820154_INSPECTIONS_20171231

NORTH CAROLINA ..�
Department of Environmental Qual
II

Type of Visit: 0 Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time:
`� ! De arture Time: County - Region:
Farm Name: SX5,50 ►'LS r..114wner Email:
Owner Name: r� I V l �l�QY1o/"ts Phone:
Mailing Address:
Physical Address:
FacilityContact:✓t�s �J Title:
Onsite Representative: i
Certified Operator: �Vxc�l
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Phone:
Certification Number: l�[J
Certification Number:
Longitude:
IRCapacity
Design
Pop.oultry
FaN
©esCurrent
Capacity
l'op
`= CWean
to Finish
Dai Cow
DairyCalf
Dai Heifer
D Cow
Wean to Feeder
Ha er
Feeder to Finish
Farrow to Wean
Design Current
D , P,oultc E" aci 1?0":
Farrow to Feeder
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
EL Beef Brood Cow
Boars
Pullets
Other
Other I 10ther
Turkeys
Turkey Poults
Discharges and Stream Impacts
l- 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)
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
❑ No
[0 NA
❑ NE
[] Yes
❑ No
0 NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes [—]No � NA ❑ NE
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Faciiii-t 4,umber: Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure I� Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
0 No ❑ NA ❑ NE
❑ No rej 1NA ❑ NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): - u
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.) T
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes E?fNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes EUNo ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) T
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? 'A
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes n No ❑ NA ❑ NE
maintenance or improvement?
t I. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑Yes rnNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen'Ground ❑ Heavy Metals (Cu, Zn, etc.
❑ PAN ❑ PAN > 10% or l0 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
P No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
10 No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
N No
❑ NA
❑ NE
acres determination?
17.
Does the facility lack adequate acreage for land application?
❑ Yes
1P No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
[P No
❑ NA
❑ NE
RKguired
Records & Documents
19.
Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
IM No
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? Ifyes, check
❑ Yes
F 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. 0 Yes No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tr sfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
DNA ONE
Page 2 of 3 21412015 Continued

F cili Number: Date ofinspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes j No [] NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes J��. No ❑ NA ❑ NE
the appropriate box(es) below. J�
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
NE
❑ Yes
No
❑ NA
❑ NE
❑Yes E�No ❑NA ❑NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes P No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to gnes#on'#() Explain any YES answers and/or any additional. recommendations or, any other comments.;,
Use drawings of facility to°better explain situations (use additional pages as necessary); � `
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 911D - 33102
Date: 17 VI'7
21412015

Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: • Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: p 1. �7Arrival Time: ID; Departure Time: ;D County's©^/Region:r{�
Farm Name: ' r ` '5�SScon S r+r• Owner Email:
OwnerName: U YlS SDr+s Phone:
Mailing Address:
Physical Address:
Facility Contact: JQnv
Onsite Representative: k
Certified Operator: C'R t/�ti '
Back-up Operator:
Title:
Phone:
Integrator: ple��
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Swine -
Des gn Current Design Current
Capacity P-op. W,et Paultry Capacity Pop.
Design Current
Cattle Capacity Pop.
Wean to Finish
La er
Dairy Cow
Wean to Feeder
Non -La er
I
airy Calf
Feeder to Finish
Farrow to Wean
Design
Dg. Point , Ga acity
Current
P,o ,
Dairy Heifer
Dry Cow
Farrow to Feeder
Farrow to Finish
Non -Dairy
Beef Stocker
Layers
Gilts
Nan -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
1
Other
Other
Turke s
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
Z. 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 Oa No ❑ NA ❑ NE
❑ Yes
❑ No
NA
[] NE
❑ Yes
❑ No
NA
❑ NE
[:]Yes
No
0 NA
❑ NE
❑ Yes
No
[DNA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page I of 3 21412011 Continued

F cili Nhmber: - Date of Inspection: 10
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
�iA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: iJ
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Z L/
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11, Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �? No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of AcceptableCrop Window Evidence of 'nd rift Applicati Outside of Approved Al2. Crop Type(s):L C. a� !�' 10)LE]
�
13. Soil Type(s): ,T1t / /.�[-j /VP
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
CP No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[—]Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21 _ Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tr9❑ fers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Condnued

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

type of visit: a Compliance inspection V Vperation Review t, Structure Evaluation V Technical Assistance
Reason for Visit ® Routine O Complaint O Follow-up O Referral O Emergency O Others O Denied Access
Date of Visit: ! Arrival Time: /O , q � Departure Time: G" / ouuty: Region: loyto
Farm Name: J E'�ls�/i/fs���,.i/.c.� Owner Email:
Owner Name: l,)?jU*r _5�_P.Ssy Phone:
Mailing Address:
Physical Address:
Facility Contact: ��W41W5 L.-.•� Title:
6/
Onsite Representative:
Certified Operator: 6t1t/ Ll
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:Z��j'L
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
R'et Poultry
La er
Design
Capacity
I
Current
Pop.
Design
Cattle Capacity
I Dairy Cow
Current
Pop.
Wean to Feeder
Feeder to Finish
I lNort-Layer
U = �I',o.ultr
I
Design
Ca aci
Current
P,o
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
3
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
La ers
Beef Stocker
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Turkeys
Turkey Poults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes No ❑ NA ❑ NE
[::]Yes [:]No NA ❑ NE
[—]Yes ❑ No V9NA ❑ NE
❑ Yes [:]No
❑ Yes No
❑ Yes CP
No
NA
❑ NE
❑ NA
❑ NE
❑ NA
❑ NE
Page I of 3 21412014 Continued

acili Number: - Date of Ins ection: i
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 22�
Structure 2 Structure 3 Structure 4 Structure 5
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
Erqo ❑ NA ❑ NE
❑ No IRI NA ❑ NE
Structure 6
[:]Yes 0 No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes No
❑ NA
❑ NE
waste management or closure plan?
/�9
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
Waste Auulication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes !� No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop/ Window -/❑ Evidence off Wino Drift ❑ Application Outside of Approved Area
12. Crop YP T e(s):
..--
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
SM No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[� No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
� No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[] Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes []4 No
❑ Waste Application El Weekly Freeboard ❑Waste Analysis ❑Soil Analysis ❑Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �] No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 5D No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

FaciliNumber: 45Z, - Date of Inspection: /
24. Did the facility fail to calibrate waste application equipment as required by the permit. [—]Yes �io ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes T[;D No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ER No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes NJ No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No [] NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes a No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ® No ❑ NA ❑ NE
lUse'
omments- refer to uestion E .lain any YES answers andlor any addittonal recommendafJons or any other
C ( 9 xP drawrn2s of facility to better eiplain situations (use additeonal pales as necessarvl: �_ _ :.
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: �l Q 3;,ag
Date: Zy S
2/4/ 014

Type of Visit: 0 Compliance Inspection U Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ® Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Ar 'val Time: Q - A- Departure Time: County:- Region:
Farm Name:'�O t ��� - Z3 7 Owner Email:
Owner Name: . �I nSyh s S p Phone:
Mailing Address:
Physical Address:
Facility Contact: J q hcS La_" Title:
ti
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Calo&k 0, 142t I
Latitude:
Integrator:
Phone:
Certification Number: < �ZLL.-'-
Certification Number:
Longitude:
7EdeF
Design Current
La er
Non -La er
Design
Current
Design Current
Dai Cow
Dai Calf
DairyHeifer
3QD
33
Farrow to Wean
D , P,oul
Layers
Non -Layers
Design
Ca aci
Current
P,o
Cow
Farrow to Feeder
Farrow to Finish
Non-D '
Beef Stocker
Gilts
Beef Feeder
Boars
Pullets
I
Beef Brood Cow
Mer
Turkeys
Turke Poults Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 0 No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ® NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No NA ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes l No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

acili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes `t' No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No 0 NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1
Spillway?:
Designed Freeboard (in):
r� u
Observed Freeboard (in): 2
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 [�j No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes PQ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) IV
9. Does any part of the waste management system other than the waste structures require ❑ Yes �No ❑ NA ❑ NE
maintenance or improvement?
Waste Apnlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No [] NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus [] Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): Gi Lj" 4_o L-Y ,
13. Soil Type(s): & A 1 X
14. Do the receiving crops iffer from those designated in the CAWMP?
❑ Yes
EpNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
0ZNo
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
ETpo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
rp%No
[ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
allo
❑ NA
[3 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
[�TNo
❑ 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
[g No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
[Q-No
❑ NA
❑ NE
Page 2 of 3
21412014 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes IP No
❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes P No
❑ NA
❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes yNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes 1PNo
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes EP No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes KM No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes [� No
0 NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
T
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes EPNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No
❑ NA
❑ NE
9 = TP Y Y Y
- _ _ mments ` Comments refer to question E lain an YES answers.and/or an additional recommendations or an other co
Use drawings of facility to better explain situations use ad'dttxorial'pa�es as necessary).
T
�� r
Reviewer/Inspector Name: 7 V , ,L f4 1a Phone:
Reviewer/Inspector Signature: Date: plql.`(
Page 3 of 3 2/4/2014

1"ype of Visit: 0 Compliance Inspection V operation Review U Structure Evaluation V Teclinical Assistance
Reason for Visit: O Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Or Departure Time: / + County:-Y�+F��II Region: - !�
Farm Name: S59MS - Owner Email:
Owner Name: �� /�r%t�D/1 SSOMS Phone:
Mailing Address:
Physical Address:
Facility Contact: �WiQS lQ�,,`j Title:
Onsite Representative: 1 { �/�
Certified Operator: i �A [ V`d Yt r' #4�j
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: r&
jg qe
Certification Number: W691 c' ZA
Certification Number:
Longitude:
Design Current Design Current;
Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop:
Cattle Capacity Pop.
Wean to Finish Layer
DairyCow
Wean to Feeder
Non -Layer
DairyCalf
1aa1
-_ "
Dai Heifer
Feeder to Finish
Farrow to Wean
Design C_urrerit
D Cow
Farrow to Feeder
Dry P,oult . Ca acity Ptio .�
Layers
Non -Dairy
Farrow to Finish
Beef Stocker
Non -La ers
Beef Feeder
Gilts
Boars
1pullets.
Beef Brood Cow
Turkeys
Otber
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 DWQ)
❑ Yes F
No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
NA ❑ NE
NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No go NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes M No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes [P No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility Number: jDate of inspection: N Za
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): A
!I
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., 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 F No ❑ NA ❑ NE
❑ Yes P No ❑ 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 No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [] Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require [] Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [� No ❑ NA ❑ NE
maintenance or improvement? T
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes I 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 II[ ]/�Evidence/off Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): _ �n'_4jq &�
13. Soil Type(s): A t A B4 /t/ta 4
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
[:]Yes 471
No
❑ Yes RR No
[—]Yes ® No
❑ Yes 1P No
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

Fa_6Ii Number: -7W Date of Inspection: t1
24. Did the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes W 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 to 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 M No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[�0] No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
® No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
® No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
T
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Use mren t (refer9 gj {yam
facility #o sett). Explain any YES answers and/or any additional recommendations or any other commentg: Comments refer to question #
er explain situations (use additional pales as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: uA0 1/3
21412011

I ype of visit: M Compliance inspection V operation Review u structure Evaluation V 1 ectinicai Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: I 011pO III Departure Time: ;,�D CountyZAWSO/J Region: r—fw
Farm Name: -23 2 SesSorrlS f" Owner Email:
Owner Name: �� 1 +' ltn✓�OI'j som s Phone:
Mailing Address:
Physical Address:
llr,p" 4-
Facility Contact: Title:
Onsite Representative: �C _
Certified Operator: 1 C-hQ_4` Se�SO r'I
� 1
Back-up Operator:—t{�VIr, nSOtA
Phone:
Integrator: -P"Ox z
Certification Number: 1 79i oT
Certification Number: 119 2s62
Location of Farm: Latitude: Longitude:
_
r DesignCurrent
.� Caacity Pap.
i-1.t - 1.Wean
k _.;= f
Design
W,et Poultry Capaciy
Currentwore
Pop.ity
to Finish
La er
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
eeder to Finishlml
rF
Da Heifer
arrow to Wean
Design
Current
D Cow
arrow to Feeder
Dr. P,oult.
Ca aci
Po ,
Non -Dairy
arrow to Finish
La ers
Beef Stocker
ilts
Non -La ers
lBeefFeeder
Boars
Pullets
113cef Brood Cow
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 DI
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes 1p No ❑ NA ❑ NE
❑ Yes
❑ No
® NA
❑ NE
❑ Yes
❑ No
® NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
[] No
® NA
❑ NE
[] Yes
J� No
❑ NA
❑ NE
❑ Yes
P No
0 NA
❑ NE
Page 1 of 3 21412011 Continued

Facili Number: - / Date of Inspection: 7 z
L
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
P NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: _
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 50"
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[ No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
[n 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 or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes §5 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): 0"SS L-1T"Q r v
13. Soil Type(s): AM t PJF 1tJoA _
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �D No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes ® No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes W No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes T No
[:]Yes [P No
❑ Yes [ No
❑ Yes ® No
❑ 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 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes] No
❑ Yes No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - / Date of Inspection: Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes 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 to provide documentation of an actively certified operator in charge? ❑ Yes. 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?
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/Irnspector fail to discuss review/inspection with an on -site representative?
Reviewer/inspector Name:
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes fo No ❑ NA ❑ NE
❑ Yes [P No ❑ NA ❑ NE
❑ Yes [�g No ❑ NA ❑ NE
❑ Yes `P No ❑ NA ❑ NE
[—]Yes
$ No
❑ NA
❑ NE
❑ Yes
[� No
❑ NA
❑ NE
Reviewer/Inspector Signature:
Page 3 of 3
Date: IL25�L
21412011

Type of Visit: 40 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 0 Denied Access
Date of Visit: Arrival Time: I ocy Departure Time: - 1 County: �
Region: W
Farm Name: smSOM Owner Email:
Owner Name: fY 00 5�Sor-+ s Phone:
Mailing Address:
Physical Address:
r 0i
Facility Contact: Title: Phone:
Onsite Representative:<a►t ,y Integrator:
Certified Operator:Certification Number: ` 1"
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
I( 'CT
Design Current _`_
Design Current
Design l rent
Swine
Capacity P,op
Wet Poultry
Capty POP.,,
Cattle Capacity Pop.
M.
,
to Finish
La er
Dai Cow
to Feeder
-
Non -La er
Da' Calf
r to Finish
'"
Da' Heifer
w to Wean
F
ign Cur ent ..
D Cow
w to Feeder
D , P,oult .
Ca acyty Po :.- -?
Non-Daw
to Finish
La ers
Beef Stocker
Non -Layers
w
Beef Feeder
Boars
Pullets
" v
Beef Brood Cow
.. s
Turke s
Other
h
Turkey Poults
Other
Other
Discharges and Stream Imnacts
1. Is any discharge observed from any part of the operation? [:]Yes [�JNo ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No [RNA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No � NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ® NA ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yes rno ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes Ejq No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

[Facility Number: - Date of inspection: 1771,571 /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ObNo ❑ 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):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes En No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
q No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
� No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Avulication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window � ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): � fJ" ''�7[Q eyk1 Ou �J
PCB f -
13. Soil Type(s): A2& i t
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes P No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes Qq 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 properly operating waste application equipment?
❑ Yes No
❑ Yes No
❑NA ❑NE
❑NA ❑NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [P No ❑ NA ❑ NE
20. Does the facility fail to have ail components of the CAWMP readily available? if yes, check ❑ Yes [P 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 Q9 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 10 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EP No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection: y
'*24. Di*the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [ No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List 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 r No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No E� 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?
Comments (refer to question #): Explain any YES answers and/or any additional recommer
Use drawings of facility to better explain situations (use additional -pages as necessary). '
�6o-,fig
S;�
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes
No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes N No ❑ NA ❑ NE
❑ Yes
[5 No
0 Yes
Ep No
❑ Yes
FM No
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
Phone:
Date:
2✓412011

f
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit • Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0�Other
,, ❑ Denied Access
Date of Visit: i Arrival Time: . 3 Departure Time: 2 f Q County: S�0 �Q Region: _L_j '�
ram,,Farm Na Name: e f� M Owner Email:
Owner Name: F,, r 50n .SSon1_5 Phone:
Mailing Address:
Physical Address:
Facility Contact: -�` a Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
integrator:. r
Operator Certification Number: r r r oq
Back-up Certification Number:
Latitude: = o = 0 =, Longitude: = ° = 1 = "
Swine
Design
Capacity
@urrent
Population
Design
Wet Poultry Capacity
Current Design Current
Population Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ DairyCow
❑ Wean to Feeder
❑ Non -Layer
❑ DairyCalf
Feeder to Finish
/
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ DairyHeifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
El Beef Feeder
❑ Beef Brood Cowl
Number of Structures
El Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Turke s
❑ Turkey PoElts
❑Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes y No ❑ NA ❑ NE
❑ Yes
❑ No
C�PfilA
❑ NE
❑ Yes
❑ No
[FNA
❑ NE
❑ Yes
❑ No
73 NA
❑ NE
❑ Yes
[ No
❑ NA
❑ NE
❑ Yes
79 No
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Faci$ty Number: 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
❑ Yes [?No ❑ NA ❑ NE
❑ Yes ❑ No P NA ❑ NE
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
i
Observed Freeboard
(in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA ElNE
(iel large trees, severe erosion, seepage, etc.)
F
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
1P No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
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
0 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?
I I . 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
�
v
12. Crop type(s) S`w fly"
13. Soil type(s) AV, POE IV0
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
�9 No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment'?
❑ Yes
No
❑ NA ❑ NE
Comments (refer to gIlesteon #): Explain any YES answers andlor �y-recommendations or any oth-i' menu. [
Use drawings: of faci itvito better explain situations (use addtttonal;pages as necessar}-) } t
.t
ReviewerAnspector Name - —. ` .' ¢: t� ^"1� � ' Phone:
Reviewer/Inspector Signature: Date: (Q
Page 2 of 3 12129104 Continued

Facility Number: Date of Inspection f0�
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers (❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
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 ❑ No 4 NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
V9 No
El NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
W No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
P No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes P 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
Q§ 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
1PNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
Jj3 No
❑ NA
❑ NE
Additional Commentsaadlor Drawiags:` :' _t ;ice
Page 3 of 3 I2128104
Page 3 of 3 I2128104

e
iF
i
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: Arrival Time: 1zPDeparture Time. County: 2kwsom
Farm Name: N1S —23 2 Owner Email:
Owner Name: Son 5 _ Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: .aVY�s to"
Certified Operator: F14d%4,- M .
Back-up Operator:
Location of Farm:
Region:—
Phone No:
Integrator:
Operator Certification Number: 7
Back-up Certification Number:
Latitude: = c Q 6 = 6i Longitude: = ° = d = 4i
Design
Current Design Current Design Current
M
Swine Capacity
Population Wiet Poultry Capacity Population Cattle Capacity Population
La er ❑ Dai Cow
ffNon -Layer I ❑ Dairy Calf
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
❑ Dairy Heifer
El Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
El Farrow to Finish
❑ Layers
❑ Non -Layers
❑ Beef Stocker
El Feeder
Gilts
Gilts
PO Boars
❑ Pullets
❑ Turkeys
❑ Beef Brood Co
Other
❑ Other
❑ Turkey Poults
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �'No ❑ NA ❑ NE
❑ Yes ❑ No ?9NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes ❑ No NA
❑ NE
❑ Yes MNo ❑ NA
❑ NE
❑ Yes No ❑ NA
❑ NE
J
12128104 Continued

f
IF
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 I Stnicture 2 Structure 3 Stnicture 4
Identifier: I
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 5rt
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 4V No ❑ NA El NE
❑ Yes ❑ No NA ElNE
Structure 5 Iructure 6
❑ Yes [? No ❑ NA ❑ NE
❑ Yes `t' No ❑ NA ❑ NE
If any of questions"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)
4. 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 I«4o ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ETNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failureto Incorporate Manure/Sludge into Bare Soil
❑ Outside off Acceptable Crop Window- ❑ Evidenc�614u"L)t
Wind Drift
❑ Application Outside -of Area
12. Crop type(s) �9-W �rn+� GSS �M' � �,�^ o Qedi
13. Soil types) 4yyV
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination' ❑ Yes
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ Yes
��/o
L��<0
I(2<0
LLf<0
PNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ 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):
ReviewerAnspectorName
Phone: - 3" 33
Reviewer/Inspector Signature.
DateSignature. Date: 3�
12128104 Continued

r
Facility Number: — Date of Inspection
Required Records & Documents ,,--,,��++
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes lydtvo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes O<o ❑ NA ❑ NE
the appropriate box: ❑ WUP ❑ Checklists ❑ Desig
n ❑Maps El other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
(2 o
❑ 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
//❑
L�f'No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Ek o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
OlNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
O No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
dNNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
�o
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes U o ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[�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?
El Yes
��--,,!!
U 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
ElLr Yes
,,_,/
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
eNo
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
LDS No
❑ NA
❑ NE
12128104

Facility Number I=;
Q Division of Soil and Water Conservation
0 Other RgERT .
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: Arrival Time: Departure Time: ! 0 oo - County: Region: �A 0
Farm Name: t Owner Email:
Owner Name: � ., 5enoM S Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: :riQS integrator: Yr�°5 10
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: E—] e ❑ ' [_—] w Longitude: = ° =
• Design Current
Design Current
Swine
Capactty Population WEt -oultry C"aaci Po ulatian
.,r_ �.a P� h P
y
Cattle Ca aci Po ulation
P ty P
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
❑ Non -Layer
❑ Dai Calf
Feeder to Finish
3 s�
, ��',
❑ Dai Heifer
❑ Farrow to Wean
t e
'Dry Poaltry �"
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑Non -La ers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
:, ❑ Turkeys
Other.
❑ Other
' "' i . ❑ TurkeyPouets
❑Other
Number of Structures:
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes PNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes ❑ No
MNA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes ❑ No�NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes ❑ No
t&NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes (t No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes �No
[]NA
El NE
other than from a discharge?
CC
Page I of 3
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 l Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3cr
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Arc iucre siruciures un-siie which are nui properiy addressed and/or managed
through a waste management or closure plan?
❑ Yes M No ❑ NA ❑ NE
❑ Yes ❑ No ONA ❑ NE
Structure 5 Structure 6
❑ Yes ,9 No ❑ NA ❑ NE
LI Yes PNo LJ 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 (I No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes PNo ❑ 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 PsNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 'E�No ❑ NA ❑ NE
maintenance/improvement'?
I. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ONo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop types) 1 &,nn,ewcL6�ass
13. Soil type(s) ! V0_, goo, AW
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 6 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
j9No
❑ 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
Q9No
❑ NA
❑ NE
Reviewer/Inspector Name
e
Reviewer/Inspector Signature:
Date:
Page 2 of J 1111M/U4 (,onunuea

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n ❑ Maps
p El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
V No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
10 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
WNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
PI No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
EpNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�No
El NA
El 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
[P 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
M No
❑ NA
❑ NE
General Permit? (iet discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
W No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
M No
El NA
El NE
Additional Comments and/or Drawings:
r;
Page 3 of 3 12128104

M
ivisian of Water Quality
=Facifiqumber b2 O Division of Soil and Water Conservation
- 0 Other Agency
Type of Visit Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit outine O Complaint 0 Follow up O Referral 0 Emergency O Other ❑ Denied Access
Date of Visit: / Arrival Time: � Z 400 Departure Time: Q � : l}8 County: Region:
C
Farm Name: I��.' i r1S Y7 aSS�_ _ Owner Email:
Owner Name: t � U�C "wr &�ao S Phone:
Mailing Address:
Physical
Facility
Onsite RepresentaEwe:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
Integrator•
Operator Certification Number:
Back-up Certification Number:
Latitude: ❑ o = d ❑ Longitude: ❑ ° = ' =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
T. ❑ La er
L❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity. Population
❑
Daia Cow
❑
Dairy Calf
❑
Dairy Heifei
❑
Da Cow
❑
Non -Dairy
❑
Beef Stacker
❑
Beef Feeder
❑
Beef Brood Cowl
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes Wqo ❑ NA ❑ NE
❑ Yes
❑ No
f� NA
❑ NE
❑ Yes
❑ No
Q5 NA
❑ NE
[51 NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

1+acTty Number: ), — I Date of Inspection 1 1
Waste Collection & Treatment 'T
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes (k] 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 Stucture 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
S. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No Cl 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 [PNo ❑ 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? i
1 1. 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) &Vn C, f 1S
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
N No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[P No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:]
Yes
[a No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
M No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Q�No
❑ NA
❑ NE
Comments (refer to question ##): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Nam WNTO►V L,& Phone: 1 /d 33 3QD
Reviewer/Inspector Signature: J, ALLM Um Date:
I2/28/0 Continued

FacilityNumber: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 14 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. ❑ VAR ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [PNo ❑ 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
10 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
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
[0 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
F No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[P No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[0 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
t
-
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 reviewlinspection with an on -site representative?
❑ Yes
[P No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
P No
❑ NA
❑ NE
Comments and/or
12128104

ot0F IN r�9Q�
--I
CERTIFIED MAIL
RETURN RECEIPT. REQUESTED
F Minson Sessorns
Sessoms Hog Farm
581 Concord School Rd
Clinton, NC 28328
Dear F Minson Sessoms:
Michael F. Easley, Governor
William G. RossV. Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
April 25, 2007 L08VR-7FA%-MVL
D
j
LF REGIONAL OFME
Re: Request for Information
Facility Annual Stocking Average
Sessoms Hog Farm
Permit #: NCA282154
Sampson County
Based on information submitted with the facility's Animal Facility Annual Certification Form,
the Division of Water Quality (DWQ) is requesting additional information related to -the annual
average of animals for the year 2006.
The Certificate of Coverage (COC) NCA282154 of your NPDES Permit states:
"This approval shall consist of the operation of this system, including, but not limited to,
the management of animal waste from the Sessoms Hog Farm located in Sampson
County, with an animal capacity of no greater than an annual average of 3300 feeder to
finish, and the application to land as specified in the facility's Certified Animal Waste
Management Plan (CAWMP). If this is a Farrow to Wean or Farrow to Feeder operation,
there may also be one boar for each 15 sows. Where boars are unnecessary, they may be
replaced by an equivalent number of sows. Any of the sows may be replaced by gilts at a
rate of 4 gilts for every 3 sows."
The Division received your annual certification form on February 26, 2007. On that form, you
indicated that your annual average was 3632. This exceeds the annual average specified in your
COC of 3300. To avoid possible enforcement action for a violation of your permit, please
submit the facility's stocking records for the year 2006 within thirty (30) days to the following
address:
No Camlina
-- Naturally
Aquifer Protection Section 1636 Mail Service Center
Internet: www,newaterQuality.org Location: 2728 Capital Boulevard
An Equal Opportunity/Affirmative Action Employer— 50% Recydedl10% Post Consumer Paper
Raleigh, NC 27699-1636 Telephone: [phone]
Raleigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
Customer Service: [phone]

Contd. Page 2
April 25, 2007
F Minson Sessoms
NCA282154
Miressa D. Garorna
Division of Water Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
Please bp,, advised^that nothing in this letter should be taken as removing from you the
n._._ n__1., Qa„+c Q+ofi ra �� TPrmitt1T10
responsibility `or liability for failure to comply with any .�Ld�C .c.ut�, u�.. U�..�..., r_._.�.____a
requirement.
If you have any questions regarding this letter, please do not hesitate to contact me at (919) 715-
6937 or the Fayetteville Regional Office at [phone].
Sincerely,
Miressa D. Garoma
Soil Scientist
cc: APS Central Files
Fayetteville Regional Office

o��� W a r�gpr,
Michael F. Easley, Governor
ovriql:�-c
December 1, 2006
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
CERTIFIED MAIL RECEIVED
RETURN RECEIPT REQUESTED RECEIVED
F Minson Sessoms DEC 06 M
Sessoms Hog Farm
581 Concord School Rd Il)M-FA*7MWKWWWQ
Clinton, NC 283281162
Subject: Application for Renewal of Coverage for Expiring NPDES General Permit
Dear Permittee:
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 http://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: [phone]
In order to assure your continued coverage under one of these two types 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 - 820154
Prestage Farms Inc
Aquifer Protection Section 1636 Mail Service Center
Internet: www.ncwatcraualitv.vre Location: 2728 Capital Boulevard
An Equal OpporlvnitylAffirmaWe Action Employer— 50% Recycledl10% Post Consumer Paper
Raleigh. NC 27699-1636 Telephone:
Raleigh, NC 27604 Fax 1:
Fax 2:
Customer Service:
N"pr�th,Carolina
�vrrtura!!
(919)
[phone]
[phone]
[phone]

.L
rQD
Division of Water Quality
acility Number �yivision of Soil and Water Conservation
Other Agency
Type of Visit 61ffompilance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 6-1(outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other [j Denied Access
Date of Visit: Arrival Time: Departure Time: ' Q County: Region: ! nV
Farm Name:C �� SS ��[ 5 !l B� �R/r7'C. Owner Email:
Owner Name: "` 'W . ri _S n /1 Phone:
Mailing Address: +_�I eo'ne L`'// �L iIO G do 4f/I %�� 6—
Physical Address:
Facility Contact: ir► ice}-- _Sr�.SSy_m3 Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: E-1 o = = Longitude: 1--] ° = I = u
Design Current
Swine Capacity Population
Design Current
Wet Poultry Capacity Population
Cattle
Design Current
Capacity Population
❑ an to Finish
10 Layer
❑ Dairy Cow
❑ an to Feeder
10 Non -Layer I
❑ Dairy Calf
Feeder to Finish 00
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
❑ Beef Stocker
❑ Gilts
❑Non -La ers
[I Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cowl
❑ Turkeys
Other
❑ Other
❑ Turkey Poults
10 Other I
umber of Structures:
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes A No ❑ NA ❑ NE
❑ Yes
&No
❑ NA
❑ NE
❑ Yes
)!g No
❑ NA
❑ NE
El NA
❑NE
El Yes
QqNo
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
&I No
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of Inspection _*� %�._ 6
,k
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes 4 No ❑ NA ❑ NE
❑ Yes �No El NA El NE
Structure 5 Structure 6
❑ Yes No ElNA ❑ NE
❑ Yes allo ❑ 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 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 f tNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes N No ❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
ANo
❑ 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 Winnow ❑ Evidence of Wind Drift El Application of Area
12.
/Outside
Crop type(s) Z2'/'rr1l►�[ �t, . 7 A1`A—
13.
Soil type(s) X 9 0 113D 5 117' 9
---
--
14,
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
[)o No
❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement? ® Yes
�o
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination , ❑ Yes
[4 No
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application'? ❑ Yes
2rbQ�No
El NA [I NE
18.
Is there a lack of properly operating waste application equipment? Eltit Yes
No
❑ NA ❑ NE
15- �B�'�/l ��Ia 't W 4 ✓ �C 7 d�"� /!%ids i h ��flflc�
Reviewer/inspector Name I /�V-� �, � ,;.d Phone: 9/9-.7KU
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: A2 — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [KNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 0No ❑ NA ❑ NE
the appropiate box. ❑ wuP ❑ Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
EKNo
❑ NA
❑ N E
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
X 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
KNo
❑ 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
4 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
KNo
❑ 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
A No
❑ NA
❑ NE
Additidnal Cominents and/or Drawings:
12128104

r
of Visit • Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: ® Tune: 3 ; P
Facility Number oZ Lf`
�� 6,-� Q Not O ratiional Q Below Threshold
ma
EPermitted 12'6erfified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ... ._,.._. ..
Farm Name: ..... SC_'up mil. ....- ry��j -.. F r .^ ... ._...._ .............._......... County: . �.�i!� S o n .» ...._._.. � . �/� 0...._.
Owner Name:..... FL I R..ign.......... S/C.S ..P. .� L...../_�.._ ................ . Phone No:... 910...:.. S `� ....�. ` •---....._ ..........
Mailing Address: _. S?1_.. �fl t2 _pl GS ......... sG .Q I..._ IC oci ...... ........... .......
sc s-"'J
Facility Contact: ..rMa� �oy�. �,G�:.t...,�.... f �e...�.�Z�'.. �.. Title :...................._.............. ----•---•-•--•---.... Phone No:_...._....�---��.�..........._._..........
Onsite Representative: ,�?'�� r �o r d�u�.�.t ,._rf /��4e: s ��3 Q !� i.........._..... Integrator:
Certified Operator:. r i'e,� .. rra s .......... .. ... Operator Certification Number:
Location of Farm:
Eg-S"wine ❑ Poultry ❑ Cattle ❑ Horse Latitude 4 " Longitude • 4 66
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? [] Yes E]-No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes 91fo
b: If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes p-o
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes [JNo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes Q No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes MXo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
[:1 Yes E3W6
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure b
Identifier• 1....... ....._.._..........._...._................................................................................. .........
Freeboard (inches): "1S
12112103 Continued

Facility Number: S -7 —/ r
Date of Inspection 5 'o
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑-PTo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or 0 Yes 94%
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes 0-Ko.
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes UNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes 0-No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancerunprovement? ❑ Yes BNO
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes �10
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type /7r,..,. ,,,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWNIP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes E3No
b) Does the facility need a wettable acre determination? ❑ Yes GI -No
c) This facility is pended for a wettable acre determination? ❑ Yes UNo
15. Does the receiving crop need improvement? ❑ Yes ❑-Ko
16. Is there a lack of adequate waste application equipment? ❑ Yes Q-Iqo
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes [9-N6
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes B-90-
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes [U]-Ko
Air Quality representative immediately.
to `esf<otn: F.x YESnswe s aad/a� er oaendates�as or an oilier comments. ' Comments
s{refer qu ) plat:u any _ �y _,_ y a a
Ue drawrngs of £ac�ty #o better arplam sriaiatrotus. {use additional pagers as nec+e,sary) teld COPY ❑ Final Notesx
�_..
r -1 L
rGlr/ m ri wel>I /�e"7r
Re c a i c/ f ci r e Lv c
Reviewer/Iuspector Name fj/� _ J V ^ �7 �,_,7% , '= x'
Reviewer/Inspector Signature: Date: Z/ -
12112103 Continued

Facility Number:,y;L Date of Inspection o
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
EI-90
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie! WUP, checklists, design, maps, etc.)
❑ Yes
❑'i;o
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[allo
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑Wo
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
[9-No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
�o
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
EJ-No
28. Does facility require a follow-up visit by same agency?
❑ Yes
B-No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ONO
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
9-Yes
❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
ONO
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
MWo
34. Did the facility fail to calibrate waste application equipment?
❑ Yes
[g-No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑-No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

Facility Number._R:�:_
Division of Environmental Management
Animal Feedlot Operations Site Visitation Record
Date: a i3 R6
Time: - , 2,!!�)
General Information:
Farm Name: Se s s o �,,r, s k T �tiY = County:
r
Owner Name:_ sad S 4 ssox. s Phone No: Sq 2
On Site Representative:_ G (c n y, _ h'j±-,,. _. _Integrator: �f s-�
Mailing Address: a2�' to � o x 31`� - Ph
Physical Address/Location: 1 mite- s,k.L at-P _0=1 Hwy aYZ
Latitude: I 1 Longitude: I I
O eration Description: (based on design characteristics)
Type of Swine No. of Animals. Type of Poultry No. of Animals Type of Cattle No. of Animals
❑ sow ❑ Layer ❑ Dairy
❑ Nursery ❑ Non -Layer 0 Beef
ifFeeder 3330
OtherType of Livestock Number of Animals:
NBmber of Lagoons: 1 (include in the Drawings and Observations the freeboard of each lagoon)
Facility In ecti
Lagoon
Is lagoon(s) freeboard less than 1-foot + 25 year 24 hour storm storage?:
Is seepage observed from the. lagoon?:
Is erosion observed?:
Is any discharge observed?
Q Man-made' 11 Not Man-made
Cover Crop
Does the facility need more acreage for spraying?:
Does the cover crop need improvement?:
( list the crops which need improvement)
Crop type: ��a� Rye Acreage:
Setback Criteria
Is a dwelling located within 200 feet of waste application?
Is a well located within 100 feet of waste application?
Is animal waste stockpiled within 100 feet of USGS BIue Line Stream?
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream?
Yes ❑
No A -
Yes ❑
No U
Yes ❑
No U
Yes ❑
No 0
Yes ❑ No 14
Yes a No M
Yes ❑ : No
Yes ❑ tNo
Yes ❑ No 9
Yes ❑ No
AOI — January 17,19%

Maintenance
Does the facility maintenance need improvement? Yes ❑ No
Is there evidence of past discharge from any part of the operation? Yes ❑ No I&
Does record keeping need improvement? Yes a No
Did the facility fail to have a copy of the Animal Waste Management Plan on site? Yes a No Ef
Explain any Yes answers:
cc: Facility Assessment Unit
Drawings or Observations:
ash ri. � _ -. • ' _
AOI — January 17,19%
Date: 3
Use Attachments if Needed
___ ._ -n(t l'7:•Rr--r.- nr-+— K.tA* f tiA r!l.ta r. t! l.w�..ZYr-.�+:+,-kr-..-•Tf �: '14.'= .._ -,_

Farm Name/Owner:
Mailing Address:,
Site Requires Immediate Attention:
Facility No. ��3 6 8
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: — % , 1995
Time: �J ly
;/� 5d
_�5� 5.5 0
County: 1. ter/
Integrator: i r at c. Phone:
On Site Representative: 1-co Phone:
Physical Address/Location: L1,�J1 cL��.5 F .aoje--AyCo— Z-�i;,r h ACx. Siy� /�r s Pam✓
L
Type of Operation: Swine
Design Capacity:
DEM Certification Number:
Latitude: °
Poultry Cattle
Number of Animals on Site: . V zf- _� `,v e'6,*
ACE DEM Certification Number: ACNEW
Longitude: t r3S f �3 U6 — .2-q- 2 --o
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) Ue or No
Was any seepage observed from the lagoon(s)?
Is adequate land available for spr�a,�' . Y s "o �o
Crop(s) being utilized: ^ 15O- M
Ac Freeboard:�Ft. Inches
Yes or 1 Was any erosion obse ? Yes or Q)
Is the cover cr p adequate? or No
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellin&orJb�q
C�'e"r No
100 Feet from N% .
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or o
Is animal waste land applied or spray irrigated within 25 Feet of a. USGS Map Blue Line: Yes or N�
Is animal waste discharged into water owe state by man-made ditch, flushing system, or other
similar man-made devices? Yes o N j If Yes, Please Explain.
Does the facility maintain adequate waste management rvolumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Y or No
Additional Comments:
Inspector Name
a, 'j -
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

NORTH CAROLMA DEPARTNMU OF , MALTZ' & NAMAL RESOURCES
Fayetteville Regional Office
Animal Operation Compliance Inspection Form
Farm Smoms12
L!__-
Bb 161ACltn�n z
[GNU) �aa� 4z
All questions answered negatively will be discussed in sufficient detail in
the -Comments Section to enable the deemed Permittee to perform the appropriate
Corrections:
sE=ION r
Animal operation $: I' n I s r 1
Horses, cattle swine poultry, or sheep
§ECTION Iz
Y ) N I CaMMEMS
1. Does the number and type of animal meet or exceed
the (.0217) criteria? [Cattle (100 head),
horses (75), swine (250), sheep (1,000), and
poultry (30,000 birds with liquid waste
system)] _
2. Does this facility meet criteria for
Animal Operation REGISTRATION?
3. Are animals confined fed or maintained
in this facility for a 12-month period? -
4. Does this facility have a CBRTIFIM
WASTZ_MAKAGEKENT PIM7.2
5. Does this facility maintain waste management
records (Volumes of manure, land applied,
spray irrigated on specific acreage With
specific cover crop)?
6. Does this facility meet the 5CS minimum
setback criteria for neighboring houses,
wells, etc?

field Sit2 manammat
1. ra animal va6W tsLuekpilM Or iagoou
construction within 100 ft. of a USCS
Map Blue Line Stream?
2. Is animal waste land applied or spray
irrigatod w; th4n gS ft. v4 a UCOGO map
Blue Line Stream?
3. Does this facility have adequate acreage
on which to apply the waste?
4. Does the land application'site have a
cover crop in accordance with the
T IGTI
S. Is animal waste discharged into waters of
the state by man-made ditch, flushing system,
or other similar manmade devices?
5. Does the animal waste management at this
farm adhere to Best Management Practices
( 8MP) of the approved CZRTMCA�
7. Does animal waste lagoon have sufficient
freeboard? Now much? (Approximately )
8. Is the general condition of this CAN facility,
including management and operation,
satisfactory?
LEC` ON IV
Comments
Farm re � 5�e red f� � i owed b� cer+i fi c�-i oY1 �a � � 3 G5

tt
/ K
Zo
Az
101
el
`Q • `_ I A
4 tl 1
• x � r• /.r t. r 7 �
.Y pp
AI

r
ANIMAL WASTE NIANAGENIENT PLAN CERTIFICATION FOR EXISTING FEEDLOTS
Please return the completed form to the Division of Environmental Management at the address tin the
reverse side of this form.
Name of farm (Please print) : r" i K (kr 5 e 5 5 anti S
Mailing Address: 7
r 2 Phone No.: �� � .S5 �-�: 4/
Counts• (of farm —
Farm location: Latitude and Longitude: 1-1 S s-'I-Z i 7gd 3/" 3g" f required). Also. please attach a
copy of a county road map with location identified.
Type of operation (swine, laver, dairy, etc.) 5o� 1 ,v L
Design capacity (number of animals)
average size of operation (12 month population avg. ): __ 3 "
Average acreage needed for land application of waste (acres)
Technical Specialist Certification
As a technical specialist designated by the North Carolina Soil and leaser Conservation Commission pursuant
to 15A NCAC 6F .0005, 1 certify that the existing animal waste management system for the farm named
above has an atimal waste management plan that meets the operation and maintenance standards and
specifications of the Division of Environmental Management and the USDA - Soil Conservation Service
and/or the North Carolina Soil and Water Conservation Commission pursuant to 15A NCAC 2H.0217 and
15A NCAC 6F .0001 - .0005. The following elements and their corresponding minimum criteria have been
verified by me or other designated technical specialists and are included ir. the plan as applicable: minimum
separations (buffers); adequate quantity and amount of land for waste utilization (or use of third party):
access or ownership of proper waste application equipment; schedule for timing of applications, application
rates; loading rates; and the control of the discharge of pollutants from stormwater runoff events less severe
than the 25 - year, 24 - hour storm.
When checked, see reverse side of form for conditions/exceptions.
Name of Technical Specialist (Please Print): 1r L e r
Affiliation (Agency): C 5
Address (Agency): tc ,,L C ( Phone No.: . /J 4 5-2 2 ? 2' (. ?
Signature: 1 -�� ) 1 Date -.I!
I _
Owner/Manager Agreement
I (we) understand the operation and maintenance procedures established in the approved animal waste
management plan for the farm named above and will implement these procedures. I (A,e) know that any
expansion to the existing design capacity of the waste treatment and storage system or construction of new
facilities will require a new certification to be submitted to the Division Of Environmental Management
before the new animals are stocked. I (%-e) also understand that there must be no discharge of animal waste
from this system to surface waters of the state either directly through a man-made conveyance or through
runoff from a storm event less severe that the 25-year, 24-hour storm. Th.- approved plan will be filed at the
farm and at the office of the local Soil and Water Conservation District_
':dame of La d A)wner (Please Printl: _ � l��i Ai o pi� Co � � c
Signature: / v Date: / ? S—
Name of Manager, if different from owner (Please print):
Signature: ' Date:
Note: A .hanoe m land ouner:hip requires nonfication or a new certification fif ,he 3ppr0%'CJ 1� :han_-di uuhin 60 da%c of a utie =ran<frr
DELI USE ONLY: ACE#

RE
Vi c _'_4_k :.+"1o'LV FORM FOR ANIMAL F=07 OPE7ATIONS
Department of _Environment, _ea? cla and Natural Resources
Division of Eavironmental Management
Water Quality Sec_ion
I f the animal waste management system for your feedlot anerat_cr.
is
designed to serve mere than or
ecual to 100 I:ead
o� cattle,
75
horses, 250 swine, 1,000 stneep. or 30,000 birds twat
are served
by
a !:quid waste system, t e^ t~_s
fcz:a mnust be ____ed
cut and mailed
av December 31, 19-:3 pursuant, -=
_=A NCAC 2 .02=7 (c)
in order to
be
deemed Permitted by DZ*:'S. ?? ease
zzi_^.L clearly.
ar:n Name
Ma,__^g Address
County : 5 1i�1 � ?hone No. ` lJ `DC-f �- ­ .*
Owner (s) dame: i11'�o1 ��C�1 �C—,55 '� r- s�;Z
Manacer (s) Narre: 5 ..
:.essee Name:
arm Location (Be as s ecific as possible: Toad names, direction,
mi{_4P�t, e_c -) I-Ai<r T CIE RC-`�5 V'�4Z1�1. 5
if kncwr,:
Desicn capacity of animal Waste management system (Number and type
cf con:_rea an -ma-, (s))
Average anima? population on th� ,farm (Number and type of animal (s)
•i 3;sed) ��I`�1� �{ `� lam( 1V�
Year Prcducti_ Began:` , ASKS Tract No. Z36b
Type of Waste Management System Used: L� i�11 )!:�L
Acres Availa ? a for Land Anniicaticn of waste: �S 126 1�" d
Owner (s) Signature (s) 7 DATE:
DATE:

Site Requires Immediate Attention: __2
FacilityNo.
0, DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 1995 G Alo�
Time: J0 ' 2_6—
Farm Name/Owner:_ Li Ow=n--
MaiIing Address: 2t L . ,La _& / . ��.T �s _ , _•.•S _ i
County: S
Integrator: dp&g4 Phone:_ qZQ _ J = 3 aQ,
On Site Representative: cAPhone:
Physical Address/Location:
f
Type of Operation: Swine Poultry Cattle
Design Capacity: 0o=5 Number of Animals on Site: S-4o �..�...+.• ••,
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 0Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon hav sufficient freeboard of 1 Foot + 2� 24 hour storm event
(approximately ]Foot + 7 inches) se or No A Freeboard: s" t. Inches
Was any seepage observed from the laMe
n(s)? Yes or�as any erosion observed? Yes or No
Is adequate land available for spray? or No Is the cover crop adequate? Yes or No
Crop(s) being utilized: of s
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellin . Q or No
100 Feet from Wells?
or o
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes org
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or 0 If Yes, Please Explain.
Does the facility maintain adequate waste management reqKds (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? (I or No
Additional Comments:
1
A��M
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

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