: MAU= Arrival Time: I Ll r UU Departure Time: 7 untfi&— Region:
Farm Name: 1[- Owner Email:
Owner Name: J Q Phone:
Mailing Address:
Physical Address:
Facility Contact: _ ��4 f (i cv( Title:
Onsite Representative: K
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Integrator:
Certification Number: Q,
r--Q
r 'Pi(, Certification Number:
Latitude: Longitude:
Design Current
Design
Current
Design Current
Swine Capacity
Pop.
Wet Poultry
Capacity
Pop.
Cattle
Capacity Pop.
Wean to Finish
Layer
D ' Cow
Wean to Feeder
Non -La er
Da' Calf
Feeder to Finish
Da' Heifer
Farrow to Wean
Design
Current
Cow
Farrow to Feeder
D P,oult .
Ca aci_
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
TurkeyPoults
FM
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
[:]Yes
[EkWb ❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance rnan-made?
❑ Yes
❑ No
A
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
Lam`' ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
A
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
To
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
To
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

FaciliNumber: jDate of Ins ection:
W ^ to Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No E_N'A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):�`
5. Are there any immediate,threats to the integrity of any of the structures observed? ❑ Yes ❑'No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed andlor managed through a ❑ Yes [] " ❑ 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
E5"No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[2-No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
�io
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑"Ko'­
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [-]Yes to ❑ 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): {r�L� 6 Q
13. Soil Type(s): Ay o 6, W,
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [RRo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes E o o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes E>6- ❑ NA ❑ NE
❑ Yes []c ,moo ❑ NA ❑ NE
❑ Yes Q� ❑ NA ❑ NE
[:]Yes 0,?(@ ❑ NA ❑ NE
❑ Yes [ No ❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes Li"o ❑ 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 [2r o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EZ, o ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: Date of Inspection.
r `-
244"Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes a<o_ ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes D Ko ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑.Pin ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
Q�Nb
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
�o
❑ 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
[ 110
❑ 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
Q<o
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
I _T" o
0 NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[3"No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
2No
❑ 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). 71
9p4C
(266,.#.-o., I — I q (3
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
16-/V- 13 1,:- 1. r
4..7
-2`
3, c>
3, ((
3 `
3
3,z
b - �'- 5 - 7'e I
Phor6— M JS��
Date: 9- A4V
214120 I

type of visit: a Uompliance Inspection kd operation Review U Structure Evaluation () Technical Assistance
Reason for Visit: & Routine Q Complaint O Follow-up 0 Referral O Emergency 0 Other 0 Denied Access
Date of Visit: $ 3o Arrival Time: :10a... Departure Time: o: aDa. County• Region:.%CAQ0
Farm Name: QU �Li t� A)1. t_Sj2_r j es Owner Email:
Owner Name: , G—I E LC. Phone:
Mailing Address:
Physical Address:
Facility Contact: IVIr kQ yy�Q G3 —Title: Phone:
Onsite Representative: 4
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design CurrentWill
Swine Capacity Pap.
Design Current
Wet Poultry Capacity Pop.
Design► Current
Cattle Capacity Pop.
Wean to Finish
La er
Dai Cow
Wean to Feeder /57ay
er
Dai Calf
Dai Heifer
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Curren#
D , P.oultr Ca aci P,o ,
Layers
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turke Poults
Other
Discharees 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)
❑ Yes Fg No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
NA ❑ NE
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 [�j NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes TP No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No [:3 NA ❑ NE
of the State other than from a discharge? T
Page 1 of 3 21412011 Continued

Facility Number: - Date of Inspection:
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
❑ No
NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 3 �_
5
V
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 7 (1 4 7" H
.3C� y
q T i
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
[DNA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 1 - No DNA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [] Evidence of WindDrift,,,Application Outside of Approved Area
12. Crop Type(s): e,l1C L�fUSS ::!2).rn'4- Qh S
13. Soil Type(s): N h 1 _---
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [)4 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes P No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes rM No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
❑ Yes [P No ❑ NA ❑ NE
❑ Yes P3 No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
[] Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
M No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
N) No
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

Facili Number: Date of Inspection: Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Nan -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 property dispose of dead animals with 24 hours and/or document ❑ Yes ❑ No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes ❑ No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes ❑ No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? if yes, check the appropriate box below.
❑ Yes ❑ No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes ❑ No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes ❑ No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ❑ No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations.or any other comments.
Use drawings of facility,to better.explain situations (use additional pages as necessary),
a. w
Ie c&,-etS % J c Qc e. - 71 q/12t
Reviewer/Inspector Name-
Reviewer/Inspector Signature:
Page 3 of 3
r
Phone: 47 —y�3�33�
Date: Z
21417011

Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation Q Technical Assistance
Reason for Visit: S Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region: 0r'�
Farm Name: �j kt.►1h= -�� It �U.r sex i - s Owner Email:
Owner Name: J C_T, Lk-,C, Phone:
Mailing Address:
Physical Address:
Facility Contact: dg Mb A 5 Title:
Onsite Representative: N
Certified Operator:
Back-up Operator:
Phone:
Integrator: AwA,r� L'I
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Design C*urrent
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Layer
Design Current§111111MG=aaci
Capacity Pop.
Design Current
Cattle ty Pop,
Da i Cow
Wean to Feeder OkQ
Non -La er
DairyCalf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
D , P,o_ultr.
Design Current
Ca aci_ P,o
DairyHeifer
D Cow
Non -Dairy
Farrow to Finish
Layers
Non -Layers
Beef Stocker
Beef Feeder
Gilts
Boars
Pullets
Turke s
Turkey Poults
Other
Beef Brood Cow
Other
Other
Discharges and Stream IlnAactS
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes �g No ❑ NA ❑ NE
[:]Yes ❑ No
❑ Yes ❑ No
[:]Yes ❑ No
[:]Yes [R No
[:]Yes f] No
[,UNA ❑ NE
NA ❑ NE
[ NA
❑ NE
❑NA
❑NE
❑ NA
❑ NE
Page I of 3 21412011 Continued

Facility Nu ber:
r,
Date of Inspection: 2
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 U NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: Z .3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): .5-6 of q6 _ 6b N
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [0 No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes On 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 O 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 JR 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 �g 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): COZ r- -C4 5 (±Lz -4A 'g
.�il )I a
13. Soil Type(s): � ` -p 0 / yb Q
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes JK No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
® No
❑ NA
❑ NE
the appropriate box.
❑ WUP [:]Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes]
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
QO No
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

FacUi Nu ber: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [� No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [a 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 �jj No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes TT❑�� 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
QD No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
� No
❑ NA
ONE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 99 No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes �M No 0 NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question ##): Explain any YES answers and/or any additional recommendations or any other comments
Use drawings.:.of facility to better explain situations (use additional naQes as,necessarv).
�ec�s rtv � e�ed� RCS �rl �
4 /2gIr
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: %$
2/4/ 011

Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit *Routine O Complaint O Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 'D I Arrival Time: j%�sv-- Departure Time: 0.'Q County: JA Mf-�&J Region:
Farm Name: k �I 'e. ` Owner Email:
Owner Name: J Or LUL
Mailing Address:
Physical Address:
Facility Contact: ar Title:
u
Onsite Representative: i
Certified Operator:`--`-
Back-up Operator:
Phone:
Phone No:
Integrator: �W��J,�
Operator Certification Number: �`�'� l 7
Back-up Certification Number:
Location of Farm: Latitude: = c = 1 = Longitude: 0 ° a 1 = 11
Design§�=-urren
Design C«urren#
Design Curren#
Swine Capacity Population
Wet Poultry Capacity Population
Cattle Capacity Population
❑ an to Finish
❑ Layer
❑ Dairy Cow
Wean to Feeder
I
IS,6 OM
IEJ Non -Layer I
Dairy Calf
Dairy Heifer
Feeder to Finish
I
❑ Farrow to Wean
Dry poultry
❑ Dry Cow
❑ Farrow to Feeder
[INon-Dairy
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non -Layers
El Pullets
❑Beef Feeder
ElBeef Brood Cowl I
❑ Boars
❑ Turkeys
Other
❑ Turkey Poults
❑ Other
ILI Other I
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2, is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑Yes PINo El NA El NE
❑ Yes ❑ No [�LNA
❑ NE
❑ Yes [:]No NA
❑ NE
❑ Yes ❑ No 91NA
❑ NE
ElYes EA No ❑ NA
❑ NE
❑ Yes t�No ❑ NA ' ❑ NE
Page I of 3 12128104 Continued

Facility Number:— S
Date of Inspection k 4
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No NA ❑ NE
Struc e l Structure 2 Structure 3 Structure 4 Structure 5 e 6
Identifier. Z
Spillway?:
Designed Freeboard (in):
u w 3�
Observed Freeboard (in): 3
3 S
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
f# No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
No ❑ NA ❑ 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
1P No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
(4 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
to No ❑ NA ❑ NE
maintenance or improvement?
Waste Auptication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
No ❑ NA ❑ NE
maintenance/improvement?
7
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
o ❑ NA ❑ NE
W
❑ 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 ❑ 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?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
[�No
II
❑ NA
❑ NE
No
❑ NA
❑ NE
No
❑ NA
❑ NE
�No
❑NA
El NE
�No
❑NA
El NE
Comments (refer to question #):, ' Explain any YES answers and/or any recommendations br any othe comma
Use drawings of, facility to better .explain situations {use-additional!pages as -necessary) y 'tea
t ro y r�We
Reviewer/Inspector Name �;;
Phone: 33 -33c0
Reviewer/Inspector Signature:
Date:
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection r
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes � No ❑ NA ElNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑ WIJP ❑ CheckIists ❑Design El Maps El Other
21, Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ? No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus 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
P No
❑ NA
❑ NE
❑ Yes
❑ No
[)§,NA
❑ NE
❑ Yes
�No
❑ NA
ElNE
❑ Yes
5iNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
M No
❑ NA
❑ NE
❑ Yes 11 No ❑ NA ❑ NE
AddiionalCoinments and/or Drawings:- _.
Page 3 of 3 12128104

Type of Visit • Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 10 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: I lo/-Zq bi I Arrival Time: Departure Timer County: � � S - Region:
Farm Name: SOU L. 9k�VUe<�C' f - to Owner Email:
Owner Name: JAI LCC- Phone:
Mailing Address:
Physical Address: n -
Facility Contact: ` ly _ Title: Phone No:
Onsite Representative. r 'n,�,Inntegrator:
Certified Operator:L `-`�'"operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
C
02 69r,7
Latitude: [= o [= 6 Longitude: 0 ° = ' =
Design Current Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
❑ Wean to Finish ❑ Layer
❑ Dairy Cow
Wean to Feeder
(� Q"� ❑ Non -Layer I
❑ Dairy Calf
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
El Farrow to Finish
Gilts
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Dairy Heifer
❑ Dry Cow
ElNon-Dairy
❑ Beef Stocker
El Beef Feeder
❑ Beef Brood Co
Number of Structures:
PBoars
❑ Pullets
❑ Turke s
Other ❑ Turkey Poults
❑ Other ❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ;Z No ❑ NA ❑ NE
❑ Yes
❑ No
P NA
❑ NE
❑ Yes
❑ No
[�?NA
❑ NE
❑ Yes
❑ No
[RNA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Facility Number: —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [A No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
MNA ❑ NE
Structure 1 Structure 2 Structure 3 Structur 4 Structure 5
Identifier:
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 37 N
fe
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes 1p 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 No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ® No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes -] No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes E?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 Win%ddow, vid ncC�e�,of Wind Drift ❑ Applicationn�O�utside f Area
12. Crop type(s)l �W "MjC "< r$1' GY pl i 1::i ".--Is
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�jNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
® No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
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 additi©nal-pages as necessary).y
-
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date: 10 ZI
12128104 Continued

Facility Number: S — Date of Inspection
Reuuired 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 t9 No ❑ NA ❑ NE
the appropriate box. ❑ W"Up ❑ Checklists ❑ Desig
n El Maps ❑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 ❑ 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
EP No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
�3 NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
92 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
93 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
[S NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ER No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
1� No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
M No
❑ NA
❑ NE
12128104

c
i♦ Division of Water Quality
Caci6ty N -UmMeral and Mater Conservation
- Q Other Agency
Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: `� A(r+rivvajl Time: Departture Time: f County: ��!�Region:
Farm Name: Quo �- Ie M,a-SAX i es 1­6 Owner Email:
Owner Name: _ �C-T Lu Phone:
Mailing Address:
Physical Address:
Facility Contact: 5+�' Title:
u
Onsite Representative: t`
Certified Operator: L< ll 0.
Back-up Operator:
Location of Farm:
1 Phone No:
/` Integrator: LA4-10 L! j — &Vto n . L_L__C.
Operator Certification Number: 0?Pge
Back-up Certification Number:
Latitude: = o = L Longitude: = ° = { Q
Design
Capacity
Current Design Current
Population Wet Poultry Capacity Population
jze;si�lurieat
C►attle Capacity Population
❑Dai Cow
r�fine
o Finish
❑ La er
o Feeder oo
❑ Non -Layer
❑Dai Calf
❑ DairyHeifer
❑ D Cow
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
Dry Poultry
❑ Layers
❑ Non -Dairy
❑ Farrow to Finish
❑ Beef Stocker
❑ Non -Layers
❑ Pullets
Gilts
❑ Beef Feeder
FoBoars
Brood Co
❑❑Beef
Turkeys
Other
Number of Structures:
❑ Turkey Pou Its
M ❑ Other
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes '3 No ❑ NA ❑ NE
❑ Yes ❑ No Up NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes No PNA
El NE
,❑3�
El Yes ❑ NA
El NE
cL�No
El Yes L9No ❑NA
❑NE
12128104 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �INo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑Yes ❑ No L [I NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 S 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 33 4 3
5. Are there any immediate threa o the integrity of any of the structures observed? ❑ Yes
[PNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
0 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
1QNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ yes
V3Wo
❑ 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
1PNo
❑ 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
[-MNo
El NA [I 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
Window El Evidence of Wind Driftft El Application Outside of Area
❑ Outside of Acceptable Crop�
�
12. Crop type(s) GQS4iiN lZ-ri�SSC �� , 5 cgR. () "?: aLA L 4 QJ
is
13. Soil type(s) Ajo,,i l L—Akk &1d< A, R",,4,9, , N?` AG&
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
® No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
R,No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
M No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
V No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
1h No
❑ NA
❑ NE
Reviewer/Inspector Name Q I Phone: - 3W
Reviewer/Inspector Signature: Date: !
ruse Z u] 3 ■Z.ilaiv'f Uonrinueu

Facility Number: — Date of Inspection O
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps
p ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Wo ❑ 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
1!�No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
14 No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
R9 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
MNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
o
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
ElYes
ZNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
$ No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
+� No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[PNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss reviewlinspection with an on -site representative?
❑ Yes
10 No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
ONo
❑ NA
❑ NE
...: .p.
Additional°Comments aiid/ar Drawn
H
Page 3 of 3 12128104

qu Division of Water Quality
Facility Number O Division of Soil and Water Conservation
- 0 Other Agencv
Type of Visit & Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit (RRoutine O Complaint O Follow up O Referral ()Emergency O Other ❑ Denied Access
Date of Visit: ni 0:'3 `Arrival Time: , 1© Departure Time: County: Region:
Farm Name: �C sl. I,.�in 1-4 k?_ N E7jSsu 1 _e Owner Email:
Owner Name: �C-T _ Phone:
Mailing Address:
Physical Address:
Facility Contact: 4L'chu _�rn `UTitle: Phone No:
Onsite Representative: -y—A `D�_ �'M,14,_,Integrator: `' 4 - 6
Certified Operator: --, U ' Q { OL -f-L(- y"l Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Back-up Certification Number:
Latitude: = o = g = Longitude: = o = 1 = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
/5 I DU ❑ Non-Layet
❑ Wean to Finish
Rivean to Feeder
El Feeder to Finish
❑ Farrow to Wean
El Farrow to Feeder
El Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layer's
❑ Non -Layers
El Pullets
❑ Turkeys
El Turkey Poults
❑ Other
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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
I
?.'
Design , Current -
Cattle
Capacity Population
El Dairy Cow
El Dairy Calf
El Dairy Heifer
❑ D Cow
El Non -Dairy
El Beef Stocker
El Beef Feeder
El Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes q lYo ❑ NA ❑ NE
❑ Yes ❑ No
RNA
❑ NE
❑ Yes ❑ No,,E%NA
❑ NE
❑ Yes No
'�bNA
❑ NE
❑ Yes No
❑ NA
❑ NE
❑ Yes _.&No
❑ NA
❑ NE
12128104 Continued

Facility Number: Date of Inspection D
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes PNo ❑ NA ❑ NE
a. If yes, is waste Ievel into the structural freeboard? ❑ Yes C, ❑ NA ❑ NE
S cturc I Structure 2 Structure 3 Struct1re 4 Structure 5 Structure 6
Identifier: �7 �- e7 J
Spillway?:
Designed Freeboard (in): Iq , S 1q. .5-- S7 1q, S-
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes kNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes �allo ❑ 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 7ffNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
[]Yes ,Q)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
qNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
IgNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below.
❑ Yes
[% No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground [:]Heavy Metals (Cu,
Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) ttC6 4 C" 1K 'D (:0" Q _ �J a - &)-V
13. Soil type(s) A) A rl , tjO
_
14. Do the receiving crops differ from those designated in the CAW -MP?
❑ Yes
No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[]
Yes
o ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA ❑ NE
Comments (refer to question #i): 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):
i
Am
Q, 3
Reviewer/Inspector Name �7i A N7"a� �j 7 one: 33
�J
Reviewer/Inspector Signature:Aor Date: �i xm c),3 ��
12128104 Continued

Facility Number: —Q Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes XNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes PONo ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design El Maps El Other
21. Does record Keeping need improvement? If yes, check the appropriate box below. ❑ Yes �No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ 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
.CRNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
V 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
'lo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
KTo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
[3rNA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
,k To
❑ 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
fl3No
❑ 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
*0
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
1P
3(No
❑ NA
❑ NE
Additional Comments and/or Drawings:
So; s 4s�s ��cp�a-sect 6 �e�� 1 � Zn read �, �S ZI , 3
�es3.�.[•� V v�e0.d:ryt�..y�5 �� ���. co -ire It crnSidr -�LkY�
Z✓t �4� : r��Rro. l�o mare_ c� �►ti wo�s�� c� i mn ce
r � � n 6 � e a C AY 3b00
l fit V1caS �� LA7.15> .
12128104

0 Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation
-- 0 Other Agency
Type of Visit *Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit *Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: [ Arrival Time: Departure Time: d County: �SQ#x Region:
Farm Name: Q t ' `� Owner Email:
Owner Name: C Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
i ��rjlI j�
Onsite Representative:
��Rt sr' `�'`1'�'1 _ _ Integrator: _ rlV
Certified Operator: J U f r T �`ti` Operator Certification Number:
Back-up Operator:
Location of Farm:
Population
❑ Wean to Finish
Wean to Feeder
S D
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Back-up Certification Number:
Latitude: = o = 6 0 « Longitude: 0
Design .Current"
Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Cattle Capacity. Popula
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder?
❑ Beef Brood Cowl
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?
Page I of 3
❑ Yes �3 No ❑ NA ❑ NE
❑ Yes
❑ No
[ NA
❑ NE
❑ Yes
❑ No
I� NA
❑ NE
NA
❑ NE
❑ Yes
❑ No
❑ Yes
MNo
❑ NA
ElNE
❑ Yes
IQ No
❑ NA
❑ NE
12,128104 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment 1
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes F2 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
VT Identifier: 5 T 3 5T Y T_
Spillway?:
Designed Freeboard in
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes Q 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 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes It 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 ❑ 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
E�iN""o
❑ NA
El NE
15. Does the receiving crop and/or land application site need improvement?
[:]Yes
}Ttvo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
[:]Yes
E�F No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
ANo
❑ 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):
Reviewer/Inspector Nam 1 Pj T� Phone: �O
/33,/-33oa
Reviewer/Inspector Signature: Date: 3i o
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection I_lCyll�QbJ
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes jj$No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes JRNo ❑ NA ❑ NE
the appropriate box.
❑ WLiP El Checklists El Design ❑Maps El other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 1PNo ❑ 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 M No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
E9 No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
P 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
PTNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
o
❑ NA
El NE
Other Issues
111111
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Wo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
igNo
❑ 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
.1No
❑ 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
RjNo
❑ 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
allo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
#fNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 I2/28/04

W A TFRQ Michael F. Easley, Governor
�0 G William G. Ross Jr., Secretary
7 North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
September 1, 2005
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
JCT, LLC
PO Box 759
100 Lake Drive
Rose Hill NC 28448
RE: Sludge Management Plan of Action
Quwhiffle Nurseries 1-6
Facility # 82-8
Sampson County
Dear JCT, LLC:
------
p1 � - i
SEP 0 �9
The Division of Water Quality (DWQ) received your sludge}survey information on March 1,
2005. Upon review of the information submitted, it was determined that the minimum treatment depth of
Lagoon 546 is inadequate. Your NPDES General Permit Number NCA282008, Condition iV.16
specifies that within 90 days, a plan of action must be created to document the sludge management
procedures to be used. DWQ has not received -an adequate plan of action for this facility.
Attached is the Plan of Action for Lagoon Sludge Reduction form that is to be used. The form
outlines the compliance and reporting timeframes to satisfy Condition W.16 of your NPDES General
Permit.
Please submit the plan of action within 30 days of receipt of this letter to:
Keith Larick
Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Thank you for your attention to this matter. If you have any questions, please call me at (919)
715-6185, or the Fayetteville Regional Office at [phone].
Sincerely,
�v
Keith Larick
Animal Feeding Operations Unit
cc: File# 82-8
Fayetteville Regional Office WMCarotma
Aalmrully
North Carolina Division of Water Quality 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet h2o.enr.state.nc.us " 2728 Capital Blvd. Raleigh, NC 27604 FAX [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled110% Post Consumer Paper

rRe
e of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
son for Visit *Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Zs 0 Arrival Time: Departure Time: C� County: SCK
Farm Name: Q u _W4; _9 Mu e-S _ -1-10 Owner Email:
Region: f90
Owner Name: _ - 3cl- , LLC- /Phone: �!d - 5-70 — 3 2 toy
Mailing Address: � b r • �oSer x • �� �- yy s
Physical Address:
Facility Contact: M , CA'AAA NTitle:
Onsite Representative: /it � �� %
Certified Operator: — -No t i 0. 7-ex+v rv-
Back-up Operator:
Location of Farm:
Phone No: Integrator• MV�p�y - gr-ocy�
Operator Certification Number: 22-!rr g y
Back-up Certification Number:
Latitude: ❑ o = F = Longitude: ❑ ° ❑ ,
Design Current Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
I❑ Wean to Finish 4
Wean to Feeder (ate
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non -La et
Dry Poultry
❑ La ers
❑ Non -La ers
❑ Pullets
❑ Turke s
FuTurkey 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?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Dairy Cow
❑ Dairy Calf
❑ Daity Heifer
E]Dry Cow
❑ Non -Dairy
❑ Beef Stockee
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 0KNo ❑ NA ❑ NE
❑ Yes
❑ No
[!!JNA
❑ NE
❑ Yes
❑ No
[4 NA
❑ NE
RINA
❑ NE
❑ Yes
❑ No
❑ Yes
9No
❑ NA
❑ NE
❑ Yes P3-No ❑ NA ❑ NE
12128104 Continued

Facility Number: 0Z - S Date of Inspection A
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes 09No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
4 NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 5� ( C.5Y7- ,- 91
'C17SYS
SNIv
Spillway?: _ _ ✓t0
Designed Freeboard (in): �l�- �� rj�- c dal- S
5'
Observed Freeboard (in): �lb�' c Z5' ., 713
3o
r
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes EgNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes k9 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 [X No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
RNo
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
24No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
2INo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
&o
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
3v9l-K/Z75r 1 Zq 50 00(
12. Crop type(s) &ryLv)C.- , COn1-a rain i Swt • 9 chi; r -�aw . rJ�.Caf_0 SOdaP�15
13. Soil type(s) N�k� ()g-
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
�&No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
[K No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[-] yes
91
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
9§ No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
KNo
❑ NA ❑ NE
Comy+ments (refer.ta queshn>ii # ExQlam any YES answers andloir�any recommer<r] bons or any vtfier comments.
r;HS'°4, _ . , _. , �..d
se drawengs of facihty to.better e_aplam:sttuahans.=(tise.addibanaltpagessas necessary,).,
p�
LRe"viiewer/Inspector
ewer/Inspector Name I A . 1 Phone: qtQ `f,b-Irrc{�
Signature: Date:
12128104 Continued

Facility Number: a. — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 2jNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes MNo ❑ NA ❑ NE
the appropirate box. ❑ WUFo' ❑ Cheekli*!r ❑ Desi gY ❑ Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes CK No ❑ NA ❑ NE
❑ Waste Applicatiolf" ❑ Weekly Freeboare❑ Waste Analysie>✓ ❑ Soil Analysiso"❑ Waste Transfers ❑ Annual Certification
❑ Rainfall❑ StockirW"'D Crop Yielk" El 120 Minute Inspections" ❑ Monthly and 1" Rain Inspection!' ❑ Weather Coda✓
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?
Additional Comments and/or Drawings.
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
2SNo
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
WjNo
❑ NA
❑ NE
❑ Yes
9No
❑ NA
❑ NE
❑ Yes
g,No
❑ NA
❑ NE
❑ Yes
®•No
❑ NA
❑ NE
❑ Yes
QQ No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
9 No
❑ NA
❑ NE
❑ Yes
E9 No
❑ NA
❑ NE
❑ Yes R .No ❑ NA ❑ NE
12128104

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number O Date of Visit:
E34ermitted ECertified ❑ Conditionally Certified 0 Registered
Farm Name: [ :)az 1U- --
Owner Name:
Mailing Address:
Facility' Contact:
Onsite Representative:
Certified Operator: : to
Location of Farm: Ll
Title:
Time-
ro—Not Q erational 0 Below Threshold
Date Last Operated or Above Threshold:
County:
Phone No:
Phone No:
Integrator ,,
Operator Certification _' tuber:
k` / -7 Yp 3
swine ❑ Poultry ❑ Cattle ❑ IiorseLatitude �� C�" Longirude
Design Current
Swine Ca acts Population_
Wean to Feeder /s G D
El Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Ca acift Population Cattle Ca acts Population
❑ Laver I I I JEJ Da'
❑ Non -Layer ❑ Non-Dain
❑ Other -- -
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present 10 Lagoon Area Spray Field Area
Holding Ponds / Saud Traps" �_� ❑ No Liquid Waste Man cement Svstero
Discharges 8 Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ yes No
Discharge ori_inated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is obsen.-ed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ yes ❑ No
c. if discharge is observed, what is the estimated flow in saUmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes 0 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑yes ®No
Waste Collection 8- Treatment r
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ElYes LgI No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier. `/ 02 � S�
. -
Freeboard (inches): Y �f 3 3 • � J 9 •, iel//
05103101 Continued

Facility Number: qa — a
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed?.(ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 46 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes M No
❑ Yes 0 No
[] Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes W No
Waste Anolication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ElPAN j❑ Hydraulic Overload ❑ Yes ❑ No
12. Croptype �tr.r,.tn%J A/dit ZSc i-11 Le-1- / C.n n.e,u ryc ._ <n c-es,a:S.
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes M No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes El No
15. Does the receiving crop need improvement? ❑ Yes ® No
16. Is there a lack of adequate waste application equipment? ❑ Yes ON,
Reouired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes [JU No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes El No
20. Is facility not in complianceAith any applicable setback criteria in effect at the time of design? ❑ Yes 91 No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes [A No
22. Fail to notify regional DWQ of emergency situations as required by General Permit? �,r,
(ie/ discharge, freeboard problems, over application) ❑ Yes A No
23, Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ® No
24. Does facility require a follow-up visit by same agency? ❑ Yes ® No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes P No
0 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
anothommnCammea, _.__nn.cmsor Eren
. refer. to. uestion#E=P1sm_. ayYS wer
Use drawings of facWtv_to betterexplain siinatioas. (usse add:nonal pages as necessary) ®Field Cony D Final Notes ;
000—S �GVG �c� Spy$ a 5+ a �os�o•� i�aS 5tcv�cr� o•. stir^ ta��
HO-VC A'�'CH spr y i�C�Cr • OK•'K%1^ 2h� '-VtiAW MLI VL C'= ncc �//�
LJCr H'i/4^r-p�4' T � ��PC1 qrc
�l" -F G G 1 t �- c� G b 4 � r...-.G�4 C{ t 0 ►.J � h_ -
u f
_
�,,�►*�G i`�G1r�S CL- �►,c��Ca��A h� S�54 .�� c.
Reviewer/Inspector Name _
Reviewer/Inspector Signature: Date: lv?/
O5103101 Continued

Phone No:
Title: Phone No:
Onsite Representative: // (� k3�1_ 0._f�
Certified Operator: t/"Fl `> ► 4 C SI�j ' ► e- rSD n/
Location of Farm:
Integrator:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 ' " Longitude ' ���K
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lapoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Type of Visit 10 CompJfance Inspection O Operation Review O Lagoon Evaluation
IReason for Visit AfRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: Time:
Facility Number
Not O erational 0 Below Threshold
Permitted 0 Certified 0 Conditionally Certified [3Registered Date Last Operated or Above Threshold:
Farm Name: .�Ul� F� e County:
Owner Name:
Mailing Address:
Facility Contact:
❑ Yes No
El Yes No
❑ Yes No
❑ Yes
❑ Yes 7w—
El Yes
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
SPrux4ure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier:
Freeboard (inches): tl
05103101 Continued

Facility Number: 7L_ —QV Date of Inspection
S. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes L�No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? Yes
o
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? ❑ Yes o
8. Does any part of the waste management system other than waste structures require maintenance/improvement? El Yes�No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes 2<0
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes
11. Is there evidence of over ap lication? ❑ Excessive Ponding El PAN ❑ Hydraulic Overload El YesiNio
12. Crop type SM r g r
13. Do the receiving crops differ with dose designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 14, a) Does the facility lack adequate acreage for land application? ❑ Yes�No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ❑ N
16. Is there a lack of adequate waste application equipment? ❑ Yes No
Re aired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes o
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes � No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes lei
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑Yes No
21. Did the facility fail to have a actively certified operator in charge? ElYes No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application) ❑ Yes VZ�
23. Did Reviewer/inspector fail to discuss review/inspection with on -site representative? ❑ Yes
24. Does facility require a follow-up visit by same agency? ❑ Yes
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes
[] No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
tComments (refer to question #) E#ih „
any_YES answers and/or any recommendations or. any'voiher:cammenf
Use drawtngs of facihty to better eaplatit
situations (use additional pages as necessary) ❑Field Copy Final Notes t
f
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
05103101 j Conti uen d

l
Type of Visit (A Compliance Inspection O Operation Review Q Lagoon Evaluation I
Reason for Visit %Routine ()Complaint O Follow up O Emergency !Notification O Other ❑ Denied Access
Facility Number T Date of Visit:
Permitted ffCertified E3 Conditionally Certified [3 Registered
Farm Name: i� t"Jk"L,4e 10UP, zr: '3
Owner Name: 3GT
Mailing Address:
TIT2 Time:
10 Not Overationall 0 Below Threshold
Date Last Operated or Above Threshold:
County:
Phone No:
Facility Contact: �`'Q q- (AM,4A _ t I Title: ^►►n�a. 1Phone No: 53
Onsite Representative: �im !` "4fle�Integrator:
Certified Operator: 1c M,'4de_11 Operator Certification Number: OQIS7�f
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 4 " Longitude 0 6
Design Current Design Current Design Garrent
Swine Ca acity Po ulatiloe Poultry Ca achy P.o ulation Cattle Ga achy P,o ulation
Wean to Feeder
I 1 Ob
❑ La er
I IE]Dairy
❑ Feeder to Finish
I
ILI Non -Layer 1110 Non -Dairy
❑ Other
Total Design Capacity
T©tal SSLW
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons ❑ Subsurface Drains Present ❑ La oon Area ❑ 5 ra Field Area
Holding Ponds 1 Solid Traps1.
1=10 No Li uid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. if discharge is observed, what is the estimated flow in gaUmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Colliection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillwav
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: 44 Q'
Freeboard (inches): aR 3-] L4 �2
05103101
Structure 5
5
❑ Yes Q9 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes Q9 No
❑ Yes M No
❑ Yes M No
Structure 6
r
q 5 t/1�
Continued

ip
Facility Number: $2 — g Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not property addressed and/or managed through a waste management or ��yy
closure plan? El Yes [1� No
(It any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
S. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [N No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste Anplication
10. Are there any buffers that need maintenance/improvement? ❑ Yes MNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes M No
12. Crop type I7L�rriun�n Srr�11 �t a�.� } �1 Cnrn --
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ®No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ® No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
[K No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
Cl Yes
® No
18,
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
❑ Yes
® No
(ie/ WUP, checklists, design, maps, etc.)
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
IM No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
91 No
22
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, fi"eeboard problems, over application) ❑ Yes [54 No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes No
24. Does facility require a follow-up visit by same agency? ❑ Yes ® No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes [Z No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Use.drawings of facility to Better, explain s�tua�ons. (use additronal pages as neces5sary) ❑ Field Copy ❑ Final Notes
r` I LL 6C"r 4- evs Aced 5� (�ine� �r LUr�S. �r� UA( ilEe4
iY1C�M-%c red fc,- pCsS5t 6� f"e-Seri y�i � �
Reviewer/Inspector Name j
Reviewer/Inspector Signature:
05103101
Date:
Continued

Facility Number: g — Date of inspection 19 02
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes [� No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or �,�t or broken fan blade(s), inoperable shutters, etc.) ElC
Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes *No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
,AdditionalKohtments and/or Drawings;,
AL
05103101

i. -
Type of visit A Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit ® Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: % Tune:
Facility Number Z
FO _NotO
perationall Q Below Threshold
® Permitted ® Certified (] Conditionally Certified © Registered Date Last Operated or Above Threshold: _ ...__.
Farm Name: .. `�)."?'�''!. !t ... , %r ................ County:... S��° ...
Owner Name:.. _....... Y/.z�...G. C ...........� ........... .......� Phone No: ..t. `../C j �Z l'5;
Facility Contact: ....... Title: ....... ..._.....................0..... _ Phone No: ..... _» _� .. .. .
.. ,,1
rD0 •._........_.---- .W. .... .W....--- �_ .__.
Mailing Address: .. .....
Axe
.......... .�f -f -
Onsite Representative: .......... ./..../..-� .— 44 �/ 04 ... Integrator• ...... GR ... ._� ...
Certified Operator: ..... ..�ri,,�. .... ,�����5 ..... Operator Certification Number:......
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 46 Longitude • •
Deslga Current Desigzt, .: Current Desip
Capacity Population P40( Capadty .Population _ .- Cattle _' _ . Capac
Wean to Feeder
z�dlJ
dp
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
❑ Other I -
Total Desigu_Capaot
Total SSLw
Number of Lagoons ' Subsurface Drains Present Lagoon Area JE3 Spray >±ield Arm
Holding Ponds I Solid Traps. No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
❑ Yes XNo
a. If discharge is observed, was the conveyance man-made? ❑ Yes X110
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ) ❑ Yes XNo
c. If discharge is observed. what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes Mo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes �`No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes rRN, o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Spillway
❑ Yes o
ucture 3
5tru urf�4
StructurW
Struc u 1
Identifier: ._....__..Eructure>. .... ......Structured......-3.L....................:........�1..............................��.1..........................................._..
Freeboard (inches):
5100 Continued on back

Facility Number: — Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below JffYes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes X No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes &,No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes JarNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes Q 'No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes Qr-Ro
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? KYes ❑ No
5/00

- i
Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes �'To
seepage, etc.) e
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes ANo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancerimprovement? ❑ Yes gNo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes ANo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes WNo
Waste Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes �[No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes IRNo
l
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes XNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes Jg No
b) Does the facility need a wettable acre determination? ❑ Yes JRNo
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes XNo
16. Is there a lack of adequate waste application equipment? ❑ Yes ;'No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes )irNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ Wes, checklts , design, maps, etc.) ❑ Yes XLNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis soil sample reports) ❑ Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design. ❑ Yes ANo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes )WNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
l (ie/ discharge, freeboard problems, over application) ❑ Yes JRNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes JNo
24. Does facility require a follow-up visit by same agency? ❑ Yes ® No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes FJ'No
0 iVq.*iQlhiigns ee ftrideride wgre )~ dig �his;vIs�t; Yoh wii� l�t:eeive 4o futtho ...)
corresporideike: about this visit
Comments (mfer..to question'#):.Explain any YFS'answers andfor any recommendations or:any oth4 Comments.-
Use `dr&`vings. of facility to better euplain'sitaatians. (use ad'diitional. pages as�iery) .. _ ' {�-' � � ;
Reviewer/Inspector Name '. ~ -t_
Reviewer/Inspector Signature: ,.�� Date: /Z ! d/ 5/00

0 Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency = _
Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other
© Denied Access
Facility Number
Date of Visit: /o / 2� Time: O _' /r Printed on: 7/21/2000
Z
Q Not Operational 0 Below Threshold
® Permitted 0 Certified © Conditionally Certified © Registered Date Last Operated or Above Threshold: ................
Farm Name: ............. 4Pifs 4&..��...vle-4 �.' .. County. .4 .J
Owner Name: z,j..'..1.. �rG...G ,.. Phone No:.....
Facility Contact: .............1l..tr ......... .P`c< ...ZZ....... Title: ................................................................ Phone No: ...................................................
MailingAddress:....................................................................................................................................................... ..........................
Onsite Representative:...........1. �- ...... <:.!.�.............. /........................--................ integrator:....../ u'Yf° .... l..:F t' �s!............................
Certified Operator: ............... ^! .,12 � .......... Operator Certification Number:......Z
...........................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• C�` �•� Longitude �• �� �
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Po ulation
Wean to Feeder ❑ Layer ❑ Dairy
1-1 Feeder to Finish JE1 Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lag—n Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes No
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ)
El Yes XNo
c. If'dischame is observed. what is the estimated flow in galhnin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes ,® No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes /91 No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes ❑ No
3 t�rt�ture 1 Structu2 � Structure �� Structurf7 Structure ��
Slru�r�e b �
Identifier: ............... ...............-................................................... ......... .......�.............. ... ............. ................................................
Freeboard (inches):
5100
Continued on back

Facility Number: 001- — C Date of inspection Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes 6No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ANo
8. Does any pan of the waste management system other than waste structures require maintenance/improvement? ❑ Yes eK-No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes AM
Waste' Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes R'No
11. Is there evidence of over application? ❑ Excessive Ponding ❑// PAN ❑ Hydraulic Overload ❑Yes allo
12. Crop type err, k .�� s�►-.o��q�iYi� Cr�u4�A.rJ
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes �"N0
14. a) Does the facility lack adequate acreage for land application? ❑ Yes E[No
b) Does the facility need a wettable acre determination? ❑ Yes F�jNo
c) This facility is pended for a wettable acre determination? ❑ Yes E] No
15. Does the receiving crop need improvement? JKYes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes $-No
Required Records & Documents
IT Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
{ie/ WUP, checklists, design, maps, etc.}
Yes No
Cl.-
19. Does record keeping need improvement? (ie/ irrigation, freed, waste analysis & soil sample reports) ❑ Yes A No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ANo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes KNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes �No
24- Does facility require a follow-up visit by same agency? ❑ Yes X No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes KNo
�: �'�10 violafioris;or• def 6 ncies -were n6tea• during thisMsit: • You Will •receive iio fui-thof •
corrko6iri #eitce: ahouti this visit :: :
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
7e-)Z_Lrff_11��W), Ac Ae�_64 AAA--cle 4f A
,4/lam XAe� e'li �P.—d
Reviewer/Inspector Name
Reviewer/inspector Signature: _ 464r 7—f C;;r� Date: 12�/&/2606 5100

10 Routine Q Complaint Q Follow-up of DWQ inspection O Follow-up of DSWC review ® Other
Facility Number Date of Inspection
Time of Inspection 0 24 hr. (hh:mm)
0 Permitted © Certified [3 Conditionally Certified © Registered 113 Not Operational I Date Last Operated:
..........................
r
Farm Name . ...............( . -- z!� ..... e County: .. ........... ........ ...............
........................................................ ........ �� -. soy..✓...
OwnerName: ^^ .. ............ �1 ......................... ............ Phone No: ...................................... _.................................. ........
.....
Facility Contact: , t/1..27�
........ Title / �/ Phone No:
Mailing Address: .........�r�<......1 .....r ���1..�t'.•..�.r......... ,2.1�........................... ........... I ..........
.--.
Onsite Representative:............-........................................................... Integrator: .......,"!.��.........<:,e`
Certified Operator: ................. _7.........................�f rc�� ......................... Operator Certification Number: ................... .....................
Location of Farm:
.............. ...................... ..................................................................................................... _........................ ..-.....------- .......................................................
........
Latitude 0 �` ��� Longitude 0
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes �No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other C
a. If discharge is observed, was the conveyance man-made.'? ❑ Yes RNo
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes [R-No
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes 1�4'No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes allo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes JR No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes FRNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): .............Z. .� ............aS.d.¢ ......./.6. .. .. �� ....................... .........f...!.................
......... ......................... ................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes .6 No
® see a e/et/c.)
3/23199/J� Continued on back6

Facility Number Z Date of Inspection HT9
Time of Inspection 24 hr. (hh:mm)
® Permitted ® Certified .[3 Conditionally Certified [3 Registered 10 Not Operational I Date Last Operated:
Farm Name: ............. T�,r.�s €� �c. ! , tr �. County:..........Sa................... ......... ..............
.
Owner Name: �I Phone No: ....................................
1...-.-.....Y...-....-........................
Facility Contact: y jn.... �z f ll...................................................
............................................/..............................Title:.............................................................-. Phone ti°o:
Mailing Address: O_ 6 . ....... .- --- .Y�.Y.....................................I..............
Onsite Representative: .��....... ......... ..... Integrator:....... / .................
...........................
Certified Operator: Z249!!!(!!f.... �..... ,/�,�?�.✓•��11ri Operator Certification Number.
P .............Zo %�......
Location of Farm:
.. ................. ...................................I.. .............................................................................I....-. ...
Latitude ' ° 4� Longitude • 46
ne
Design Cui ent' =
-Canacity Population
Wean to Feeder
1,?&56
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Nuumber ottagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds_/ Solid
❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
b. If discharge is observed, did it reach Water of the Sate? (If yes, -notify DWQ)
c- if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
[]Yes WNo
❑ Yes qN0
❑ Yes k'No
❑ Yes
KNo
❑ Yes
; No
❑ Yes
Ig'No
[]Yes .8 No
Structure I Structure 2 Structure 3 Structure 4 Structurc 5 Structure 6
Identifier: 4
Freeboard (inches): /`... ........... '
.........._..9.......................Z ........... ... .3- .._.........
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes KNo
seepage, etc.)
3/23/99 Continued on back

r,
Facility Number_ Z — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes XNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? Yes ❑ No
S. Does any part of the waste management system other than waste structures require maintenarice/improvement? ❑ Yes .�g No
9_ Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes &No
Waste Anolication
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
jffNo
11.
is there evidence off over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
,KNo
12.
Crop type
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
'R No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
[ KNo
b) Does the facility need a wettable acre determination?
❑ Yes
InNo
c) Ibis facility is pended for a wettable acre determination?
❑ Yes
i® No
15.
Does the receiving crop need improvement?
❑ Yes
.V'No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
O(No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
KNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
XNo
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
XNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
gNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
bj[No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
ONo
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
'KNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
& No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ANo
0: Rio yiblattods or defeie ....mere .. d-OtWingg #his;visit.- Yoit tvitl•reeeiye fio lour#hey ;
correspondeHC aharit this visa_
Comments.(refer t6 question #): Ezplaiin 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
E
■n
Reviewer/Inspector Signature:
Date: ♦ 9R
3/23/99

. .`
Facility Number: z— fate of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below10
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes PrNo
2$_ Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes WNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? El Yes [IVo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ -Yes [$No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ERNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ /J�No
onComments an or. rawtngs•
A�l
3/23/99

Division of Soil and Water Conservation 0 Other Agency
Division of Water Quality
10 Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Date of Inspection
Facility Number Time of Inspection I = D 24 hr. (hh:mm}
13 Registered 0 Certified 13 Applied for Permit [3 Permitted 0 Not Operational Date Last Operated:
Farm Name:' r��.?,a..,-its�l'i ..A//'.t<..... uf^ ...f—. ll'` `--........ County: ........... ..?.e� �!}.. ............................
Owner Name: ...................�1{trr±,�.� ......... ��,�tl�........................................... Phone No: �����
................................'.............................................
Facility Contact: .............. � . Title: Phone No:.,I.?
MailingAddress: �, % �. ...... f 1 K.,..... ,r�
• --rV..... ................... ........
.... ..................
S
Onsite Representative: .......... V.............................................. Integrator:.....,om... ,
Certified Operator; ... ..... 21100.. ....... �..... A&f e.V.6............................. Operator Certification Number:. �DlF/
Location of Farm:
Latitude 0' ' 0"
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Longitude
Design Current
Poultry �Capacity_Topglati'oniG
U Non -Layer
❑ Other
`Total Desil
C
C
Design;: Current
atEte :
Uapaciv, raputanon _
❑ Dairy
❑ Non -Dairy
---------------
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
No
2. Is any discharge observed from any part of the operation?
❑ Yes
'KNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
XNo
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
KNo
c. If discharge is observed, what is the estimated flow in gai/min?%y
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
Wo
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
9No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
gNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
KNo
maintenance/improvement?
6- Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
KNo
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
JKNo
7/25/97

Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures [ agoonsMolding Ponds, Flush Pits, etc.))
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes KNo
❑ Yes XNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
............. ......................
Freeboard (ft): ,Z. ��. .... `�rL.........
i .... ... ...........................................
............. .... ........... ................... ......... ......... ......................................................... .
10. Is seepage observed from any of the structures? ❑ Yes XNo
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes )KNo
12. Do any of the structures need maintenanceJimprovement? lKyes ❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
XNO
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
No
(If in excess of WMP; or runoff entering waters of the State, notify DWQ)
15.
Crop type ... ....''.1..�'_44e.lIAe'P, 9" .......................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
N No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
$ No
18.
Does the receiving crop need improvement?
JQ Yes
❑ No
19.
Is there a lack of available waste application equipment?
❑ Yes
Wo
20.
Does facility require a follow-up visit by same agency?
❑ Yes
PrNo
21.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
NNo
22.
Does record keeping need improvement?
❑ Yes
No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
IN No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
(K No
13- No.vioIa'tions-or deficiencies -were -noted -during this:visit:_ . Oki receive no turEtier�
: _•correspQtade�ceatiou�iEhis:visit:-::�.; '�.:-:�-:-::::�.:.-:.•:.�; ::�.-:•.•::.:-:�:::�
'of 'A�
,4
I Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: V'— Z — f

10 DSWC Animal Feedlot Operation Review
®DWQ Animal Feedlot Operation Site Inspection
IA Routine O Comulaint O Follow-up of DNVO inspection O Follow-un of DSWC review O Other 1
Date of Inspection /o- -9
Facility Number 2
Time of Inspection t}t � 24 hr. (hh:mm)
13 Registered 0 Certified [3 Applied for Permit E3 Permitted JE3 Not O erational] Date Last Operated
le
Farm Name: ..................... ke:.�t�. � ...- /a rflJ County:......S �xyo.Sl9,e�?.
OwnerName: -ff Phone No: „�O 2.`...��/J................
7..—...............................................'. , ....
Facility Contact: .....T %^ - .., .7,6.//............... Title:.............. ..... T. Phone No: ..............................
Mailing Address:..................../.�...f.... .............ZT„�........................................... ..........................Onsite Representative:......... ...... ...................................... Integrator:----...- ..............I .
Certified Operators ....... Do•r•• !P........ ..... q/R / .--..................... .. Operator Certification Number, ... +?a��
Location of Farm:
.............. ...... ....... :..
Latitude ' ; " Longitude ' 4 44
Design Current Design Current Design Current:: -
Swine Capacity -Population Poultry Capacity Population Cattle Capacity Population,
Wean to Feeder 60❑ Layer 1 10 Dairy
❑ Feeder to Finish ❑ Non -Layer L I JE3 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder JE1 Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons / Holding Ponds U ❑ Subsurface Drains Present ❑ Lagoon Area I0 Spray Field Area
❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement?
2. is any discharge observed from any part of the operation?
Discharge ori�,_inated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If dischar�-c is observed, did it reach Surface Water? (if yes, notify DWQ)
c. If dischaq e is observed, what is the estimated flop' in gallmin?
d. Does discharge bypass a lagoon system`? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes '® No
[:]yes A No
❑ Yes No
❑ Yes No
❑ Yes j No
❑ Yes RNo
❑ Yes No
❑ Yes No
❑ Yes JR No
❑ Yes �No
Continued on back

Facility Number: z —
&. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes 19 No
Structures (Lagoons,I-Iolding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes t$No
Structure I Structure 2
Structure 3
Structure 4 Structure 5
Structure 6
Identifier: -
Freeboard (ft): 23'y�f; 2 a rQa .? L ............................................. ..J.........................�.......... ,.
10. Is seepage observed from any of the structures?
❑ Yes )Q No
11. Is erosion, or any other threats to the integrity of any
of the structures observed?
❑ Yes XNo
12. Do any of the structures need maintenance/improvement"
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ...! ......................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0 No.viulatioRs-or deficiencies were`note'd-during' this.visit. You.will receive no ft>irttier
` correspondence about this'visit.
t'Yes ❑ No
❑ Yes Wo
❑ Yes t1K)'No
❑ Yes eKNO
❑ Yes KNo
IkIff Yes ❑ No
❑ Yes No
❑ Yes M No
❑ Yes 4-No
ftP
Yes ❑ No
❑ Yes ANo
❑ Yes 9No
❑ Yes 11KNo
Comrnents (Iefer to uues ion #) . Explain any YES answers and/or any recommendations or any other comments. .'
Use drawings of f6ciitty to -better explain situations. (use additional pages as necessary):
rev
C20 _;O::�� a•✓ fJ!/�i�pp..�.T
7/25/97 14
Reviewer/Inspector Name�,�
Reviewer/inspector Signature: Date:

Division of Soil and Water Conservation ❑ Other Agency `5
10Division of Water Quality
O Routine Q Complaint O Follow-up of DWQ inspection O Follow-up (of DSWC review O Other
Date of Inspection Z
Facility Number
Time of Inspection 24 hr. (hh:mm)
13 Registered ® Certified jjE3 Applied for Permit Q Permitted 0 Not O erational Date Last Operated:
Farm Name: ..............�r./�t ...--- �..................... Countyp2Sd�
OwnerName: ....... ���f'"!£ ................ 72!..................... ........ .............................. Phone No:...( 1� .-.1 ............................................
Facility Contact:...... /�+.!.:'..� ........ &Z ................ Title:................ .. Phone No:
Mailing Address ........... 1.-.:...(J��... .¢...7...... , �.... Gf.... !Z�.1.�1�/T....................................................... ..........................
..... ......... ........
Onsite Representative:........ z' Integrator:.---..G�r��J-..`� `.....................
Certified Operator: .............. lf> !f ....-...... p , Z d / �!
�.?�!!...n ... ........................... O erator Certification Number•.........................................
Location of Farm:
............................................................................................&........................................� .�...............................................................................................................
.yzf
Latitude =• 0' 0" Longitude 0• =' ='G
F Ctlrr eqt
..
De51gII Current De5rgti . " IIrrent '
,
Swiae=: Capacity Populatiiia
Poultry.
Capacity PopulatioIICat#le . Capacity Population`.
Wean to Feeder
❑ Layer
'<'
❑Dairy
❑ Feeder to Finish
❑ Non -Layer
J�
❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑Other
❑ Farrow to Finish
Total Desigd Capacity:
❑ Gilts
❑ Boars
u
Total SSLV
O.
Number of Dons f Hal Ponds <
A;.
❑ Subsurface Drains Present
❑ Lagoon Area
❑ Spray Field Area`'
E „dmg: �.
❑ No Liquid Waste Management Syst em
General
1.
Are there any buffers that need maintenance/improvement?
❑ Yes
b(No
2.
Is any discharge observed from any part of the operation?
❑ Yes
PTNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
WNo
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
c. If discharge is observed, what is the estimated flow in gal/min?
JJXNo
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
O[No
3.
Is there evidence of past discharge from any part of the operation?
❑ Yes
KNo
4.
Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
Q,No
5.
Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
KNo
maintenance/improvement?
b.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
WNO
7/25/97

r
Facility Number: Z —`g�
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons.Holding Ponds. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Freeboard (ft): .._....... .............. .....
10. Is seepage observed from any of the structures?
11. is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat; notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Anulication
❑ Yes X No
❑ Yes WNo
Structure 5 Structure 6
❑ Yes Wo
❑ Yes JR No
9Yes ❑ No
❑ Yes RNo
14. Is there physical evidence of over application? ❑ Yes A No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type �.....r�i ��,,' 1----------------------------------
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes )o No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes JO No
18. Does the receiving crop need improvement?
Yes
❑ No
19. Is there a lack of available waste application equipment?
❑ Yes
No
20. Does facility require a follow-up visit by same agency?
❑ Yes
No
21. Did Reviewer/Inspector fail to discuss reviewfinspection with on -site representative?
❑ Yes
No
22. Does record keeping need improvement?
❑ Yes
gNo
For Certified or Permitted Facilities On1
23. Does the facility fail to have a copy of the Animal -Waste Management Plan readily available?
❑ Yes
Pff No
24. • Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
QfNo
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
P No
No.vi6lati6rii-or deficiencies. were-noted•dliring this.visiL You:vKill i-ecei've•nof&thei-:
correspbndence Ahoitt -this:visit.:
_r1x- j' AOePo1,4
1A e.- 7125197
1
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
?- Z2

'b DSWC Animal Feedlot Operation Review `
®DWQ Animal Feedlot Operation Site Inspection q,,
r
Routine 0 Com hint O Follow-uL of DWQ inspection 0 Follow-up of DSWC review 0 Other
Date of Inspectiots fo-2-47
FacilityNumber
Time of Inspection S 24 hr. (hh:mm)
Registered M Certified 0 Applied for Permit © Permitted [3 Not Operational Date Last Operated:..
Farm Name: f,�,F,1! 1.1z`'/t£ #� County:.........sC%.....................................
r _ /
Owner Name............. !~ "` � � Phone No:..
Facility Contact: ..........i r✓!!' .....tom.! !er' .... Title: ................................................................. Phone No: .............. ....................................
'Mailing Address: ............. i ��,e....Ae. h...lc .................. ......................
oo
Onsite Representative:. . ors'''°... .-. zlz •✓. ...---... Integrator:..../% .... "-~r/
...................................
Certified Operator......... ....... p Q ��............
Operator Certification Number:....�... ...
Location of Farm:
C
Latitude ' L rC Longitude • 4 °1
Design Current " Design Current Design.. Current
Swine Capacity Population • :Poultry. 'Capacity Population. Cattle Capacity' Population ,
Wean to Feeder .'ZEQG ❑ Layer ❑ Dair
y
❑ Feeder to Finish 10 Non -Layer 10 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Otber
❑ Farrow to Finish Total Design Capacity ,
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons / Holding Ponds 'r ❑ Subsurface Drains Present ❑ Magoon Area ❑ Spray Field Area
❑ No Liquid Waste.Management System
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field. ❑ Other
a- If discharge is observed. was the conveyance man-made)
b. if discharge is obsen;ed, did it reach Surface Water') Of yes. notily DWQ)
c. If discharge is observed, what is the estimated flow in aal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters.of the State other than from a discharge?
5. Does any part of the waste management system (other than Iagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
Q No
❑ Yes
® No
❑ Yes
�Q No
❑ Yes
PS No
❑ Yes O No
❑ Yes P No
i
❑ Yes Wo
❑ Yes 19No
❑ Yes 19 No
❑ Yes KNo
Continued on back
�1
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97

� � f
Facility Number: rZ—G
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons.Holding Ponds, Flush Pits, etc.1
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure Structure 2 Structure 3
Identifier:
................................. ..............................................................................
Freeboard (ft): .........Z� �I%2-
.......................................... .......... ............. ............ .......
.
10. Is seepage observed from any of the structures?
❑ Yes tSNo
❑ Yes k No
Structure 4 Structure 5 Structure 6
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
4
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WNW, or runoff entering waters of the State, notify DWQ)
15. Crop type .. eg�r_. 9,�fr r•r!.......................... .................................. i..........................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a Iack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0 No.violationsor. deficiencies were noted during this'visit.You "Will receive no ft rtlier
correspondenee ahoui t this visit:
❑ Yes LVNo '
❑ Yes K No
jKYes ❑ No,.
❑ Yes ® No
❑ Yes M No
("Yes ❑ No
❑ Yes allo
X[Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes IM No
Q"Yes ❑ No
❑ Yes CWNo
❑ Yes 6a No
❑ Yes 52 No
7/25/97

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan 8, Howes, Secretary
A. Preston Howard, Jr., P.E., Director
James Ezzell
Quwhifle ' #5
PO Box 67
Harrells NC 28444
Dear Mr. Ezzell:
IDF-=HNF;Z
April 3, 1997 n--(;EI%V§ED
APR 0 7 1997,
FAYE I TEV1LLE
REG. OFFICE
SUBJECT: Notice of Violation
Designation of Operator in Charge
Quwhifle #5
Facility Number 82-686
Sampson County
You were notified by letter dated November 12, 1996, that you were required to designate a
certified animal waste management system operator as Operator in Charge for the subject facility by
January 1, 1997. Enclosed with that letter was an Operator in Charge Designation Form for your
facility. Our records indicate that this completed Form has not yet been returned to our office.
For your convenience we are sending you another Operator in Charge Designation Form for your
facility. Please return this completed Form to this office as soon as possible but in no case later
than April 25, 1997. This off -ice maintains a list of certified operators in your area if you need
assistance in locating a certified operator.
Please note that failure to designate an Operator in Charge of your animal waste management
system, is a violation of N.C.G.S. 90A-47.2 and you will be assessed a civil penalty unless an
appropriately certified operator is designated. Please be advised that nothing in this letter should be
taken as absolving you of the responsibility and liability for any past or future violations for your
failure to designate an appropriate Operator in Charge by January 1, 1997.
If you have questions concerning this matter, please contact our Technical. Assistance and
Certification Group at [phone].
Sincerely,
for Steve W. Tedder, Chief
Water Quality Section
bb/awdesletl
cc: Fayetteville Regional Office
Facility File
Enclosure
P.O. Box 29535, N-vf
FAX [phone]
Rpleigh. North Carolina 27626-0535 An Equal Opportuni y/Affirmotive Action Employer
Telephone [phone] recycles/ 10% post -consumer paper

Site Requires Immediate Attention: 0
Facility No. S Z - S
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: J �L�. Z S , 1995
Time: / O
Farm Name/Owner: 14 u.rr s er i c- s :tt- i % J mow► s C-7 7-z e. t k
Mailing Address: PO 3oX (P-T �-1 arrr z �� - hl C_ Z S 4-*4-
County: o so r f -
Integrator: koL;_ I �n Fa_y*, s Phone:
On Site Rer serve alive: M m i s C-z_ ze1X Phone: (WO) 6-3Z - *101
Physical Address/Location: us i-!_ Zt N � f ffa rrc CI s N C.
Type of Operation:
Design Capacity: _
DEM Certification
Swine ✓
Z(OOo
Poultry Cattle
Number of Animals on Site:
Number: ACE DEM Certification Number: ACNEW
Latitude: 0 9 0Longitude: 0 1"
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm
(approximately 1 Foot + 7 inches) &or No Actual Freeboard: 3 Ft. O Inches
Was any seepage observed from the la oon(s)? Yes or�Was any erosion observed? Yes ordp
Is adequate land available for spray? or No Is the cover crop adequate? (jj�)or No
Crop(s) being utilized: Cgas�
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Yes or No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or No
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or No 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)? Yes or No
Additional Comments:
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.
event

Site Requires Immediate Attention: N D
Facility No. SZ - 9
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: J --�n _ s 1995
Time: / S : 4 3
Farm Name/Owner: Q u-w k i -M e.r l� u rs e►r; s At Z. J a `" <-s C_ z z c-1 i
Mailing Address: PO Q--,c 4 T H a trr-cAs NC_ Z $A/44-
County: somesv^l _
-Integrator: 4 ta,, ! �j Far w.. s Phone:
On Site Representative: 3'c- k., e- s E z-,_e. L l Phone: I'9 /o-) 5 3 Z— 4/0 I
Physical Address/Location: us 4 Z 1 N N C,
Type of Operation: Swine ✓ Poultry Cattle —
Design Capacity: Z&OC3 Number of Animals on Site: -Z_Goo
DEM Certification Number: ACE . DEM Certification Number: ACNEW
Latitude: 0 Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately i Foot + 7 inches) e�, r No Actual Freeboard: 2 Ft. 0 Inches
Was any seepage observed from the la n(s)? Yes oreV5INas any erosion observed? Yes or<!gP
Is adequate land available for spray. e r No Is the cover crop adequate? Y& or No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? �or No
100 Feet from Wells? (�r No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes oltip
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or®
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or® 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)? i es r No
Additional Comments:
'. Re ✓e~CS
-Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

Site Requires Immediate Attention:
Facility No. S Z - S
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SFTE VISITATION RECORD
DATE: a", , 2 S , 1995
Time: 1 S : 4L S
Farm Name/Owner: 0Lk W �-L jIkv s eri e-5 3 . aVl,-.t- E��-11
*Mailing Address: P Q r3o7c & 7 H MV --P_ l l s NC 2 4 q- f-
.�ty; Saw.�son.
Integrator: A u �p ham, Fa►-.-� 1 �, �arr1 s Phone:
On Site Representative: 3awu.s F'-z-l-r-i\ Phone: / Wo) 5' 3 Z - W 0 I
Physical Address/Location: "s q- d c
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: 'Z(o00 Number of Animals on Site: Z&OO
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) Gor No Actual Freeboard: 4 Ft. fa Inches
Was any seepage observed from the la oon(s)? Yes oro Was any erosion observed? Yes or®
'Is adequate land available for spray? or No Is the cover crop adequate? (:& or No
Crop(s) being utilized: Cta
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellin ') a or No
100 Feet from Wells? C��' or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes otz�s)
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or 1�
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes ordg� 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:
. g'j,- K "V d s
Inspector Name
&4,3r-
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

Site Requires Immediate Attention: NO
Facility No. S Z - S
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: JAG, ZS , 1995
Time: t 5 % `E IF
Farm Name/Owner:
EZZO -I 1
Mailing Address: PO O K & 7 f -fa [-r e-ll s 10 1vC Z S 4L5clf
County: SawtPso,.►
Integrator: ,�Uiurflti Fah"; ly FaV-r--s Phone:
On Site Representative.. _-7awe 5 F'zz.e. i t Phone: Z - W
Physical Address/Location: GCS Sal /w/ NC_
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: `Z &00 Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 0 Longitude: ' "
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Qe or No Actual Freeboard: 2 Ft. Inches
Was any seepage observed from the la oon(s)? Yes o>rp Was any erosion observed? Yes ordV
Is adequate land available for spray? a or No Is the cover crop adequate? 6�or No
Crop(s) being utilized: 6,c,�
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? <�r No
100 Feet from Wells%iP or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o6
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or�
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes ordV 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)? e6;�6r No
Additional Comments:.
led, A
Inspector Naime Signature
,cc: Facility Assessment Unit Use Attachments if Needed.