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HomeMy WebLinkAbout820042_INSPECTIONS_20171231NORTH CAHOLINA Department of Environmental Qual type of visit: eidtiom Nance Inspection U Operation Review U Structure Evaluation U Technical Assistance t Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access J Date of Visit: (, ��, Arrival Time: f? Departure Time: ; oD County: Farm Name: JA'► cT_ H Owner Email: Owner Name: "�u', 0. ]�{ic�Gz-{ Phone: Mailing Address: Physical Address: Facility Contact: L' cr wA S t-3,t ✓-tU fr Title: Onsite Representative: t( Certified Operator: Back-up Operator: Location of Farm: Latitude: Phone: Region: Integrator: 0 ( --5 Certification Number: f 7F D Certification Number: Longitude: Design Swine Capacity to Finish to Feeder 006 to Finish Current PoImamp. Design Current Wet Ppultry Capacity Pop. La er Cattle Dai Cow t Design CMove Capacity Non -La er DaCar Dai Heifer w to Wean w to Feeder to Finish E Design Current Dr. Paul C•a at Po La ers Cow Non-Dairyw Beef Stocker Non -La ers Beef Feeder Pullets Beef Brood Cow -S.Turke Other Other s Turkey Poults Other Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notify DWR) c. What is the estimated volume that reached waters of the State (gallons)? d. Does the discharge bypass the waste management system? (If yes, notify DWR) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? ❑ Yes 1_440 L� NA ❑ NE [:]Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes D-Iq—o ❑ Yes ❑`No []"9A' ❑ NE C11NA ❑ NE a'KA ❑ NE ❑ NA ❑ NE ❑ NA ❑ NE Page 1 of 3 21412015 Continued FaciliNumber: WZY_ Z Date of Inspection: ov -G Waste Collection & Treatment 4. Is sforage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [ N6 �, J NA ❑ NE a. If yes, is waste level into the structural freeboard? ❑ Yes [:]No Q-NA—❑ NE Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Spillway?: Designed Freeboard (in): !� u Observed Freeboard (in): gs 3 i 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes EDNT—❑ 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 C] Yes Io ❑ NA ❑ NE waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR DDo any of the structures need maintenance or improvement? CE I es , —❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes �❑ 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 [D-N-6❑ NA ❑ NE maintenance or improvement? _Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need [] Yes ❑-ITT ❑ NA ❑ NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 2rTVO ❑ 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 -/� 4 13. Soil Type(s): &. �J' X 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [P4o ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes �❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [ - o ❑ NA ❑ NE acres determination? 17. Does the facility lack adequate acreage for land application? ❑ Yes ff 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 ❑] IeNA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes fo ❑ NA ❑ NE the appropriate box. ❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other: 21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes E'No ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Wastc Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l " Rainfall Inspections Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? []Yes �❑ [!JNo ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes ❑ to ❑ NA ❑ NE Page 2 of 3 21412015 Continued Facili Number: _Z Date of Inspection: 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes QN�❑ NA ❑ NE 25. Is the facility out of compliance with permit conditions related to sludge? if yes, check [] Yes C3'No ❑ NA ❑ NE the appropriate box(es) below. ❑ Failure to complete annual sludge survey C]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? 2T Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately. 30. Did the facility fail to notify the Regional Office of emergency situations as required by the permit? (i.e., discharge, freeboard problems, over -application) 31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Application Field ❑ Lagoon/Storage Pond ❑ Other: ❑ Yes `tom o ❑ NA ❑ NE ❑ Yes E]No ❑ NA ❑ NE ❑Yes �EJNA ❑NE ❑ Yes No ❑ NA ❑ NE ❑Yes [J —[]NA ❑NE ❑ Yes I]i"O ❑ NA ❑ NE 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [D-Na1 ❑ 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 I5g ❑ NA ❑ NE Comments (refer to question #): Explain any YES answers and/or any adiitional recommendations ar any other comments. Use drawings of fi sciGty to better exp R-n situations (use additional pages as necessary,}. a --� 9-- -z- s — r (0 Sl -,zly -e_ t�,__e� ► / c t-{( qtp-- 3 D$ Reviewer/Inspector Name: 11 V Phone: 210 - 3 3 J 3 Reviewer/Inspector Signature: Irk W OAA Date: k Page 3 of 3 r 21412015 k ype of visit: ip Loroutine nce inspection U Operation Review U Structure Evaluation U Technical Assistance I Reason for Visit: O Complaint O Follow-up Q Referral p Emergency O Other O Denied Access Date of Visit: J jArrival Time: Departure Time: %(, `� _ County: S c �� Region: �` G Farm Name: Zydi[-`"�i y�� 4f� Owner Email: Owner Name: - �J a �f - Phone: Mailing Address: Physical Address: Facility Contact: C.cick(15 f✓cl.�t` Title: Phone: Onsite Representative: i Integrator: Certified Operator: i J p�� �. La4 Certification Number: ! � ( U Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Des�ig Current �� Destgn,Current Design Current � Swine a „C ctty .Pop. Wet Poultry Cap ctty`� Pnp. Cattle Capacity Pop. Wean to Finish La er Dairy Cow Wean to Feeder Nan -La er Dairy Calf Feeder to Finish Farrow to Wean Dairy Heifer Current Dry Cow D "Piitilt = Ca act �` P_o Non -Dairy Farrow to Feeder Farrow to Finish La ers Beef Stocker Gilts Non -Lavers Beef Feeder Boars 1pullets. ir 113eef Brood Cow ,'::. Turkeys ' VhnerWm Turkey Pouets Other Other Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notify DWR) c. What is the estimated volume that reached waters of the State (gallons)? d. Does the discharge bypass the waste management system? (If yes, notify DWR) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any observable adverse impacts or potential adverse impacts to the waters of the State other than from a discharge? ❑ Yes [ o ❑ NA ❑ NE ❑ Yes No ❑ NE [:]Yes 0 No [''' 1A ❑ NE ❑ Yes D No ❑ Yes [� Nl o ❑ Yes No E3 NA ❑ NE DNA ❑NE ❑ NA ❑ NE Page 1 of 3 \ 1 21412015 Continued Facili Number: _ Z Date of Inspection: Waste Collection & Treatment 4_ Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [9'1ao ❑ NA ❑ NE a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No �NA❑ NE Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): Z� zz- 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �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 [21�o ❑ 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 []'fsio ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes �o ❑ NA ❑ NE (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require ❑ Yes Q-I�o ❑ 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 [T`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. CropType(s): $-e rwc 56jD cor 1, 13. Soil Type(s): 14. Do the receiving crops differ from those desi�mated in the CAWMP? 15. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? Required Records & Documents ' 19. Did the facility fail to have the Certificate of Coverage & Permit readily available'? 20. Does the facility fail to have all components of the CAWMP readily available'? If yes, check the appropriate box. ❑Yes 1. o ❑NA ❑NE ❑ Yes F91�o ❑ NA ❑ NE ❑ Yes E3-1 o ❑ NA ❑ NE ❑ Yes E21�o ❑ NA ❑ NE ❑ Yes ErNo ❑ NA ❑ NE ❑ Yes ENo ❑ NA ❑ NE ❑ Yes [2rNo ❑ NA ❑ NE ❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other: 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [:JNo ❑ 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 dNo 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment'? ❑ Yes ff No ❑ NA ❑ NE ❑ Weather Code ❑ Sludge Survey ❑ NA ❑ NE ❑ NA ❑ NE Page 2 of 3 21412015 Continued Facilitv Number: _ Z 1 jDate of Inspection: ' 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑Yes Q No ❑ NA [] NE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE the appropriate box(es) below. ❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels ❑ Non -compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes []"No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �o ❑ NA ❑ NE Other Issues 28_ Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes []-No ❑ NA ❑ NE and report mortality rates that were higher than normal? 24. At the time of the inspection did the facility pose an odor or air quality concern? ❑ YesE3<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 [2'1lo ❑ 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 FP 1 ❑ 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 [ r o ❑ NA ❑ NE Comments (refer to question #):-Explain any YES answers and/or any additional recommendations or any other comments. Use drawings of facility to better eXDlain situations [use additional naves as necessarvl. Slt y� Sn(G'a'I l �� �� LC Reviewer/Inspector Name: C Reviewer/Inspector Signature: Page 3 of 3 3N­j9�-5f Phone: O-- Date: - as 2/4l 015 Type of Visit: Q'Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance Reason for Visit: Q>i!-utine 0 Complaint 0 Follow-up O Referral O Emergency 0 Other 0 Denied Access Date of Visit: Arrival Tim . epartnre Farm Name: .j u �ti 0 Owner Name: a -e' rn, tf _ Mailing Address: Physical Address: Time: y'*j V r /J-# County: J i Region: pEi� Owner Email: Phone: Facility Contact: • (�L14�1 50 -w CC, Title: Phone: Onsite Representative: Integrator: rT Certified Operator: J �� cti Certification Number: f 7 '? i t 1 Back-up Operator: Location of Farm: Latitude: Certification Number: 101600,3RS_ 7416 -JcG Longitude: Design CurrentM Current Design Current Swine Capacity Pop. .� y 3 UCaya'siga Pop. Wean to finish La er Dai Cow Wean to Feeder I I iNon-Layer I Dairy Calf Feeder to Finish d', " ` �� ' ' Dairy Heifer Farrow to Wean Design Current Cow Farrow to Feeder 11 D , P,oult , Ca acts Pop Non -Da' Farrow to Finish La ers Beef Stocker Gilts Non -La ers Beef Feeder Boars Pullets Turkeys Beef Brood Cow Other. Turke Poults Other Other Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notify DWR) c. What is the estimated volume that reached waters of the State (gallons)? ❑ Yes [!3 o ❑ NA ❑ NE ❑ Yes [] No [! NA ❑ NE ❑ Yes ❑ No F!f NA ❑ NE d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No ❑'<A ❑ NE 2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [D'No ❑ NA ❑ NE 3. Were there any observable adverse impacts or potential adverse impacts to the waters [—]Yes [TNo ❑ NA ❑ NE of the State other than from a discharge? Page 1 of 3 21412014 Continued Fac#U. NumbeN jDate of Inspection: � 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 E<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 [Z[.Xo ❑ 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?<o ❑ 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 [;�o ❑ 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 ADDliCatiOn 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes VrNo ❑ NA ❑ NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes EJ'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): S [9 Q 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Dio ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? [:]Yes Q- o ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes E3 o ❑ 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 [?'No ❑ NA ❑ NE ❑ Yes (?fNo ❑ 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 [;31�o ❑ 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 [%f No ❑ NA ❑ NE 23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [(No ❑ NA ❑ NE Page 2 of 3 21412014 Continued Facilitu Number:• - Date of Inspection: to I 24. Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes [ oo 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [ZP?° 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: ❑ NA ❑ NE ❑ NA ❑ NE 26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [::]Yes to ❑ 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? Reviewer/Inspector Name: ❑ Yes To ❑ NA ❑ NE ❑ Yes D�Mo ❑ NA ❑ NE ❑ Yes Ej K'o ❑ NA ❑ NE ❑ Yes [y<o ❑ NA ❑ NE eyes ❑ NA ❑ NE ❑ Yes L. ]4o ❑ NA ❑ NE ❑ Yes []ta ❑ NA 0 NE Reviewer/Inspector Signature: Page 3 of 3 21412014 Structure Evaluation Inspection Facility Number:-- Z Date: Time in: Time out: t �0 _ Farm Name: ..�—� Farm 911 address:���•' Owner Name: 1_*x__1 r41 Phone Facility Contact: G',c A 3 a v ► Onsite Representative: - Integrator: NN-� Certified Operator: fah%& Cert. Number Is storage capacity less than adequate? Yes ZINo If yes is waste level into the structural freeboard? Yes No 4/ Was non -compliant level reported to DWR VCS POA received Uea Structure: 1 Identifier: Spillway? Designed Freeboard (in.): 2 3 Observed Freeboard (in.): Z% I S 4 5 6 Are there any immediate threats the integrity of any of the structures observed? Yes No Do any structures lack adequate markers as required by the permit? Yes — Noi/ Does any part of the waste management system need repair Yes No Condition of field's Q c,_r Condition of receiving crop Comments: Water Resources ENVIRONMENTAL QUALITY John O. Royal 4025 Mt Moriah Church Road Clinton, NC 28328-8821 Subject: Dear Mr- Royal: PAT MCCRORY Govemor DONALD R. VAN DER VAART April 25, 2016 NOTICE OF DEFICIENCY John O. Royal 82-0042 Sampson County Incident # 201600385 NOD-2016-PC-0120 Sec-r-y S. JAY ZIMMERMAN Dfrector On February 16, 2016 staff of the NC Division of Water Resources (DWR), Water Quality Regional Operations Section (WQROS) were notified by Curtis Barwick of a high freeboard level in the #3 lagoon. We wish to thank Curtis Barwick and Mr. Royal for notifying DWR of this incident. As a result of this incident, you are hereby notified that having been permitted to have a non - discharge permit for the subject animal waste disposal system pursuant to 15A NCAC 2T Section .1300, you have been found to be in violation of your Certified Animal Waste Management Plan and the Swine Waste System General Permit No. AWG100000 that you are covered to operate under, as follows: Deficiency 1: Failure to maintain waste levels in your lagoon/storage ponds in accordance with the facility's Certified Animal Waste Management Plan in accordance with Condition V. 2. of Swine Waste System General Permit No. AWG100000. On February 16, 2016 a lagoon/storage pond level was documented at 15 inches in the #3 lagoon. A level of 19.0 inches is the maximum level allowed by your permit and Certified Animal Waste Management Plan, Required Corrective Action for Deficiency 1: DWR has received a copy of your 30-Day Plan of Action (POA) for the high freeboard occurrence. Take all necessary additional steps to insure lagoon levels remain in compliance with your Certified Animal Waste Management Plan and permit. State of North Carolina � Environmental Quality I Water Resources 1611 Mail service Center I Raleigh, North Carolina 27699-1611 919 707 9000 If you have any questions concerning this Notice, please contact me at (910) 433-3326 Sincerely, Belinda S. Henson Regional Supervisor NCDEQ-Division of Water Resources Water Quality Regional Operations Section Fayetteville Regional Office cc. Sarnpson County Soil and Water Conservation District Kraig Westerbeek, Srnith£eld Foods T ype of visit: w-c:ompiiance inspection U Uperation xeview U Structure Evaluation u i eennlcai Assistance Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit: Arrival Time: Departure Time: 1 County: Farm Name: Owner Email: Owner Name: [( Phone: Mailing Address: Physical Address: Facility Contact: (S-�O--tCL,t Cr( Title: Phone: i Onsite Representative: Integrator: Certified Operator: yi Back-up Operator: Location of Farm: Latitude: Region: F9Z Certification Number: 17 [ o I Certification Number: Longitude: Design Current Design Current Design Current acity Pap. et Poultry Capacity Pop Cattle Capacin to Finish La ern to Feeder rRF Non -La erder to Finish �Pp `J° _"'4 Dai Heifer ow to Wean Design Current D Cow ow to Feeder D , $oul Ca act P,o , Non -Dairy Farrow to Finish Layers Beef Stocker Beef Feeder Beef Brood Cow Gilts Non -La ers Soars Pullets Turkeys Qther Turkey Poults Other 10ther Discharizes and Stream Impact I. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? [:]Yes , No ❑ NA ❑ NE ❑ Yes ❑ No E5 NA ❑ NE b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No E] NA ❑ NE c. What is the estimated volume that reached waters of the State (gallons)? d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No NA ❑ NE 2. Is there evidence of a past discharge from any part of the operation? ❑ Yes 0--N-o ❑ NA ❑ NE 3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ff No ❑ NA ❑ NE of the State other than from a discharge? Page I of 3 21412011 Continued Lacifity Number: - Date of Inspection: - a Waste 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 ❑-N* ❑ NE Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): pZ 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes []g 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 2<o ❑ 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 EjK ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑Yes [�,W ❑ 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 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 6 12. Crop Type(s): _ _ _ �f .,, Z - 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [ZI,Fd`o [DNA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA 0 NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes B 1 _o ❑ 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? Required Records & Documents [:]Yes LS o ❑ NA ❑ NE ❑ Yes No ❑ NA ❑ NE 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes �o ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes QXo'_ ❑ 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 ltd""'o ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and I" Rainfall Inspections ❑ Sludge Survey 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ❑ NE Page 2 of 3 21412011 Continued Faeili Number: - Date of Inspection: f 24c Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes E2,Xo" ❑ NA ❑ NE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [a-X-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 [able ` ❑ NA ❑ 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 ❑ Yes [ZLNw ❑ 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 [g_Nx5' ❑ 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 E 7 "o ❑ NA ❑ NE permit? (i.e., discharge, freeboard problems, over -application) 31. Do subsurface tle drains exist at the facility? If yes, check the appropriate box below. ❑ Yes NA ❑ NE ❑ Application Field ❑ Lagoon/Storage Pond ❑ Other; 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes B- o ❑ NA ❑ NE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes � rr ❑ NA ❑ NE 34. Does the facility require a follow-up visit by the same agency? ❑ Yes [ -Na ❑ NA ❑ NE Comments (refer: to question ;#) Explain any YES answers and/or any -additional recommendations or any -other comments. Use;draw►ngs oi:facility. to better explain°situations"(use"add�tional pages as necessary)�� 6 �I Su- en Reviewer/Inspector Name: Phone: Reviewer/Inspector Signature: Date: Page 3 of 3 2142014 Type of Visit: (CKompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access _ Date of Visit: � Arrival Time :11 A�lf/L I Departure Time: County: '�r t Regioj Farm Name: 6r�� 1A Ci �K_.4c.» d Owner Finail: Owner Name: %- Phone: Mailing Address: Physical Address: Facility Contact: _ � 7 jKi[cA4(.0 (j�� Title: ��G Phone: Onsite Representative: Integrator: Wf (J Certified Operator: 1 (4 - Gc Certification Number: j [ � o z Back-up Operator: Certification Number: Location of Farm: Latitude: Longitude: Desi n Current e g � �, � esi Dp gn Current Design Current Swine Ca acr Po ty p Wet Poult t Pad : Pop. Cattle Capacity Pop. ;- as rK ,,n_,, Wean to Finish La er Dairy Cow Wean to Feeder Layer Dairy Calf Feeder to Finish y Dairy Heifer Farrow to Wean" Dry Cow Farrow to Feeder.aci rDes�gnCurrent Po P. Non-Dai Farrow to Finish La ers I Beef Stocker Gilts -Layers Pullets Turkeys Beef Feeder Beef Brood Cow Boars y I Qther Turkey Poults Other Other Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? ❑ Yes [T'No ❑ NA ❑ NE Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? ❑ Yes ❑ No ONA ❑ NE b. Did the discharge reach waters of the State? (if yes, notify DWQ) ❑ Yes ❑ No ff�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 C�r<A ❑ NE 2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [�, o [] NA ❑ NE 3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ❑,Ko 0 NA ❑ NE of the State other than from a discharge? Page 1 of 3 21412011 Continued Facility Dumber: Date of Inspection: Waste Collection & Treatment rV 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes l?qo ❑ NA ❑ NE a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑-ice ❑ 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 E;,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 to ❑ 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 U X-o ❑ NA ❑ NE 8. Do any of the structures tack adequate markers as required by the permit? ❑ Yes [D X8 ❑ 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 ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes L -110 ❑ NA ❑ NE maintenance or improvement? r 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):o 13. Soil Type(s): No 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �o ❑ 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 ❑Xo ❑ 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 E! o ❑ NA ❑ NE ❑ Yes 0,<o ❑ NA ❑ NE Required Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [(aWo ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [�ao ❑ NA ❑ NE the appropriate box. ❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other. 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �No ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute inspections ❑ Monthly and I" Rainfall Inspections 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [3 No 23. If selected, did the facility fail to install and maintain rainbrcakers on irrigation equipment? ❑ Yes LJ 'No ❑ NA ❑ NE ❑ Weather Code ❑ Sludge Survey ❑ NA ❑ NE ❑ NA ❑ NE Page 2 of 21412011 Continued Facili Number: Date of Ins ection- iN 24. bid the facility fail to calibrate waste application equipment as required by the permit? [] Yes � ❑ NA ❑ NE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check M>ef- ❑ No ❑ NA ❑ NE the appropriate box(es) below. lure 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 [ .N15_ ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [3446— ❑ NA ❑ NE Other issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes le- ❑ 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 CJ Z ❑ NA ❑ NE If yes, contact a regional Air Quality representative immediately. 34. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes L`7 o ❑ NA ❑ NE permit? (i.e., discharge, freeboard problems, over -application) 31_ Do subsurface the drains exist at the facility? If yes, check the appropriate box below. ❑ Yes [2-vo ❑ NA ❑ NE ❑ Application Field ❑ Lagoon/Storage Pond ❑ Other: 32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [�1a ❑ NA ❑ NE 33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes [P�K6­ ❑ NA ❑ NE 34. Does the facility require a follow-up visit by the same agency? [] Yes Ula ❑ NA ❑ NE Comments refer.to fi ( gueshon #) Explain any YESansRers and/or any additional recommendateons or any other cort�ment"s.' Use drawings`o#.facility to better explain situations;(use additional pages as necessary) . � , .. C a' Ac X)o�—'- ,G r Reviewer/Inspector Name:; PhV V J J — 3w J Reviewer/Inspector Signature: M Date:f to Page 3 of 3 21412011 �Iva�f a� Type of Visit: 0 Corltpliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access Date of Visit:C:% 1^ 1 � Arrival Time: Departure Time: h Countyp� Region: r—/e0 Farm Name: �`�`�''!' Owner Email: T Owner Name:t:7R!3LAL Phone: Mailing Address: Physical Address: Facility Contact: {SQL _qc%,K Title: Onsite Representative: Certified Operator:�� Back-up Operator: Location of Farm: Latitude: Phone: Integrator: Certification Number: Certification Number: Longitude: .siSwtneC CPorpent Cg ., Dpsatg rent Design Current g h Wet Poultry t3 op. Cattle Capacity Pop. Wean to Finish La er DairyCow Wean to Feeder Non -La er Dairy Calf Dairy Heifer Feeder to Finish ra Farrow to Wean "y Design ^Current Dry Cow Farrow to Feeder Dr, P.oul_ , Ca .acih' Po ; Non -Dairy Farrow to Finish Layers Beef Stocker Gilts Beef Feeder Beef Brood Cow Non -Layers Boars Pullets I I, III gill 4 Turkeys Other Turkey Poults Other Other Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? ❑ Yes [gfo ❑ NA ❑ NE ❑Yes [:]No C NA ❑NE ❑Yes [:]No [BNA ❑NE d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No Ur"NA ❑ NE 2. Is there evidence of a past discharge from any part of the operation? ❑ Yes []14o ❑ NA ❑ NE 3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes EJ/No ❑ NA ❑ NE of the State other than from a discharge? Page 1 of 3 21412011 Continued Facili Number: - kA jDate of Inspection: Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes []J'I�o ❑ NA ❑ NE a. If yes, is waste level into the structural freeboard? [:]Yes ❑ No EB"N' A ❑ NE Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Spillway?: Designed Freeboard (in): q Observed Freeboard (in): -c5? 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 [9No ❑ 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 [TNo ❑ NA ❑ NE $. Do any of the structures lack adequate markers as required by the permit? ❑ Yes gNo ❑ 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 [2No ❑ 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 [9/No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN [] PAN > 10% or 10 tbs. ❑ 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): A r 13. Soil Type(s): NOA 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [ 44o DNA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes [E(No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [�(No ❑ NA ❑ NE acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of property operating waste application equipment? Required Records & Documents ❑ Yes [911No ❑ NA ❑ NE ❑ Yes F3/No ❑ NA ❑ NE 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [� INo ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [9"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 [ *N� 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 [S(No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [:]No �TA ❑ NE Page 2 of 3 21412011 Continued Faciliq Dumber: a, jDate of Inspection: s 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [g"'No 25. Is the facility out of compliance with permit conditions related to sludge'? If yes, check ❑ Yes M"No the appropriate box(es) below. ❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels ❑ Non -compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes []I"No 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? Ifyes, 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? ❑ NA ❑ NE ❑ NA ❑ NE ❑ NA ❑ NE Mf A ❑ NE [-]Yes [21No ❑ NA ❑ NE ❑ Yes 0a No ❑ NA ❑ NE ❑ Yes [S�4o ❑ NA ❑ NE [:]Yes [1 Ko ❑ NA ❑ NE ❑ Yes E1Xo ❑ Yes �No ❑ Yes FOINO ❑ NA ❑ NE ❑NA ❑NE ❑ NA ❑ NE ncV1VWUJ/1J1nPcUw1 jNanuc. . pt 1 FlIVI c. -t tv w- — pJ Reviewer/Inspector Signature: Date: Page 3 of 3 21412011 • �tr�►S 7/Iy�Za! Date of Visit: Arrival Time10'4 Departure Time: County: Region: Farm Name: • , Owner Email: Owner Name: cZ Phone: Mailing Address: Physical Address: Facility Contact: �� " S V tt=�Title: Onsite Representative: Certified Operator:�� 4 Back-up Operator: Location of Farm: Latitude: Phone: Integrator: - 6 Certification Number: Certification Number: Longitude: l'7go I Desig "CurrenWJVDesigCu DesignSwineCilctty Trent Pop Cattle Capacity Pop. Wean to Finish Wean to Feeder Feeder to Finish La er Non -La er= - A DairyCow DairyCalf Dairy Heifer Farrow to Wean wCnrrent D Cow Farrow to Feeder D , P,oult , WC-a_Po Non -Dairy Farrow to Finish Gilts Layers Non -Layers Beef Stocker Beef Feeder L_LqoaTs Pullets .a, ` Beef Brood Cow Turke s Other° Turkey Poults. NJ er 10ther Discharges and Stream Impacts 1. Is any discharge observed from any part of the operation? ❑ Yes 210 ❑ NA ❑ NE Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: a. Was the conveyance man-made? ❑ Yes [:]No 03 A ❑ NE b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No �iA ❑ 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? 0 Yes �No ❑ NA ❑ NE 3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE of the State other than from a discharge? Page I of 3 21412011 Continued Facili Number: - Date of inspection. Waste 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 QqZ�❑ NE Structure 1 Structure Struc e 3 Structure 4 Structure 5 Structure 6 Identifier: 1 Spillway?: Designed Freeboard (in):� Observed Freeboard (in): f—_ 5. Are there any immediate threats to the integrity of any of the structures observed? [:]Yes B'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 0<0 ❑ NA ❑ NE waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes <O ❑ NA ❑ NE 8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 2<o ❑ NA ❑ NE (not applicable to roofed pits, dry stacks, and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require [:]Yes ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �o ❑ NA ❑ NE maintenance or improvement? 11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes VXo ❑ 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 ❑ vidence of Wind Drift ❑Application Outside of Approved Area 12. Crop Type(s): 13. Soil Type(s): 14. Do the receiving crops differ from those designated in the CAWMP? I5. Does the receiving crop and/or land application site need improvement? 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acres determination? 17. Does the facility lack adequate acreage for land application? 18. Is there a lack of properly operating waste application equipment? [—]Yes g3 <oo ❑ Yes 53' 0 ❑ Yes EE '`'o ❑ NA ❑ NE ❑ NA ❑ NE ❑ NA ❑ NE ❑ Yes 2<0 ❑ NA ❑ NE ❑ Yes �j<o [] NA ❑ NE Reauired Records & Documents 19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes I Jo ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes o ❑ 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 53<o ❑ 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 UNo ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No EKA ❑ NE Page 2 of 3 21412011 Continued Facility Number: - Date of Insuecdon: 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes to ❑ NA ❑ NE 25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [ No ❑ NA ❑ NE the appropriate box(es) below. ❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels ❑ Non -compliant sludge levels in any lagoon List structure(s) and date of first survey indicating non-compliance: 26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes <o ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NA Other Issues 28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes [j. , o ❑ NA ❑ NE and report mortality rates that were higher than normal? 29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ 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 191<0 ❑ 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 E;�<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 11 oKo 0 NA ❑ NE 33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 16Xo' DA' ❑ NA ❑ NE 34. Does the facility require a follow-up visit by the same agency? ❑ Yes ❑ NA ❑ NE Comments {refer to question : Erfi)Mn any YES answeradryadilitioal rco.endationsor any other commensomm Uedrawingsofltacility toeterexplan situations (useaditionalpanessary)46 CMr`16_0L,5 cr&JAk_:C� 14- Reviewer/Inspector Name: Reviewer/Inspector Page 3 of 3 Phone: 9JO Date: 7//'9 1 4/2011 8TWs z - o y- 20 /O Type of Visit& Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit v rcoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access Date of Visit: Z—DI—/D Arrival Time: Departure Time: �� 3S- „? County: _ _� SoN Region: Farm Name: Sol. PJ iz5 A, i �ar►,� � — 8 Owner Email: Owner Name: 7Z--0 l,,v Qo 4 0. Phone: Mailing Address: Physical Address: Facility Contact: Title: 5��� ' Phone No: Onsite Representative: Integrator:vl Certified Operator: Back-up Operator: Location of Farm: Operator Certification Number: Back-up Certification Number: Latitude: = o =' = Longitude: = ° =' = Design Current Swine Capacity Population Wet Poultry' Design Current Design Current Capacity Population Cattle Capacity Population Finish ❑ Layer ❑ DairyCow ❑ DairyCalf to Feeder ❑ Non -Layer Rf ceder to Finish O ✓�Jr� pry Poultry ❑ Da Heifer ❑ D Cow ❑Non -Dairy ❑ Beef Stocker to Wean w to Feeder ❑ Layers Eto w to Finish ❑Non -Layers ❑Pullets❑ Turke s❑ Turke Puuets ❑Other El Beef Feeder Beef Brood Ca❑ Dumber of Structures: Dischartses & 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 ErNo ❑ NA ❑ NE ❑ Yes ❑ NoL�Y, N/A El NE El Yes ❑ No L7 NA ❑ NE ❑ Yes ❑, NNo NA ❑ NE ElYes l �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'? a. If yes, is waste level into the structural freeboard? Structure Structure Structure Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): zg '' z & k Z 2 � Structure 4 ❑ Yes �L,I NNo El NA El NE [I Yes LI Flo ❑ NA ❑ NE Structure 5 Structure 6 5. Are there any immediate threats to the integrity of any of the structures observed'? ❑ Yes ETNo ❑ 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? El Yes LINO ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes CJ 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 B No ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance/improvement? ❑ Yes l-'SNo ❑ NA ❑ NE 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes L No ❑ NA ❑ NE ❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,Ln, etc.) ❑ PAN ❑ PAN > 14% or 141bs ❑ 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) /4o 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No El NA El NE 15. Does the receiving crop and/or land application site need improvement? El Yes �E L7 No ❑ NA ❑ NE t6_ 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 L`JB No ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes 9< ❑ NA ❑ NE "Comments (refer to quesdon #) Expiain any YES answers and/or any recommendations or any other comments i Use draw7n s of fac�ii. to better explain situations. use additional a es as necessary): Reviewer/Ins ector Name [ iC. �e.v p � �. � S Phone: 910, V33, 330D Reviewer)) nspector Signature: Date: Z - 0 1 ` 2,010 12128104 Continued Facility Number: Z — f42. Date of Inspection Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 9 No ❑ NA ❑ NE L"J No 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ NA ❑ NE the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes YN. ❑ 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? El" Yes No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? 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 ❑ Yes No ❑ NA ❑ NE ❑Yes • NNoo DNA ONE ❑ Yes 2 o ❑ NA ❑ NE 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 MINo ❑ NA ❑ NE ❑ Yes LJ No ❑ NA ❑ NE ❑ Yes D<o ❑ NA ❑ NE ❑ Yes L3No ❑ NA ❑ NE ❑ Yes No ❑ NA ❑ NE ❑ Yes Na ❑ NA ❑ NE ❑ Yes ErNo ❑ NA ❑ NE Additional Comments aadlar D�mags: i T 12178104 "B1M S la —a5— ;,7007 01firv—ision of Water Quality Facility Number 0 Division of Soil and Water Conservation 0 Other Agency Type of Visit ompliance Inspection O Operation Review 0 Structure Evaluation Q Technical Assistance Reason for Visit S'Ftoutine O Complaint 0 Follow up O Referral O Emergency O Other ❑ Denied Access Date of visit. 9 /8 [? Arrival Time: /�'3Q .- Departure Time: I/,20,q,.., County: Farm Name: oI& j Re a./ Fay►"` I ` g Owner Email: Owner Name: _ -1 0 Le,,j Rey «j Phone: Mailing Address: Region: /4:7710 Physical Address: Facility Contact: Cur-+i's 134rw. c' K Title: _1 0- pex__ - Phone No: Sot. N 2., 4J Onsite Representative: C== Yr -,-S_ cy�.sic.k _ Integrator: L`°"'1 t- C7,xYt,^s Certified Operator: Back-up Operator: Location of Farm: Swine Operator Certification Number: Back-up Certification Number: Latitude: ❑ e = A Longitude: =1 ° = I = Design Current Design Current Capacity Population Wet Poultry Capacity Population ❑ Layer ❑ Non -La er ❑ Wean to Finish ❑ Wean to Feeder Feeder to Finish 16000 1 q Q ❑ Farrow to Wean ❑ Farrow to Feeder ❑ Farrow to Finish ❑ Gilts ❑ Boars Other ❑ Other Dry Poultry ❑ Layers ❑ Non -Lavers ❑ 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'? b. Did the discharge reach waters of the State? (If yes, notify DWQ) Design Current Cattle Capacity Population ❑ Dairy Cow ❑ Dairy Calf ❑ Dairy Neifet ❑ Dry Cow ❑ Non -Dairy ❑ Beef Stocker ❑ 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 CYNo ❑ NA ❑ NE ❑Yes []No N❑ E3SA NE El Yes ElC No ivA ❑ NE ❑ Yes ❑ No lAA El NE ElL�I Yes 40 P�LTIVA ❑ NE ❑ Yes P< L9< ❑ NE 12128104 Continued l� acility Number: Date of Inspection Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 ❑ Yes B No ❑ Yes No Structure 5 El NA [3 NE El NA ONE 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 ETNo ❑ NA ❑ NE (ie/ large trees, severe erosion, seepage, etc.) ,�,� 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes LTNo ❑ NA ❑ NE through a waste management or closure plan? If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes D No ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? El Yes 3 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 DN—o ❑ NA ❑ NE maintenance/improvement? 11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [-do ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window/ ❑ Evidence of Wind Drift ❑ Application Outside of Area 12. Crop type(s) t_4?Yi&%,1_ L -- C G� f�4 S;�// G. r•,•'.., �D S. 13. Soil type(s) / VA . 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 to ❑ NA ❑ NE ❑ NA [I NE ,. �Io B No ❑ NA [IN E E 'No ❑ NA ❑ NE ❑dam ❑ NA ❑ NE Woomments7 RKeg=uestioninflExplain any YES answers and/or any recommendations or any otffierilcomn!nts.1111111111111111111111 Use drawings of facility to better explain situations. (use additional pages as tsecessary,): Reviewer/Inspector Name rG !�, / :k t/ m Phone: 970,V33.333 Reviewer/Inspector Signature: 2—_9_4fg__— Date: 9 —A8' Z da c% Page 2 of 3 12128104 Continued Facility Number: 82 — StZ Date of Inspection Required Records & Documents �,/ 19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes L7 No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes L7 No ❑ NA ❑ NE the appropirate box. ❑ WUP El Checklists ❑Design El Maps El Other �.,,►v� 21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes L7 o []NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes B<o ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes l�o ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? [IB Yes ,L. ivo ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? El Yes ��� E Noo ❑ NA [INE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes 9 o ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes O-go ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes 3- o ❑ 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 ,� LI ivo ❑ 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 01 o ❑ NA El NE General Permit? (ie/ discharge, freeboard problems, over application) ,.,� 32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? El Yes oo [I NA ❑ NE 33. Does facility require a follow-up visit by same agency? El Yes ,1��, Ea o ❑ NA ❑ NE Additional Comments and/or Drawings: H 12128104 a -T►14 s 1 os 06 JAR_ Type of Visit (-Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access Date of Visit: 6V!?_98 I Arrival Time: Departure Time: %: $5 County: J Region: IX-40 Farm Name: Owner Email: Owner Name: 10m^'„.,_.RO4eJ Phone: Mailing Address: Physical Address: Facility Contact: Title: ���'-`' • �Pe c Phone No: Onsite Representative: C� s 1i"�i t- k Integrator: C01a Vr t Fa ►� S Certified Operator: Back-up Operator: Operator Certification Number: Back-up Certification Number: Location of Farm: Latitude: E] o a ' E=1 Longitude: = o = 6 = Me.urrent Capapulation 1111=Design CurrenSwine Wet Poultry Capacity Population Cattle Capacity Population ❑Dai co; ❑Dai Calf ❑ Wean to Finish ❑ La er _ ❑ Wean to Feeder on -Layer Feeder to Finish ❑ Farrow to Wean ❑ Farrow to Feeder Farrow to Finish (p000 (oZ Dry Poultry ❑ DairyHeifer ❑ D Cow El u El La ers ❑ Beef Stocker El❑ ❑ Non -Layers ❑ Gilts El Beef Feeder ❑ Beef Brood Cow ❑ Boars El Pullets the ❑ Other ❑ Turke s::: ❑ Tur ke y Poults ❑OtherI - Numherdf Structures: Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? ❑ Yes E No ❑ NA ❑ NE Discharge originated at: ❑ Structure ❑ Application Field ❑ Other a. Was the conveyance man-made? El Yes ❑ No �,� L7 NA ❑ NE b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No 2 A ❑ NE c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No 19<A ❑ NE 2. Is there evidence of a past discharge from any part of the operation? ❑ Yes Bfo ❑ NA ❑ NE 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑ Yes 2<o ❑ NA ❑ NE other than from a discharge? Page 1 of 3 12128104 Condnued Facility Number: gZ—Z Date of Inspection�'O Waste Collection & Treatment 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? a. If yes, is waste level into the structural freeboard? Structure 1 Structure 2 Structure 3 Structure 4 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 2-5 St 22, 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? ❑ Yes ETNo ❑ NA ❑ NE ❑ Yes [lio ❑ NA ❑ NE Structure 5 Structure 6 ❑ Yes �o ❑ NA ❑ NE ❑ Yes B<o ❑ NA ❑ NE If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ 7. Do any of the structures need maintenance or improvement? ❑ Yes U 1vo ❑ NA ❑ NE 8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes E3<o ❑ NA ❑ NE (Not applicable to roofed pits, dry stacks and/or wet stacks) 9. Does any part of the waste management system other than the waste structures require ❑ Yes 0-� �o ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need [:1 Yes fo ❑ NA ❑ NE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [}�E] NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area 12. Crop type(s) a.. C f>�•j ��r. � _� �h�al% Gr t,,,a Co. S. :. 13. Soil type(s) N o 4 14. Do the receiving crops differ from those designated in the CAWMP? ElE,Yes �// No ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes B o ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes LOB NNoo El NA ❑ NE 17. Does the facility lack adequate acreage for land application? ❑ Yes I 2 <o ❑ NA El NE 18. Is there a lack of properly operating waste application equipment? [I Yes , Ehlo ❑ NA ❑ NE Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. Use drawings of facility to better explain situations. (use additional pages as necessary): Reviewer/Inspector Name Phone: q/0. f133.333'a Reviewer/Inspector Signature: Date: 12128104 Continued Facility Number: $Z Date of Inspection 8—i`f-08 Required Records & Documents / 19. Did the facility fail to have Certificate of Coverage & Permit readily available? El, Yes L'� No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes l3No ❑ NA ❑ NE the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Bo El NA El NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? El Yes ,� oo El NA El NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? Yes ElW7 ,L-T, L�lt o ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes E3 No ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes O'lrlo ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes L3No ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 0To ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes O 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 D<o ❑ 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 � 2 o ❑ 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 ElNE 33. Does facility require a follow-up visit by same agency? El3 Yes o ❑ NA ❑ NE Additioaal'Comments.and/or Dr'awtngs t, _,. Vic- a.Y Page 3 of 3 12128104 ® Division of Water Quality Facility Number gZ Z O Division of Soil and Water Conservation Q Other Agency Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation 0 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: Z:Op County: Farm Name: —7 aL•+.i Q®i.", Ywt -$ Owner Email: Owner Name:-S'0i"1 i2e c.rs( PhnnP- Mailing Address: Region: C'� Physical Address: Facility Contact: _ Cu1+1`s_ $ctr Wic. k Title: 15AJ1/, /ua i-^_ Phone No: Onsite Representative: ,- � e'3ary.I�c� Integrator: C04_-'- c " -S Certified Operator: Operator Certification Number: Back-up Operator: Back-up Certification Number: Location of Farm: Latitude: = b 0 I ❑ 11 Longitude: = ° ❑ 6 ❑ id Swine Wean to Finish Wean to Feeder Feeder to Finish Farrow to Wean Farrow to Feeder Farrow to Finish Gilts Boars Other ❑ Other Design Current Design Current Capacity Population Wet Poultry Capacity Population ❑ Layer ❑ Non-Layet Dry Poultry ❑ La ers ❑ Non -Layers ❑ Pullets ❑ Turkeys ❑ Turkey Poults ❑ Other Discharges & Stream Im acts 1. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other a. Was the conveyance man-made? Design :Cur'rent Cattle Capacity `= Population ❑ Dairy Cow ❑ Dairy Calf ❑ Dairy Heifer ❑ Dry Cow ❑ Non -Dairy ❑ Beef Stacker ❑ Beef Feeder ❑ Beef Brood Co Number of Structures: b. Did the discharge reach waters of the State? (If yes, notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes M No ❑ NA ❑ NE ❑ Yes ® No ❑ NA ❑ NE ❑ Yes [A No ❑ NA ❑ NE ❑ NA ❑ NE ❑ Yes [M No ❑ Yes [� No ❑ NA ❑ NE ❑ Yes EM No ❑ NA ❑ NE 12128104 Continued Facility Number: Date of Inspection �o—a3'07 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: Spillway?: Designed Freeboard (in): Observed Freeboard (in): 27 Z to 4/ly 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes q 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 [XNo ❑ 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 4 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 [7 No ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes (A No ❑ NA ❑ NE maintenance/improvement? 11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE ❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) ❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil ❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area 12. Crop type(s) r irwu ct�.. ( Sill/ tf SJ 13. Soil type(s) 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ® No El NA El 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 (4 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 l Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. fUse drawings of facility to better explain situations. (use additional pages as necessary): Reviewerlinspector Name Re_V f,jS Phone: 9/0- V33, 3360 Reviewer/Inspector Signature: Date: /D— d3 —zeo 7 12129104 Continued Facility Number: 8`2 — Date of Inspection Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes U No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 2 No ❑ NA ❑ NE the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other 21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes En No ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [� No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 1� No ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes [� No ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes [ No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes [A No ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes `F'' 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 [2 No ❑ NA ❑ NE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ® No ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes [11 No ❑ NA ❑ NE Comments and/or Drawings: 12128104 WAr�9Q� Michael F. Easley, Governor December 1, 2006 CERTIFIED MAIL RETURN RECEIPT REOUESTED John O Royal John O. Royal #1-8 4025 Mt Moriah Church Rd Clinton, NC 28328 William G. Ross Jr., Secretary North Carolina Department of Environment and Natural Resources Subject: Application for Renewal of Coverage for Expiring NPDES General Permit Dear Permittee: Alan W. Klimek, P.E. Director Division of Watr Quality RECEIVED DEC a 6 20M [N-FAi'Ei W FSM OfflGE Your facility is currently approved for operation under one of the Animal Waste Operation NPDES General Permits, which expire on July 1, 2007. Due to changes in federal rules, facilities that do not discharge nor propose to discharge may choose whether or not to retain coverage under an NPDES General Permit. Copies of the draft animal waste operation NPDES general permits and the State Non -Discharge General Permits are available at hqp://h2o.enr.state.nc.uslaps/afou/downloads.htm or by writing or calling: NCDENR — DWQ Animal Feeding Operations Unit 1636 Mail Service Center Raleigh, North Carolina 27699-1636 Telephone number: (919) 733-3221 In order to assure Your continued coverage under one of these two tunes of general permits, you must submit an application for permit coverage to the Division. Enclosed you will find a `Request for Certificate of Coverage Facility Currently Covered by an Expiring NPDES General Permit.' The application form must be completed and returned by January 2, 2007. Please note, you must include two (2) copies of your most recent Waste Utilization Plan with the application form. Failure to request renewal of your coverage under a general permit within the time period specified may result in a civil penalty. Operation of your facility without coverage under a valid general permit would constitute a violation of NCGS 143-215.1 and could result in assessments of civil penalties of up to $25,000 per day. If you have any questions about the draft general permits, the enclosed application, or any related matter please feel free to contact the Animal Feeding Operations Unit staff at 919-733-3221. Sincerely, Ted L. Bush, Jr., Chief Aquifer Protection Section Enclosures cc (w/o enclosures): Sampson County Soil and Water Conservation District Fayetteville Regional Office, Aquifer Protection Section AFO Unit Central Files - 820042 Coharie Farms Aquifer Protection Section 1636 Mail Service Center Internet: w'wWncWatgqualitv,org Location: 2728 Capital Boulevard An Equal Opportun4lAffirmative Action Employer- 500h Rec ycled110% Post Consumer Paper Raleigh, NC 27699-1636 Telephone: Raleigh, NC 27604 Fax 1: Fax 2: Customer Service: No ` Carolina (919) Aaturally (919)715-0588 (919)715-6048 (877)623-6748 ® Division of Water Quality Facility Number 4; Z 0 Division of Soil and Water Conservation Other Agency Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access Date of Visit: 15 -00-061 Arrival Time: Departure Time: County: ��s e.✓ Farm Name: :7 S7z n., Owner Email: Owner Name: �, n'�v, ^ Phone: Mailing Address: Physical Address: Facility Contact: Z7 +9�_ _7t�� ;l Title: r Onsite Representative: / Certified Operator: Back-up Operator: Location of Farm: Phone No: Integrator: Operator Certification Number: Back-up Certification Number: Region: /:ia Latitude: [= o [= 1 Longitude: = ° =' = " Design Current Design Current Design Current Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population ❑ Wean to Finish _ ❑ Wean to Feeder ® Feeder to Finish C) ❑ Farrow to Wean ❑ Farrow to Feeder ❑ Farrow to Finish ❑ Gilts ❑ Boars Other ❑ Other ❑ Layer ❑ Non -La er Dry Poultry ❑ La ers ❑ Non -Layers ❑ Pullets ❑ Turkeys ❑ Turkey Poults ❑ Other Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other a. Was the conveyance man-made'? ❑ Dairy Cow ❑ Dairy Calf ❑ Dairy Heifer ❑ Dry Cow ❑ Non -Dairy ❑ Beef Stockei ❑ Beef Feeder ❑ Beef Brood Cowl b. Did the discharge reach waters of the State? (If yes. notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? Number of Structures: �F d. Does discharge bypass the waste management system'? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [9 No ❑ NA ❑ NE ❑ Yes No ❑ NA ❑ NE ❑ Yes Q No ❑ NA ❑ NE ❑ NA ❑ NE ❑ Yes 1A No ❑ Yes No ❑ NA ❑ NE ❑ Yes No ❑ NA ❑ NE 12128104 Continued Facility Number: Z— Lf z 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 -I ;Structure 2 ,-,Structure 3 Structure 4 Structure 5 Structure 6 Identifier: Spillway?: Designed Freeboard (in): Observed Freeboard (in): {,2.9 5. Are there any immediate threats to the integrity of any of the structures observed? El NA ❑ NE ❑ Yes QNo (ie/ large trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes [SI 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 �3 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 17(No ❑ NA ❑ NE maintenance or improvement? Waste Application 10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes EfNo ❑ 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 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).utC(ddc �ya3e_ 5/�„G`,✓^f - 13. Soil type(s) 141pA 14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 59 No ❑ NA ❑ NE 15. Does the receiving crop and/or land application site need improvement? ❑ Yes ® No ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination, ❑ Yes L9 No ❑ NA ❑ NE IT Does the facility lack adequate acreage for land application? ❑ Yes 0 No ❑ NA ❑ NE 18. Is there a lack of properly operating waste application equipment? ❑ Yes X No ❑ NA ❑ NE Reviewer/Inspector Name ���-�� j y f�5 Phone: 4C) Reviewer/Inspector Signature: ,j�� .� -�._ - Date:—(]g—ZF"G{P 1L/L5/U4 u0nnnuea Facility Number: F� — Z Date of Inspection Required Records & Documents 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [A No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [I Yes ®No ❑ NA ❑ NE the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other 21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes IN No ❑ NA ❑ NE ❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ® No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes KNo ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes N No ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge'? ❑ Yes] No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification'? ❑ Yes No ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes KNo ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ yes P9 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 W 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 0 No ❑ NA ❑ NE General Permit? (ie/ discharge. freeboard problems, over application) 32. Did ReviewerA n spector fail to discuss review/inspection with an on -site representative? ❑ Yes R) No ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency? ❑ Yes E0 No ❑ NA ❑ NE :. r Addrfoial Catnments:and/or Drawings: . r;• _.ter ` "' x 3. VW , _ 12128104 Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance Reason for Visit 19 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access Date of Visit: Arrival Time: f/ % 3��' Departure Time: County: p-s c,A-) Region: 1✓ ky Farm Name: � a� r. R o u� - Owner Email: Owner Name: e ` + —n d u_C), Phone: Mailing Address: y 02S 1.y��.. yy/Tiohi � Ccy( M*orl C, Physical Address: +-�t e- _ C. Z Gfa c4 C_- _ Facility Contact: Title: Phone No: 4 ? a 41-V Y.Vi 7 Onsite Representative: ZYGAI, IL412AG k r � � � sR 4 V L- . c6egrator: G to 1. a %r t 4- FQr Certified Operator: SO 11 ►i a� C Operator Certification Number: 1 -7 q b I Back-up Operator: Location of Farm: Back-up Certification Number: Latitude: 0 0 =. Longitude: = e = = Design Current Design Current Swine Capacity Population Wet Poultry Capacity Population Cattle ❑ Wean to Finish ❑ Wean to Feeder ® Feeder to Finish ana ❑ Farrow to Wean ❑ Farrow to Feeder ❑ Farrow to Finish ❑ Gilts ❑ Boars Other ❑ Other ❑ La er ❑ Non -La et Dry Poultry ❑ La ers ❑ Non -Layers ❑ Pullets ❑ Turkeys ❑ Turkev Poults ❑ Other Dischart?es & Stream impacts 1. Is any discharge observed from any part of the operation? Discharge originated at: ❑ Structure ❑ Application Field ❑ Other a. Was the conveyance man-made.' Design Current Capacity Population ❑ Dairy Cow ❑ Dairy Calf ❑ Dairy Heifei ❑ Dry Cow ❑ Non -Dairy ❑ Beef Stocker ❑ Beef Feeder ❑ Beef Brood Cow Number of Structures: b. Did the discharge reach waters of the State? (If yes. notify DWQ) c. What is the estimated volume that reached waters of the State (gallons)? d. Does discharge bypass the waste management system'? (If yes, notify DWQ) 2. Is there evidence of a past discharge from any part of the operation'? 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? [:]Yes [2No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE ❑ Yes ❑ No ❑ NA ❑ NE ❑ NA ❑ NE ❑ Yes ❑ No ❑ Yes [K No ❑ NA ❑ NE ❑ Yes [2 No ❑ NA ❑ NE 12128104 Continued Faehity Number: 8.2— d 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 Spillway?: ./a /rolp"Us G 0'm P"- `7 0.e Ar 1 fa . _S� t V G-- � _ _ l:rz, e.R �—T Designed Freeboard (in): Observed Freeboard (in): 31 " 3 ill 5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes E ] No ❑ NA ❑ NE (ie/ Iarge trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes R 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 4 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) e. w a a.� > f_M rr►u� S}.�rG / S �? O S 13. Soil type(s) _ _1 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 EgNo ❑ NA ❑ NE 16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[:] Yes Q 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 Reviewer/Inspector Name RRMW 4--.?a : , w* Phone: 21-"C /J Reviewer/Inspector Signature: Date: 12128104 Continued [rFac`tlity Number: �,Z — t!a Date of Inspection 2 -u_ a. Required Records & Documents t. 19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [A No ❑ NA ❑ NE 20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE the appropirate box. ❑ WUP ❑Checklists ®Design El Maps ❑Other 21. Does record keeping need improvement? If yes, check the appropriate box below. ® Yes ❑ No ❑ NA ❑ NE ❑ Waste Application ® Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification ®Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code 22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ® No ❑ NA ❑ NE 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA ❑ NE 24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ® No ❑ NA ❑ NE 25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes N No ❑ NA ❑ NE 26. Did the facility fail to have an actively certified operator in charge? ❑ Yes CO No ❑ NA ❑ NE 27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes [5� No ❑ NA ❑ NE Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes EP No ❑ NA ❑ NE 29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes ERNo ❑ NA ❑ NE and report the mortality rates that were higher than normal? 30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ® No ❑ NA ❑ NE If yes, contact a regional Air Quality representative immediately 31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes ® No ❑ NA ❑ NE General Permit? (ie/ discharge, freeboard problems, over application) 32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ® No ❑ NA ❑ NE 33. Does facility require a follow-up visit by same agency'? ❑ Yes [l No ❑ NA ❑ NE Additional Comments andlor Draw' ings:= 1ag0o/%�s a 1 CQ�C �.j �`C�� �S� tL }Y •. C 1=. C,a rCk i GVc.1-�'�rGl�l LL c Ck 21- 1 1e&.,c- 17 ��� ��1� laL0- +�c. C_Orr N+S C-_rprQV tC� Ro V- �c r C-ti`G d Gr� GL �-. 1k r 0,Z h-c a- l`, I r L 12128104 [Type of Visit (5 Compliance Inspection Q Operation Review O Lagoon Evaluation for Visit Q'Routine O Complaint Q Follow up O Emergency Notification Q Other ❑ Denied Access Facility Number $'', Date of Visit: � Time: rQ Not Operational Q Below Threshold 13Termitted WCertiiied 0 Conditionally Certified //�� II 13 Registered Date Last Operated or Above Threshold: ...---- �.... � i ....................... Farm Name: 11 �Oi�. l �--------•-- County: .. ......��..�°................................... Owner Name: 7°6!l......... � �_ R°}�`� .. _n.�.....j ............ Phone No: _... 54.. �� ......_._ .._.....__.... . ?VUuhngAddress:..._ .. as...... Mf .h'1°r'.a ._.. ----G46 Facility Contact: ............................. ..Title: BwreR Phone No: Integrator:......_ R6r1t.... Certified Operatar:._..._-..�.J;4 ..... Operator Certification Number. y - '� -- --- »......._..._.......... _. ...__. Location of Farm: EaSwine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �� �« Longitude �• �� ��� Discharges & Stream Impacts 1. Is any discharge observed from any part of the operation? ❑ Yes 3<0 Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other a. If discharge is observed, was the conveyance than -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 gallmin? 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 [1To 3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ErNo Waste Collection & Treatment 4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway Identifier: Structure 1 Structure 2 Struure 3 Structure 4 Structure 5 ❑ Yes [}'No Structure 6 ...........3 .................. _.............3_�......._ ..------------a5....._....... ------.---------------------..... _._........................ _ ..................... ...... .... Continued Freeboard (inches): 12112103 Facility Number: Q,Z -- Date of Inspection R a 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, seepage, etc.) 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or closure plan? (If any of questions 4-6 was answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ) 7. Do any of the structures need maintenance/improvement? 8. Does any part of the waste management system other than waste structures require maintenancelimprovement? 9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level elevation markings? Waste Application 10. Are there any buffers that need maintenancerunprovement? 1 l . Is there evidence of over application? If yes, check the appropriate box below. ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc 12. Crop type ❑ Yes ErNo ❑ Yes 2 No ❑ Yes YNo ❑ Yes ErNo ❑ Yes ErNo ❑ Yes UrNo ❑ Yes 2No 13. Do the receiving crops differ with those designated in the Certttied Animal Waste Management Plan (CAWMP)? ❑ Yes ErNo 14. a) Does the facility lack adequate acreage for land application? ❑ Yes ErNo b) Does the facility need a wettable acre determination? ❑ Yes GrNo c) This facility is pended for a wettable acre determination? ❑ Yes QNo 15. Does the receiving crop need improvement? 16. Is there a lack of adequate waste application equipment? Odor Issues 17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below liquid level of lagoon or storage pond with no agitation? 18. Are there any dead animals not disposed of properly within 24 hours? 19. Is there any evidence of wind drift during land application? (i.e_ residue on neighboring vegetation, asphalt, roads, building structure, and/or public property) 20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional Air Quality representative immediately_ I- com'.'L +. &%U-')r- art IS "' Reviewer/inspector Name =` Reviewer/Inspector Signature: ca'. P4}4_-'/" g-e U ❑ Yes [9-1Vo ❑ Yes ["lo ❑ Yes [RI�o ❑ Yes 3fio ❑ Yes [R10 ❑ Yes QTio Copy ❑ Final Notes Date: 5 / as /o r7n1ml Facility Number: ga — Date of Inspection Required Records & Documents 21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? 22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? (ie/ WUP, checklists, design, maps, etc.) 23. Does record keepirpeed improvement? If yes, check the appropriate box below. ❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling 24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? 25. Did the facility fail to have a actively certified operator in charge? 26. Fail to notify regional DWQ of emergency situations as required by General Permit? (ie/ discharge, freeboard problems, over application) 27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? 28. Does facility require a follow-up visit by same agency? 29. Were any additional problems noted which cause noncompliance of the Certified AWMP? NPDES Permitted Facilities 30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) 31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 32. Did the facility fail to install and maintain a rain gauge? 33. Did the facility fail to conduct an annual sludge survey? 34. Did the facility fail to calibrate waste application equipment? 35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below ❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After V Rain ❑ 120 Minute Inspections ❑ Annual Certification Form ❑ Yes [6No ❑ Yes Q No ❑ Yes 5No ❑ Yes G'No ❑ Yes ❑`No ❑ Yes ENINo ❑ Yes ETNo ❑ Yes [°f No ❑ Yes O No 131Yes ❑ No ❑ Yes ErNo ❑ Yes [" No ❑ Yes JgNo ❑ Yes ff No ❑ Yes eNo 12112103 Site Requires Immediate Attention: t-16 Facility No. IZ,2 -4.Z DIVISION OF ENVIRONMENTAL MANAGEMENT ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD DATE: 7_ �1TAy , 1995 Time: 13 ` I $ Farm NanWOwner: e�.,eL I 0 I- S Mailing Address: Ry t s 3 NCB County: So m n.4on Integrator: VfV7e,-,c ,s Tic _ - Ph. On Site Representative: Physical Address/Location: 52 t s Type of Operation: Swine X Poultry Cattle Design Capacity: Number of Animals on Site: t0000 DEM Certification Number: ACE DEM Certification Number: ACNEW Latitude: Longitude: ° 2g-' .35'" 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) (aor No Actual Freeboard: 3 Ft. & Inches Was any seepage observed from the lagoon(s)? Yes orb Was any erosion observed? Yes or No Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No y 1%0 Crop(s) being utilized: Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellin s? or No 100 Feet from Wells? Lor No Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or 19 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(&� 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 ;1� Additional Comments: -T : s ,,,� ►-: nA,1 �3 ■ �.w1\� C�1 V . i W iSF Inspector Name c4k. iAt ?t �..a! Signature Su+ 6c -1+4 wac" —CL eick. g r y etk":t[e NC Saw 1 cc: Facility Assessment Unit Use Attachments if Needed. Site Requires Immediate Attention: Na Facility No. Q _ 4 �Z DIVISION OF ENVIRONMENTAL MANAGEMENT ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD DATE: 7 as- , 1995 Time: 1.3 t $ Farm Name/Owner: _NV, 1 c, I - 'Mailing Address: Rj, N tAok t S 3 County: Integrator: Cp.« 1 s T7ejnt�s _ .,c _ Phone: On Site Representative: . n . Gz.#4! lb Phc 'Physical Address/Location: Sit t335- '/a_ Type of Operation: Swine X Poultry Cattle Design Capacity: Number of Animals on Site: coo oo DEM Certification Number: ACE DEM Certification Number: ACNEW Latitude:. ° n (a Longitude:-7,7 ° 25' -35'' 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) 4e or No Actual Freeboard: 3 Ft. & Inches Was any seepage observed from the lagoon(s)? Yes or® Was any erosion observed? Yes or No Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No Crop(s) being utilized: Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellin s? or No 100 Feet from Wells? Lor No Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or 10 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�l 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 s -04 t-4 -a cCL aV �..� Additional Comments: d (1ae.o n titc s1: -�� ep �- Inspector Name r,.-kk,;l[t ?0-,, at o MCC Signature 5-o 1.c 7+4 waC�eV:a Q[d. COY e� ��•:1Ie NC .28301 cc: Facility Assessment Unit Use Attachments if Needed. Site Requires Immediate Attention: nks Facility No. DIVISION OF ENVIRONMENTAL MANAGEMENT ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD DATE: as , 1995 Time: IA! �S Farm Name/Owner: Mailing Address: t Rex C. County: ?io -� 4 Integrator: Ct�,;m\V& _ Phone:—( s-A A o f a 1 ,On Site Representative: k , ".,6sa" Cal-mul end % Phone: t5+o) 2 A I AI Physical Address/Location. S R 13 33 s,g aas- y _ tsx—a Type of Operation: Swine X Poultry Cattle Design Capacity: Number of Animals on Site: DEM Certification Number: ACE DEM Certification Number: ACNEW Latitude: 3S am" Longitude: ° _!RTI-4 Circle Yes or No Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event Actual Freeboard: a Ft. Inches Yes or No Was any erosion observed? Yes or No Is the cover crop adequate? Yes or No vas ^p;- Crop(s) being utilized: Does the facility meet SCS minimum setback criteria? (approximately I Foot + 7 inches) Yes or No Was any seepage observed from the lagoon(s)? Is adequate land available for spray? Yes or No 200 Feet from Dwellin s? r No 100 Feet from Wells?or o Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes orW f Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or No +•col` eoJoJe�l Is animal waste discharged into water o -11pe 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)? Yes or Now Additional Comments: _4._ 4_ : se�r`c►-:d.., T ; S V �� �(Zr e i Cf +n & Mole Ak n �-a %! -S% 10�SCMI-i' W, un A Io @ Inspector Name o �' a Signature 5%,; r- -714 Old. S-ao y el-k4:ile NC 283o j cc: Facility Assessment Unit Use Attachments if Needed. Site Requires Immediate Attention: N6 Facility No. DMSION OF ENVIRONMENTAL MANAGEMENT ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD DATE: _Ts 1995 Time: 13'. a,5- Farm Name/Owner: `� d L..�, `t�sydl - irOtw, " 2. _ Mailing Address: t C County: `hb - 4 4 'Integrator: C_'� l�s Fcx,r].s i..c . Phone:_ Lgio S-52 o t 41 On Site Representative: A,,.s to V"san , a.mU lids Phone:I con s a, ^ I S1 Physical Address/Location: 3-7 ,.,:le 4 sd= d 3 Type of Operation: Swine x Poultry Cattle Design Capacity: Number of Animals on Site: _ ��+essr� DEM Certification Number: ACE DEM Certification Number: ACNEW Latitude: 3s 19 " Longitude: Circle Yes or No .Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event (approximately I Foot + 7 inches) Yes or No Actual Freeboard: 2. Ft. Inches Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or No :Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No-� Crop(s) being utilized: Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellin s? r No 100 Feet from Wells? or o Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes orqw Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or No No! e.).1.,,kj Is animal waste discharged into water o 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)? Yes or No s r.eL c"C-JV a.LAd L%. Additional Comments: T:S wnL S& 61ne.S- 1► r-,ote; *4dntm*4:nhn=,,'a "DAL 6, - i 4� nSF- Inspector Name' e4,kv;fit ?qx^al (3 Mte Signature 784 +k,)ftC"":oL Rick. r yttlet.:tie NC a6301 cc: Facility Assessment Unit Use Attachments if Needed.