820185_INSPECTIONS_20171231

Department of Environmental Qua!

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j Division ofWater Resources
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lkL J il1�l 11 F I ' '
li;.I Fac�li Ity�Nutinbew, 1�, ,k I I O laIII' [sion of Soil and Water Conservation
�'{� Other'Agency
,y ..I„Iris I_ � it • .: .. _
type of visit: Q Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
teason for Visit: 6 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: a.�7�ra� Departure Time: ` County: h Region: F-I
Farm Name: �--�"V r Owner Email:
Owner Name: '�Llnli Phone:
Mailing Address:
Physical Address:
Facility Contact: `1C.
Title:
Onsite Representative:
Certified Operator: —440►7H P1�jj
Back-up Operator:
Phone:
Integrator: ep
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
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'll �I :Wet Poultry�3,Capacityl Pop. jr ,:
� ili"
ril, Cattle
Capacity. ,Pop.'
f IA! : ik IIIII a Yrr 01 !. 11,11
i'1
Wean to Finish
La er
r j Wean to Feeder
I Non -La er ,.
Feeder to Finish
�'
hI Farrow to Wean
"� +� ` ;' ' Design1 I Current' ''
I
I Farrow to Feeder
'3 i I AI�.
�: II 4ti:i rD 1 l I� [i
Farrow to Finish
,P,oult IiPo
I� La ers�I'��
Gilts
i' Nan -La ers
Boars
Pullets
jIII II li III II I , I I i -
q;E �"
Turke s
I �I III'i
�IIliui�,Othera€
Turke Poults
-
is,
h Other
1 Other
, I
il�urnuw sr a•uc o � I _. ^Iln..lriol. n^rr,.i.lm:I .n..�.+r, r..s ,..,...� '�-.�
.,. ...: { a�;' 1 I.. '.:;
�i. i. i '. _
Dai Cow
Dai Calf
Dai Heifer
D Cow
Non-Dai
Beef Stacker
Beef Feeder
Beef Brood Cow
Discharges and Stream Imuacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify 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
IS No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

iVacili -Number: Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes PINo
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
Structure l
Identifier:
Spillway?:
Designed Freeboard (in):
❑NA ❑NE
[29?NA ❑ NE
Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Observed Freeboard (in): l'
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [P 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 0 No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes [4 No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [ No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) T
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 rjjQ No ❑ NA ❑ NE
maintenance or improvement? TT
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 Crap Window ❑ Evidence of Wjd Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
S
r
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes No
❑ NA
❑ NE
❑ Yes No
❑ NA
❑ NE
❑ Yes No
❑ NA
❑ NE
❑ Yes [P No
❑ NA
❑ NE
❑ Yes
?No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? Ifyes, check the appropriate box below. ❑ Yes MNo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tra 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
❑NA ❑NE
Page 2 of 3 21412015 Continued

Racilit -dumber: - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit ❑ Yes ."'No El NA El NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check' ❑ Yes E 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?
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)
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑NA ❑NE
❑ Yes M No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes 29 No ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes [PNo
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes O No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes M,No
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 0� No
Reviewer/Inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑NA ❑NE
Phone: r3
Date:
21412015

1/
! Division of Water Quality
Facility Number -EMI O Division of Soil and Water Conservation
O Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit:Vr
Arrival Time: �i Departure Time: ,L County: 1f81'J Region:
Farm Name: I o- M Owner Email:
Owner Name: L/y E Phone:
Mailing Address:
Physical Address:
Facility Contact: `' ZL'V'� S L�7 Title: Phone:
Onsite Representative: Integrator: &Lr St
Certified Operator: Certification Number:
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
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
i)ry rounry
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
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)
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?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non-Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes P No ❑ NA ❑ NE
[:]Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
NA ❑ NE
NA ❑ NE
NA
❑ NE
❑NA
❑NE
❑NA
❑NE
Page I of 3 21412011 Continued

l+acilit 'Number: 113ate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes X No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [DNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Structure 5
Structure 6
[J
Spillway?:
Designed Freeboard (in): _
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
M No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
0 No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or 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
f%No
❑ NA
❑ NE
maintenance or improvement?
Waste AR lication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
t 1. 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 rop Wi �dow., ❑ Evidence of ' d Drift ❑ Application Outside of Approved A ea
12. CropT e s :�fN'"�`�'7 ,,.r
YP O
13. Soil Type(s):
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
t No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[PNo
❑ 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
LL No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists [3 Design [3 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 Tra sfers ❑Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 0 No ❑ NA [] NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Gn No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA [3NE
the appropriate box(es) below. 0
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes jVhNo ❑ NA ❑ NE
and report mortality rates that were higher than normal? r
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34, Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
l,
Coiiiments;(refer to question,#): Explain.a6y YES answers and/or;.any additional. recommendations,'or.,an other comments
UsedraWin s-affacilityto.better,exnlaln' situatlo&,(useWditionalpaaes:as,necessary)
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ! t�" 3.?od
Date: 9Z24
1
21412011

i '1 0 Division of Water Resources
Facility Number - ® O Division of Soil and Water Conservation
Q Other Agency 11
(Type of Visit: ® Compliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance I
Reason for Visit: ® Routine Q Complaint Q Follow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: Arrival Time: Departure Time: � Z— /- -% County• Region_; `a
Farm Name: Ta N C. �"`�'r Owner Email:
Owner Name: js ''+S Phone:
Mailing Address:
Physical Address:
Facility Contact:Title: Phone:
Onsite Representative: Integrator: Z.1"PL4
Certified Operator: G( Certification Number: G { e j
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Layer I :::]
Non -La er
Pullets
Other
Pouets
Design Current
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
Design Current
Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ❑ No ® NA ❑ NE
❑ Yes ❑ No (O NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No E NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes W No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes Q No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412014 Continued

Facili Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
No ❑ NA ❑ NE
No NA ❑ NE
Struc re 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
® No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
I
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
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 Acceptable Crop Window C�] Evidence of Wind Drift�J ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s): 0
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Pg No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
009 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 [3Other.
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes in] 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 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
Page 2 of 3
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑ NA ❑ NE
21412014 Continued

Facility Number: Date of Inspection: Ulm 114
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
�No ❑NA ❑NE
No ❑ NA ❑ NE
❑ 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 Pg No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes MNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [P 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?
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 E No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes �n No ❑ NA [] NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
No
❑ NA
❑ NE
Comments (refer to question ##): Explain.any YES answers and/or any additional recommendations orany other,comments.'
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature: sz�i kIL4
Page 3 of 3
Phone:
Date: t
2 4/2014

Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit:. ®Routine 0 Complaint OFollow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: , Departure Time: 0.09 County
Farm Name: � Owner Email:
Owner Name: �� C . l�ln Phone:
Mailing Address:
Physical Address:
Facility Contact: S ��lh Title:
Onsite Representative:
Certified Operator: ` /o,—
Back-up Operator:
Location of Farm:
Latitude:
Region:
Phone:
Integrator.
�a6ck (0
Certification Number: / k
y *
Certification Number:
Longitude:
Design Current
esign
Current
Design Current
Swine Capacity Pop.
Wet PoulWme,
apacity
Pop.
Cattle Capacity Fop.
Wean to Finish
La er
Dai Caw
Wean to Feeder
Non -La er
EDai
Dai Calf
Feeder to Finish
Heifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
D , P,c►ult .
Ca aci
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Uther
TurkeyPoults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
[]Yes
MoNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
a NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
E3 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
[?e] No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
,� No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412014 Continuer!

Facili Number: 11677- Date of inspection: Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes M 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):
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 6D 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 E3 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 ® 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 Outside of Approved Area
Drift {❑_ ,Application
f❑
}
12. Crop Type(s): � �1 �EYIYlcdcrAL.'tf4SS(t�Q�c, ] ,- i (Q[i; 01,08t5�
13. Soil Type(s): QoA—, C1,04 f
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ED No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes g 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 eE9 No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes DNo ❑ NA 0 NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E3No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists [:]Design ❑ Maps ❑ /.ease Agreements ❑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 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 V§No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑NA ❑NE
Page 2 of 3 21412014 Continued

Facili Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes M No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [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 structurc(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 EpNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes (2g)No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
J2 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
C@ 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
5B No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
® No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
B 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
5g No
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any.other comments.
Use drawings of facility to better explain situations (use additional sages as necessary).
Reviewed] nspectorName: t` Phone: i@ 3 "VQ
Reviewer/Inspector Signature: Date: (Z Z
Page 3 of 3 21412014

�S1wts' 31nL 3
Division of Water Quality
Facility Number - O Division of Soil and Water Conservation
0 Other Agency
type of Visit: 40 Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: &Routine 0 Complaint O Follow-up O Referral O Emergency Q Other Q Denied Access
Date of Visit: Arrival Time: FOQ n. Departure Time: b',oD h County: Region: r
Farm Name: _7�0 rt Cr ,�t, 2 e1 �►Owner Email:
Owner Name: C, wo/.j4h Phone:
Mailing Address:
Physical Address:
Facility Contact: `JLC-1'SW1�j - Title:
Onsite Representative:
Certified Operator: ���h er
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:
Integrator:
Certification Number: 1965,6
,6
Certification Number:
Latitude: Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
No
n -Layer
err
]lets
Other
Poults
Design Current
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge? -
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Daia Keifer
DEZ Cow
,Non
-Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes Pg No ❑ NA ❑ NE
❑ Yes [:]No
[:]Yes [-]No
[] Yes ❑ No
[:]Yes No
❑ Yes No
(�] NA ❑ NE
�NA ❑NE
NA ❑ NE
❑NA ❑NE
❑NA [3 NE
Page 1 of 3 21412011 Continued

ti
Facili Number: Date of inspection: rtil
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
Struc 7
re 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
No ❑ NA ❑ NE
�No NA ❑ NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ® No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.) 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 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 [0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 1W 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 Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Znr
, etc
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evide of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):iI/ryr q �►
13. Soil Type(s): Q
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes t] No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes M No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [P 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 0] 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 ® 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. T
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes & No
T
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes j N
❑NA ONE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
o ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

1.
Facility Number: Date of Inspection: -;10
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 [—]Yes CK No
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 [5 No
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 0 No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes Wo No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes fp No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facilitvto better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: e-4 y 3 ODD
Date: LI 2,
21412011

ti
( _ 0 Division of Water Quality '
Facility Number.. ° ®- O Division of Soil and Water Conservation
O Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance
,Region for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: /� Arrival Time: py.c�C n Departure Time: County:.Sl4i1' P-9-W Region:
Farm Name: I.t3 Owner Email:
Owner Name: 'Pan G eo LJG1e,j Phone:
Mailing Address:
Physical Address:
Facility Contact: TAD Title: Phone:
Onsite Representative: Integrator -
Certified Operator: Certification Number: 1g��
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
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Ed " Layer
Non -La er
Design Current
Dry Poultry Capacity Pop.
Layers
Non -La ers
Pullets
Turkeys
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)
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?
Longitude:
Design Current
Cattle Capacity Pop.
flairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
,Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑Yes allo ❑NA ❑NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
IS NA
❑ NE
❑ Yes
❑ No
P NA
❑ NE
❑ Yes
[PNo
❑ NA
❑ NE
❑ Yes
[)q No
❑ NA
❑ NE
Page 1 of 3 21412011 Continued

acilit _ umber: Date of Inspection: 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 levcl into the structural freeboard?
❑ Yes
❑ No
Pa NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
t�
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
0 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
C@ 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 Acceptable Crop Window
❑ Evidence of Wind Drift ❑ Application Outside of ApprovedArea
Gas
12. Crop Type(s): `�Z ( FJ.�r 1 Yk-t Ja G Vt SS gaL�
, ), sm r ,.. 0 UAr5Ae rJ
13. Soil Type(s): —WO. A, G.
T'
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? TT
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
❑ Yes F No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [�] No ❑ NA ❑ NE
20. Does the facility fail to have ali 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 j0 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transsfcrs ❑ 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 Continued

acili umber: 05 Date of Inspection:
L
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes [�g No
❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? if yes, check
❑ Yes EP 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 10 No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes [ No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
T
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes [�1 No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[] Yes . No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question ##): Explain any YES answers and/or any additional recommendations or any;uther comments;
Use drawings of facility to better explain situations use additional . pages as.neeessa
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 91v -i/33�3�
Date:
21412011

}0 Division of Water Quality
Facility Number - ® O Division of Soil and Water Conservation
O Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review Q Structure Evaluation Q 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: Departure Time: County: yAPSQIJ Region: Q
Farm Name: T�an C. P"'u 1r, 7:; , _ Owner Email:
Owner Name: fl C, eo Phone:
Mailing Address:
Physical Address:
Facility Contact: _:44W)1 W [ Title: Phone:
Onsite Representative: !I —a Yy Qs La" Integrator: rfS�
r ll ppry
Certified Operator: Certification Number: 10 7 y+6
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Certification Number:
Latitude:
Design Current
Wet Poultry Capacity Pop.
Layer
Nan -La er I EE]
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
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)?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
,Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [P No ❑ NA ❑ NE
[-]Yes ❑ No NA ❑ NE
❑ Yes ❑ No NA ❑ NE
d. Does the discharge bypass the waste management system? (if yes, notify DWQ) ❑ Yes [:]No NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes�p No NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility Number: - jDate of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
O.Yes
W No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
0 NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:_
Spillway?:
Designed Freeboard (in):
Observed Freeboard "1
(in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[� No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
VM No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No
7
[DNA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
[] Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
1 1. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload [] Frozen Ground [] Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑/'SEvidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): �A Qs�Q I �IYI l `9,1 1 5M , �Y�[ti� 0 Art'Q�
13. Soil Type(s): /VO M , Cx04T
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
T�
❑ 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
PNo
❑ NA
❑ NE
20. Does the facility fail to have all 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 E] No
❑Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stacking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [:]Yes LP No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes CS No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑NA ❑NE
Page 2 of 3 21412011 Cohtinued

Facility Number: - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes QM No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ® No
the appropriate box(es) below. T
❑ 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
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/Inspector fail to discuss review/inspection with an on -site representative?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
in NA ❑ NE
❑ Yes fA No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes Fn No ❑ NA ❑ NE
❑ Yes [E No ❑ NA ❑ NE
❑ Yes [�j No
❑ Yes [P No
❑ NA ❑ NE
❑NA ❑NE
Phone: //0'-1I.33-3'-rb0
Date:?'
21412011

RP Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 O per"J Denied Access
Date of Visit: 0 Arrival Time: Departure Time: p County:
Farm Name: _ ..C, Bowden FR.Ilr-m Owner Email:
Owner Name: pin c eow der Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
i
U
Design Current
awine Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Title:
J
Region: Gig"
Phone No:
integrator: Prey_
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 0 = , = " Longitude: 0 ° 0
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer I E�j
Dry Poultry
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
❑
DaiEX Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
D Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes IoNo ❑ NA ❑ NE
❑ Yes ❑ No P NA
❑ NE
❑ Yes ❑ No IMNA
❑ NE
❑ Yes ❑ No �DNA
❑ NE
❑ Yes 'r No ❑ NA
❑ NE
❑ Yes to No ❑ NA
❑ NE
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?
Struc I
re I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): S�
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 [�No ❑ NA ❑ NE
❑ Yes ❑ No A NA ❑ NE
Structure 5 Structure 6
❑ Yes 19 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 93No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ji@ 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. 09No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [XNo ❑ 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 ❑ E ' ence of Wind Dririift�,.�❑ Application Outside of Area
12. Crop type(s) `'°`'t,54 i('m�A _S.' `wrl
13.
Soil type(s) IVD
l
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
IR No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
rONo
[I NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
V No
❑ NA
❑ NE
Comments (refer to question i): , Explain a'ny,YES.,answersiandlor'any recommendations orany otn`er comments t
Use drawings of facility to better czplain`situations :(use additional pages�as necessary
MTKUDY'a.}„�:.Y
L
w
Reviewer/Inspector Name
Phone: /0'4133 33GD
Reviewer/Inspector Signature:
Date: O !0
Page 2 of 3 12128104 Continued

Facility Number: Date of Inspection 0 Q
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. ❑ WCp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes (j No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers jj ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
R9 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
[PNo
rNA
❑ NE
25,
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ 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
`P No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[9 No
❑ NA
❑ NE
Additional Ciimments`andlor Drawin s. r ' r ` r,: x
g ' „'. ,..;«�z _.. to wd
Page 3 of 3 12128104

4
Facility Number J
Division of Water Quality V
O Division of Soil and Water Conservation
U Other Agency
IType of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: n County: mtp� Region: Q
-( Arrival Time: � Departure Time: � ty g� L_L�
Farm Name: Vail C10tJ�
nnP
Owner Name: Dar, eJtido-A
Mailing Address:
Physical Address:
Facility Contact: ► yy ,w, rr Title:
�.�1
Onsite Representative: AWC lib
Certified Operator: -S
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
Owner Email:
Phone:
Phone No.
Integrator: PeySa
Operator Certification Number:a
Back-up Certification Number:
Latitude: 0 0 = ' =" Longitude: 0 ° 0 ' =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
„^ ❑N❑ Layer - -- -
on -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Points
❑ Other
Dischames & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ DaiEZ Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: �I
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
T NA
❑ NE
❑ Yes
❑ No
1PNA
❑ NE
❑ Yes
❑ No
P NA
❑ NE
[]Yes
[!�No
❑ NA
❑ NE
❑ Yes
C*No
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of Inspection
Waste Collection & 'Freatnrent
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
(0No ❑ NA ❑ NE
n. if yes, is waste level into the structural freeboard?
❑ Yes
❑ No RNA ❑ NE
Sin`cture l Structure 2 Stnicture 3 Structure 4
f
Structure
5 Structurt G
Identifier:
spillway'?:
Designed Freehottrd (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
qONo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
po ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
�No © NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
RNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
f
9. Does any part of the waste management system other than the waste structures require
❑ Yes
t�)No ❑ NA ❑ NE
maintenance or improvement?
Waste AURlication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
Id No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
ENo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,
Zn, etc.)
❑ PAN ❑ PAN> I0%or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crropp Window ❑nEv_idence Wind Drifl ❑n Application Outside of Area
12. Crop type(s) �-O ?nit
rR V-1R S -C''t , G3 a�
13. Soil type(s) '�����C -0 [ bo'wUSpo M
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
El'No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
RTNNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determinations❑ Yes
L✓1 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
LJ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
t1a No
❑ NA
Q NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name r IY Phone: d
Reviewer/Inspector Signature: Date:
/14/60/V4 [.Onriff" G

Facility Number: — Date of Inspection
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Mans El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ®No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22, Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24, Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27, Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29, Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32, Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
33, Does facility require a follow-up visit by same agency?
Additional Ciirnments and/or Drawings
❑ Yes
MN"o
❑ NA
❑ NE
❑ Yes
&No
❑ NA
❑ NE
❑ Yes
2No
[INA
❑ NE
ElYes
E No
❑ NA
❑ NE
❑ Yes
O,'NNo
ElNA
ElNE
ElYes
12No
❑ NA
❑ NE
❑ Yes
1��Q NNo
El NA
[I NE
El Yes
0(No
❑ NA
❑ NE
❑Yes
B o
El NA
El NE
❑ Yes
eNo
❑ NA
❑ NE
❑ Yes
eNo
❑ NA
❑ NE
❑ Yes
[�fNo
❑ NA
❑ NE
❑ Yes
eNc,
❑ NA
❑ NE
❑ Yes
IJ No
❑ NA
❑ NE
Page 3 of 3 12128104

i
1110 Division of Water Quality
Facility Number per, 0 Division of Soil and Water Conservation
0 Other Agency
(Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit *Routine O Complaint O Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: $.Z� Arrival Time: 3t S Departure Time: County:
Farm Name: , DQ. C+ Awdez,_arm _ Owner Email:
Owner Name: !2,n L a Phone: _
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
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
Boars
Other
❑ Other
0
Latitude: =
Phone No:
Integrator: F-0-V26L
C-01
Operator Certification Number:
Back-up Certification Number:
Region: /5aO
{ = Longitude: = ° =' =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: m
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 �bNo ❑ NA ❑ NE
❑ Yes
❑ No
j� NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
IONA
❑ NE
❑ Yes
FNo
ElNA
❑ NE
❑ Yes
IQ No
❑ NA
❑ NE
Page I of 3 12128104 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. 1s 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 PNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 30
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
PNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
[�)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
F No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? []Yes
P 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
ONo
❑ NA [INE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
IV No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
D§No
❑ NA [:]NE
❑ Excessive Pond ing ❑ Hydraulic Overload ❑ Frozen Ground [:]Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [:]Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
I] 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
ER No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
JP No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
51 No
❑ NA
❑ NE
Reviewer/Inspector Name I Phone: 3
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

y
Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes t No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes b§No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ t20 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes P No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes V No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes $ No ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
"No
Lk
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
rm and report the mortality rates that were higher than noal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
�diNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
PNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104" --

' 1-
Division of Water Quality
Facility Number U Division of Soil and Water Conservation
0 Other Agency
IType of Visit ¢}Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit( Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I 17X naArrival Time:
Departure Time: 8County
Farm Name: �a� U�� C?,4rjn � -� y— Owner Email:
Owner Name! 1�J�tiV1 �Y�7�V�.�� h Phone -
Mailing Address:
Physical Addres
Facility Contact: Title:
Onsite Representative -2-
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
No:
Integrator:
Operator Certification Numficr:
Back-up Certification Number:
Region:
Latitude: = 0 0 6 Longitude: = ° = 1
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
. _,...,.1_. _ �, ❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Cattle
Design . Current;'
Capacity Population, ;
❑ Dairy Cow
❑ Dairy Calf
❑ Daia Heifei
❑ DEY Cow
❑ Non-Dai
❑ Beef Stocker
❑ Beef Feeder
El -Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes EP No ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
( NA
❑ NE
❑ Yes
❑ No
( NA
❑ NE
❑ Yes
o
ElNA
ElNE
ElYes
No
❑ NA
❑ NE
12/2"4 Continued

Facility Number: Date of Inspection d"I
Waste Collection & Treatment
Mo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate'?
❑ Yes
El NA El NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
ONo ❑ 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
�No ❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
RNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
$ Yes
❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
Nyo ❑ 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 ElNE
maintenance or improvement?
fX
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�No ❑ NA ❑ NE
maintenance/i mprovement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Driti ❑ Application Outside
of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o
❑ NA
ElNE
15. Does the receiving crop and/or land application site need improvement?
ElYes
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
E�No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name L_ WLH WTOIv &LePhone: © 3
Reviewer/Inspector Signature: Date:
7111 12128104 v Continued

Facility Number: 9 a--1 Date of Inspection 0
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 appropiiate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement`? If yes, check the appropriate box below. ❑ Yes Lr
No ElNA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[� No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
O No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
® No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
g No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
to No
❑ NA
❑ NE
al Comments and/or Drawings:
12128104

December 1, 2006
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Dan Bowden
Dan C Bowden Farm
11040 Hobbton Hwy
Clinton, NC 28328
Michael F. Easley, Governor
William G. Ross Jr., Secretary .
North Carolina Department of Environment and Natural Resources
Subject: Application for Renewal of Coverage for Expiring NPDES General Permit
Dear Permittee:
Alan W. Klimek, P.E. Director
Division of Water Quality
REC
DEC 06 =
Di-FAY!`TTE UffQ0 L0fflM
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/down]oads.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 Januarv_2, 2007Please note, you must include
two_(2) conies 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 endlosed 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 - 820185
Prestage Farms Inc
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636
Internet: www.ncwatgqualitv.org Location: 2728 Capital Boulevard Raleigh, NC 27604
An Equal Opportunity/Affirmative Action Employer— 50% Recycled110% Post Consumer Paper
Telephone:
Fax 1:
Fax 2:
Customer Service:
Iv -hCarolina
(919)?atura!!�
[phone]
[phone]
[phone]

Type of Visit Wompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: FC)--,3-0(q t
Arrival Time: a1� t� .. Departure Time: �: /k Countyi
Farm Name.Vl 1�9 � ✓ 1'Y\- Owner Email:
Owner Name: P�5TCLgP Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: Vi Integrator:r
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: 0 4 = 6 Longitude: = ° = ` =
Design Current Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
to Finish
❑ Layer
❑ DairyCow
to Feeder
❑ Non -La er
❑ Dai Calf
r to Finish
Q
❑ DairyHeifer
to Wean
Dry Poultry ❑ D Cow
❑ Non -Dairy
to Feeder
to Finish
FEBoars
La ers
❑ Beef Stocker
Non -La ers
Beef Feeder
Pullets❑
❑ Beef Brood Cow❑ Turke s
❑ Turke Points
❑ Other Number of Structures:
Dischar.es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
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 P'No ❑ NA ❑ NE
❑ Yes
❑ No
�?NA
❑ NE
❑ Yes
❑ No
QAA
❑ NE
❑Yes
❑No NA
❑NE
[:]Yes
oNo
❑ NA
❑ NE
[]Yes
CgNo
❑ NA
❑ NE
Page I of 3 12128104 Continued

r
14'aciliq 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 Structure 2 Structure 3 Structure 4
Identifier: i
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 4
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 �io
❑ Yes 9 No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
❑ Yes [ LNo ❑ NA ❑ NE
❑ Yes 5No ❑ 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 [I NA El 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 ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes &No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drift [I
Application Outside of Area
12. Crop type(s) _ 1��c'I P]L4/G �..�1'l gra.A OA 'A -1
13. Soil type(s) A to r po ! k a
.,
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
IANo ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[�JNo ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
VNo ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
EUNo • ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
;/0 ❑ NA
❑ NE
Comments (refer to question ft Explain any -.YES answers. and/or any recommendations or any other comments s U H F 1t
Use drawings of facility:fo better explain situation.`S. (use additional pages as necessa��`{{ a
.. `.�)'
Reviewer/Inspector Name J-f v V
j Phone: 10 S
Reviewer/Inspector Signature:
Date:
Page 2 of 3 Z 12128104 Continued

Facility Number: —RS hate of Inspection
Required Records & Documents
19. Did the facility fail to have 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 El Other ,.,[,
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Ly No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22, Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Additional Comments and/or Drawings:
❑ Yes [b No ❑ NA ❑ NE
❑ Yes VNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
M"'No
❑ NA
❑ NE
❑ Yes
U - o
❑ NA
❑ NE
❑ Yes
0,�o
❑ NA
❑ NE
❑ Yes
UINo
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
❑ Yes t(No ❑ NA ❑ NE
❑ Yes VNo ❑ NA ❑ NE
❑ Yes t No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
Page 3 of 3 12128104

a M /Rts
Type of Visit ® Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: SJ y /05 Arrival Time: % : U Departure Time: County: 5 a.w- -N Region;
Farm Name: aV. (16L. IOwner Email:
Owner [Same: - PYe- s -F � C- c a Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: _ Q ... �,� a+r eA�DoIntegrator: Pr c s-1-r_9
Certified Operator: OL- 1 l e- ►-- Operator Certification Number:
Sack -up Operator:
Location of Farm:
Swine
Sack -up Certification Number:
Latitude: = 0 0 1 = it Longitude: = ° = 4 ❑ 1{
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
❑
Wean to Finish
❑
Wean to Feeder
©
Feeder to Finish
p29
$J
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other
❑ Other
i
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: ©!
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
© No
❑ NA
❑ NE
❑ Yes
K} No
[]NA
❑ NE
12128104 Continued

Facility Number: b'
Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
® Yes ❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: f_31
Spillway?:
Designed Freeboard (in): a, >~ '+ /�ss�rr"e-Z -1.4 s. c .z_,s Sr-? - lSd
3 I.te. /93
Observed Freeboard (in): V
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes [3 No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes ® No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
© Yes ❑ No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
❑ No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
❑ No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[jO No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
© No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of
Area
12. Crop type(s) G e. r r— 05
13. Soil type(s) C, e rA , N a r�
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
® No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
© No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination"
❑ Yes
m 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
RI No
❑ NA ❑ NE
7` K A, e-j1�n-�b,J- vfe_� -41G
CaV<- 0+1 /nPoanl b4.v %ate
Reviewer/Inspector Name L QX'/, ,�" *� Phone:
Reviewer/inspector Signature: Date:
Ii/(.W VT ly Vrorrlrr{

Facility Number: ea? -- _)SSJ Date of Inspection S
r�
Rtauired+Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [X No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ® Yes ❑ No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
[Z 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
Q No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
® No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[ ] No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 244 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
Q No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[0 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
M No
❑ NA
❑ NE
Additional Comments and/or Drawings: ,� . s s 5. sE s r „. ;z ti.', `` �, p'
c�l�' 8,C1h►?r�o�G*5 Gr4YC Yi+aAr YGv�tr.�, he—C_O a �r �cwdC
u1.
v.e 11 �wiS1a�� Gt Yei��. ipr4G'{01-,— +-.Le—
jle�W`ja .
ad - L Q 1 0 OA.� ot y S •t t-% vti G c-Lc Ct .
12128104

(Type of Visit • Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ® Routine p Complaint O Follow up O Emergency Notification O Other ❑ Denied Access I
Facility Number Date of visit: Time:
O Not Operational O Below Threshold
MT6rmitted O-Cerdfied 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: .........................
Farm Name: ... patx...... z.... LO.W.,'i.........re/-...r.►x................................................... County:....1............................... ... F�.......
OwnerName: ......&.1........... .p wde.r............................................................................. Phone No: .....Y/W.......... r y.. y.... v.r...l..............................
Mailing Address:........ G?....... �c .7��.n.....H!^ .........Gl.A:r►.{:�? ......... .C.......;;1.3 � �................................... .................. ...
Kme' S-gv - y93/
Facility Contact: ... P.Cle,..... adl..%?tat.; .....'t3�1�1 rA . ..... Title ................................................................. Phone No: .... .1/0......
.................... .
Onsite Representative; ........M.&;�....... 4Avt W.a......................................................... Integrator:... n!"e�?,��.........................................................
Certified Operator ........ % &:.�e .......,%,� !��� 1....................... .... Operator Certification Number:.`2'1.3..................
.................................. .........
Location of Farm:
[-Swine ❑ Poultry ❑ Cattle ❑ Norse Latitude 0• 9 46 Longitude • 4 44
Discbarees A Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes [a -go
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes BV&
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes a iqo
c. If discharge is observed, what is the estimated flow in gaVmin? --��
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ®-Ko-
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑Wo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [3-Ko
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes Q} ? Ko
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ..............I .................................................................................................................................................................................................
Freeboard (inches): (?
12112103 Continued

4 '
Facility Number: 8;--J$ Date of inspection 3-0
'r
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes [-No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes M-Ko
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 MN-o
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures Iack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
[moo
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
B-96
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
U-No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type 13er'my/Li6IG S , _SMQ//
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑� -N6
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
G-No
b) Does the facility need a wettable acre determination?
❑ Yes
❑-No
c) This facility is pended for a wettable acre determination?
❑ Yes
(l1Go
15. Does the receiving crop need improvement?
❑ Yes
63-Wx
16. Is there a lack of adequate waste application equipment?
❑ Yes
0-Ko
Odor Issues
17, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes B-No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 0-No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes [-No
Air Quality representative immediately.
❑ Final Notes
, -u717 ,k.
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9vo grunt Gc7Vp/, 0nK sn114 %iNcl gome eros,' ,, , 54e Sp.d S�e +sad/.%u' Oki
701r S0 � n ��ur a' Gn� e' of l Va1S r'ol/Pr
Reviewer/Inspector Name 'j
Reviewer/Inspector Signature:
Date: 3- 6> 3 -
11411.c 01 c;onunuea

rJ =
Facility Number: gg— Date of Inspection 3- .� 3- D
Required Records & Documents
21.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
M-No
22.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUP, checklists, design, maps, etc.)
❑ Yes
M-No
23.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
91-No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
O-No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
U-No
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
(ie/ discharge, freeboard problems, over application)
M'Iqo-
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
O-No
28.
Does facility require a follow-up visit by same agency?
❑ Yes
Q No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
M No
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
91(es
❑ No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
e Yes
❑ No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
0,90
33.
Did the facility fail to conduct an annual sludge survey?
[ages
❑ No
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes
0-116'
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes 9-No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
m�?_3 /'1/`,S. iS owe4l? do' 7v c/G a Sad egsS 1pcy yPc•�^ � pu� She
his s�„ One v�>r' l�, s y ��„ (ls� wee le oIc l79ortl, �2 ao y
Mrs, Itlowclr., 4.4 e'G /ds�� k"ef5/f Gnu�r.Si$ {�Or S�fJ7Fr„ )ter
S4 f. OkI At, ?O
03
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5Omp41 avlell
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12112103

NCDENR
North Carolina Department of Environment and
Michael F. Easley, Governor
April 12, 2004
Dan C Bowden Farm
Dan and Mary Bowden
11040 Hobbton Hwy
Clinton, NC 28328
Natural Resources
William G. Ross Jr., Secretary
Alan W. Klimek, P.E., Director
Coleen H. Sullins, Deputy Director
Division of Water Quality
During a routine quality assurance and quality control check of our records, it was noted that in the
comment section on the third page of the inspection form that was done on March 23, 2004 by Mark
Brantley, that the dates for the waste analysis had the wrong year listed (2004 was listed instead of 2003).
The comment should have stated
"Mrs. Bowden used the wrong waste analysis for September spraying. She used May 2003 analysis
instead of November 2003.. 1 reminded Mrs. Bowden that waste samples should be taken 60 days before
or after irrigation event."
Our records have been corrected and we ask that you attach this letter to your copy of the inspection to
show the corrections. if you have any questions please contact Mark Brantley at the Fayetteville Regional
Office at [phone] ext. 730.
Thank you
Mark Brantley
Environmental Specialist
225 Green Street -- Suite 714, Fayetteville, North Carolina 28301-5043
Phone: [phone]-FAX: [phone]Internet: ww.enr.state.nc.us/ENW
An Equal Opportunity / A formative Action Employer — 50 % Recycled 1 10 % Post Consumer Paper
NorthCaro ina
Aatumlly

r ' Site Requires Immediate Attention:
Facility No. _ift =0.5—
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
Time: 3. db
Farm Name/Owner: pt & LL.p f-1 y .hr / bA41 C . AoW 4�t
Mailing Address: & 3 Z0.6 CJ. 6y.v _, .e1C txKs?�
County: s ­v
Integrator: M s Phone:
On Site Representative: 4"arr mCtj 1-771—, Phone:
Physical Address/Location: 5� sy►� f� __ _ _
Type of Operation: Swine Poultry Cattle
Design Capacity: 3,. a cy n_ Number of Animals on Site: 4P -7 .S!
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: " Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon hav sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately i Foot + 7 inches)mor No Actual Freeboard: _3 Ft. Inches
Was any seepage observed from the la °n(s). Yes or QWas any erosion ob ed? Yes or
OY��
Is adequate land available for spray? id or No Is the cover crop adequate? or No
Crop(s) being utilized: -1"►ri
Does the facility meet SCS minimum setback criteria? 200 Feet from DwelliuA) (0 or No
100 Feet from Wells? Cy -a or No
Is the animal waste stockpiled within 100 Feet of USGS Blue -Line Stream? Yes or�0
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or Zn
Is animal waste discharged into water of�state by man-made ditch, flushing system, or other
similar man-made devices? Yes or o If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? S or No
Additional Comments: Y 1_? a t_,•�4 {,., ��D 14 4 0"S P,>
Z')/4
CkA, ),a
4 1 w?
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

I
i
NORTH CAROMM DXPAR.TN=T OF ENYZRGt+ IMT, BIKALTA' 6 NATAL RXSOURCLS
DIVISION OF ENYiRONHENTAL NMGEN3MT
Fayetteville Regional Office
Animal Operation Compliance Inspection Form
•,'1..,:..e:•s+ .:oe.:TF.n.. .s:f':. w:fv .
�f.e i Y k i "'0�•1 S 3 r<i �..r.
'�U11!�BJ
wY> :.aw�••r 'e :f9!�.i?'�^„��:i:::y'^...,...• so.•'.a'a.; •.•�*:•':"w.r•.:.....�.•
..Y.•.< nr.-S
":•IId$CEC�'I�%a7
.y„ �"� �:��
.vl v".'w" •".:�iF...x �:.:�.�
;'a/8ii► ��^�" r, g7�IRIK.,.I+If�BR<.+ ,.
Da n Bowden
I,.Rf
Y w vw•<..!'.:.1:v.nr.. i�i:tvW���g I W h.h_J�'S i 'W 'Y
�xf
tt
- o < � T. :w'� �'_R, yM, '�i•��w"V+. T..>w0'rl.�•.•'.":�:.w•J-,N, - '. " .� a�
�Ii.LKFii3UF7A..W" N 1.
•I/. .!�..eY�sNy��.. �{/��•J-iIV ..JlL1i/%1�PMi.%...
Yi�O;.+q'A •'
1
3 Sox 20(o e.i.trj+0t\
i0-5A4-Olf
All questions answered negatively will be discussed in sufficient detail in
the -Comments Section to enable the deemed Permittee to perform the appropriate
corrections:
MIPA;
Animal pparat�on _ Ts►tae:
Horses, cattle, swine
SECTION ,Ix
Feder -to Ffoisk
poultry, or sheep
Y I N I CONKENTS
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
systaa ] '
2. Does this facility meet criteria for
Animal Operation REGISTRATIM
3. Are animals confined fed or maintained
in this facility for a 12-month period? -
4. Does this facility have a CERTM A!G
WASTE IKWGENSVT , jPLAW.
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 SCS minimum
setback criteria for neighboring houses,
wells, etc?

2
I
i N COMXRNTS
ite Mani em t
1. Is animal waste stockpiled or lagoon
construction within 100 #t. of a USGS
May Slue Line Stream?
2. Is animal waste land applied or spray
irrigated within 25 ,ft. of a USGS 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 accardance'with the
ORTIFICATIQN PLAN?
3. is animal waste discharged into waters of
the state by man-made ditch, flushing system,
or other similar man-made devices?
6. Does the animal waste management at this
farm adhere to Best Management Practices
($MP) of the approved MTTFICAT; ?
7. Does animal waste lagoon have sufficient
freeboard? How much? (Approximately }
8. is the general condition of this CAFO facility,
including management and operation,
satisfactory?
SLGTZQN I'V

and birds. The raccoon does not actuauy
wash its foods,' as many people believe.
Fin -- However, they often play with their food in, SAmPSON
water if there is water nearby. COUNTY
� � r
s
DAN BOWDEN
From 701 north farm 4 miles from Keener on right.
4Houses�/735
Q �!• + i ESL ?
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n

Z=TGISTRAT=CN =0RM FCC ANiMAI. FEEDLOT OPr:�3► IONS
Department of Environment, Health and Natural Resources
Division of Environmental Management
Water Quality Section
If the animal waste management system for your feedlot operation is
designed to serve more than or equal to 100 head of cattle, 75
horses, 25'0 swine, 1,000 sheep, or 30,000 birds that are served by
a liquid waste system, then =Ls form must be filled out and mailed
by December 31, 1993 pursuant _a 15A NCAC 2H.0217 (c) in order to be
deemed permitted by DE,%. ?lease print clearly.
Farm. Name:
Mailing Address:
County:
Owners) Name:
manager(s) Name:
Lessee Name:
Farm Location (Be as spec' fic, as possible: road names, direction,
milepost, er c .) 74� F rrL. , /ems 'Rpm.. gz�,, We.
Latitude/Longitude if known: ('✓�Sp�'S'%���
Design capacity of animal waste management syst m (N er and type
of confined animal (s) ) : G� F �o
Average animal population on the farm (Number and type of animal (s)
•raisedl ��lr,��;�(Rrirt� _
Year Production Began:, ASCS Tract No.: $'7
Type of Waste Management System Used: �r
Acres Available for Lan pplication of Waste:
Owner(s) Signatures) : C- —� DATE:
D TE :