310036_INSPECTIONS_20171231

NORTH CAROLINA ..�
Department of Environmental Qual

Div[sioa of Water Resources
.` Aila-, Number (�`� ;� Q Division' of Sdd a� Water Conse vahori F i
Li - ® [,
Other A enc :.
g, y
Type of Visit: 0 Co
anee Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit:tine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: D e (-42 Integrator:
Certified Operator: Certification Number: 14J Z
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Desk n :Curreniill
g
� "' 9%
&
D "" n
g
;sib:. b1Yi,�
Current
�if� �. q'i € �j
� �'� �' �a g
Desk n Current
.:
:. ,
Swine ,;
Capacity
P©p
.Wet Poultry r
Capacity-
Pop ~
i
Cattle
Capacity Fop
Imf"
ice. ice.
i=
Layer
i
f
Non -La er
,
�_
Resign
Current
33° De: .=Foul
capacityPo
Layers
e
Non -Layers
Pullets
Turke s
°i
Ed� �ri
�„ Itlr
g
lrOther� K.. �
TurkeyPouets
K' �'
Other
Other
Wean to Finish
Dai Cow
Dai Calf
Dairy Heifer
D Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
I. 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
❑ ❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[] 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 2/4/20I5 Continued

Facili Number: ( - Date of Inspection:
Waite Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in)
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
C3 Cr
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes No ❑ NA ❑ NE
❑ Yes pa'�`oo NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment hreat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes T 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 E2<o ❑ 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 101bs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
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.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes N ❑ NA ❑ NE
❑ Yes � ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes VNo
7 ❑ NA ❑ NE
❑Yes ❑ NA ❑ NE
Yes o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ,❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ t20 Minute Inspections ❑ Monthly and I" Rainfall Inspections/❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes g
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ YesNo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

If I
Facility Number: - Date of Inspection: 2 G
24.17id the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes o -NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �o ❑❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [] No E] ;` A ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [] Yes ffNo ❑ 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
Ef 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 0 NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
ET 5o ❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
NoE NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
[] Yes
0 No ❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
NA
❑ NE
Comrneuts (refer togquesti6,n #j. Expiain any YES answers and/©r any�sddiitionalgrecoinmendations or iily,othe"r comments.
Use drawings of -facility: to better explain situations f use additiouaE pages ,as necim,
y)• ' "
Reviewer/Inspector Name: _00 V I C t' d Phone: 10 77 6
Reviewer/Inspector Signature: Date: �ZG I! 7
�----
Page 3 of 3 21412015

Iivision-of Water>Resources
Facility, Number - O Division of 5orl'and Water Conservation
OO ey ��..
therAgen ,
Type of Visit: O Compliance Inspection Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: O Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: y Arrival Time: ' ' Departure Time: County: Region: 4
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Qe(& aro,_,l Y--
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current _ y Design Current �: Dessign Current=
Swine Capacity Pop. Wet Poultry Capacity Pop Cattie Ca aci PoP
.. b. � - P ty ����
La er
Non -La er
Design Current -,
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Weie there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Dairy Cow
Dairy Calf
Dairy Heifer
Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
x
[:]Yes 1:-No ❑ NA ❑ NE
[:]Yes E�rNo
❑ Yes -E(—No
❑ Yes 12'No
❑ Yes EfTNo
❑ Yes �No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412014 Continued

Facility Number: Date of Inspection:
Waste Ctfllection & Treatment
4~ Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑Yeso `❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? [:]Yes �No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: 1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes �- o
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
T
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes [21'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 o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes J2'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 ZNo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑"Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes _Eallo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes ,C No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes E2-No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes j2pNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes Eno
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes L2 Ro
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[:]Yes E�T"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 �'lrlo
❑ 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 ZNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [2rNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

FaciliNumber: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes P71 No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes JE!rRo ❑ 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 fast survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ;2,No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Po ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 'PI�o ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes n. o ❑ 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 , '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 �7No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAVVMP? ❑ Yes L?rNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes )2TI�o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes fa<o ❑ NA ❑ NE
Comments (refer.to question.#) Ezplain any YES a'nswers.andlor any additional;recommendations or;any,,ol ,,comments
Use drawings of facility to better eiplain situations=(use: additional'pages;as
C /13
l . S­ 7 �
l
3 1:56, 071 J /' C c.UraPs
IltlIq q? A 16 ok-
Reviewer/Inspector Name: O Phone: q
Reviewer/inspector Signature: Date: l /
Page 3 of 3 2/ of

Kacilit Number
1.
C
Division of Water Quality
Q Division of Soil and Water Conservations L�
O Other Agency
Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit tine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: 15 ACAA Arrival Time: a arture Time: County: fL Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = o = 1 = 1, Longitude: = o = t
Swine
❑ Wean to Finish
=� ❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Other
❑ Other
Design Current Design Current' Design
Capacity Population Wet Poultry. Capacity, -Population' Cattle Capacity P+
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
[Ell urkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Coul
Number of Structures „I {� 4
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
j2No
❑ Yes
;allo
❑ NA
❑ NE
❑ Yes
Zo
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility Number: - Date of Inspection:
Waste Cohection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 2iNo
❑ 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 RNo
❑ NA
❑ NE
waste management or closure plan? TT
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 ONo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes EfNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ONo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s)
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑Yes
VfNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
IZFNo
❑ NA
❑ WE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[?I'No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[2No
T;2,fvo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
T
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
oNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
C3' No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[:]Yes
[ZNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
0 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 permi . ❑ Yes Z] No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 2' Yes [:]No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ;2failure 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 RTI40
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 1;2�o
Other Issues
[] NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑NA ONE
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
L'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
JD 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
J 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
ZNo
❑ NA
❑ NE
33. Did the Reviewerllnspector fail to discuss review/inspection with an on -site representative?
❑ Yes
V'No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
[:]Yes
VNo
❑ NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or an other comments #�
Use drawings of facility to better explain situations (use additional pages as necessary).;
je
Reviewer/Inspector Name: Phone: Oro _1-7
r-
Reviewer/Inspector Signature: Date: S-.&
Page 3 of 3 2/4 .011

0 Division of Water Quality
FaCtlity Number
0 Divisio n of Sotl and Water Conservafion°
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 Other ElDenied Access
Date of Visit: J' Arrival Time: Departure Time: County: Ze,.eRegion:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
ElWean to Feeder
❑ Feeder to Finish
ElFarrow to Wean
❑ Farrow to Feede;
ElFarrow to Finish
ElGilts
❑ B
oars
Other
❑ Other
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = = Longitude: = ° = 4 = «
Design"' Current '" Design-' Current Design-, Current
Capacity. Populations Wet Poultry Capacity- Population -:�-_Cattle Capacity n `Populatio
=DrypPaultry _ -
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ElStructure [IApplication Field [IOther
a. Was the conveyance man-made?
El Dairy Cow
[I Dairy Calf
El Dairy Heifer
El Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number• of Structures � ;
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 2rNo ❑ NA ❑ NE
❑ Yes
❑ No .
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
L2rNo
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
;11Io
❑ NA
❑ NE
Page 1 of 3 12/28/04 Continued

F
Facility Nbmber: — Date of Inspection Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes FTNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 1! No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes !2,Ro
ElNA
❑ NE
ElWaste Application ❑ Weekly freeboard ElWaste Analysis ElSoil Analysis
ElWaste Transfers El 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?
I
❑ Yes XNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [�'<o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes [JIo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes QNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes �;Ko
❑ 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 E;�No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ONo
❑ 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?
ElYes
,�/
I�No
El NA
El 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
jKNo
❑ 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
5No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
;?(No
❑ NA
❑ NE
AdditionalComments and/or Drawings: 7_ •»-�+
Page 3 of 3 12128104

Facility Number: 3� Q Date of Inspection
t.,
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?
Struck I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ] T
❑ Yes,. gfNo ❑ NA ❑ NE
❑ Yes EfNo ❑ NA ❑ NE
Structure 5 Structure 6
.—i
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes C;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 WNo ❑ 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 ;2lNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes XNo ❑ 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 KNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �No El NA El NE
maintenance/improvement?
IL 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 Drift ❑ Application Outside of Area
12. Crop type(s)
l3. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ONo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ZNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
`f'' No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[ No
❑ NA
❑ NE
Comments (refer:to.question#}: Explain any YES —answers' and/or any 'recaminendations or any other comments.
Use,drawings of facility. to°.better explain situations (use'addrttonal pages as n'o"ce§sai*) 17
r;
r
IReviewer/Inspector Name I Phone: ��Q ^ C 7 I
Reviewer/Inspector Signature: f 1 Date: 2
Page 2 of 3
1
Continued

i
-V Division of Water Quality
Facility Number 3 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit Compliance Inspection Q Operation Review () Structure Evaluation Q Technical Assistance
Reason for Visit Q Routine O Complaint 0 Follow up O Referral Q Emergency 0 Other ❑ Denied Access
Date of Visit: ej Wei
Arrival Time: I J ] �arture Time- County:
1
I
Farm Name: ./%�
f/utJ
cS '!." Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: el A Title:
Onsite Representative: z )Iere
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone:
Regio4__12 V
Phone No:
Integrator „ •- _ _
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = I = 11
Longitude: = o = E—_1 u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La et
Dry Poultry
Non -
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: FI
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
❑ NA
❑ NE
❑ Yes
PNo
❑ NA
❑ NE
❑ Yes
❑ NA
El NE
El Yes
Zo
❑ NA
❑ NE
12128104 Continued

Facility Number: 3 —��
Date of Inspection
• Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
tn No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
PNo ❑ 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 ElNE
(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
VrNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
YfNo ❑ 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
INo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
P11140 ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
4No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside
of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
INo
[INA
ElNE
15. Does the receiving crop and/or land application site need improvement?
ElYes
❑ 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
EnNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name Phone: C1 o
Reviewer/inspector Signature: -- Date: Jy O -%
I2/28104 - Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ,,0 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 ❑ 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
[XNo
❑ 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
❑ 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
P No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[INo
El NA
❑ NE
Other Issues
/
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
VrNo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[4No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[/ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[�No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
E;rl o
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
Q No
❑ NA
NE
Additional Comments and/or Drawings:
- -rn(ryl, feces )ease- � -M kfp r-a-wk-. -
.
-12129104

_AoTivision of Water Quality
[F-�dfity Number 3 O Division of Soil and Water Conservati
n Other Agency
Type of Visit Compliance Inspection O Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit outine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: (/ Arrival Time: 25varture Time: County: l ,0�'t Region:
ff
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: Qf�t
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
Owner Email:
Phone:
Phone No:
Integrator•
Operator Certification Number:
Back-up Certification Number:
Latitude: = o =' Longitude: = o = A =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
i❑ Layer
❑ Non -La er II
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
EFDry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: ED
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes ;3No ❑ NA ❑ NE
El Yes
El No
El NA
❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
V1 No
ElYes
YNo
❑ NA
❑ NE
❑ Yes `ONo ❑ NA ❑ NE
12128104 Continued

Facility Number-3/ - Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
r�
❑ Yes No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes I_allo
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): v
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
,
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes 2 No
❑ NA
El 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 0No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes �No El NA El 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 EWo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes P,,No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. [--]Yes P 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 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?
[J Yes [L,Wo
U NA
U NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes PNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes ja No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes PT�4o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes UNo
❑ 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):
Wqq S 1011 on S C y fcr e S 1c> 1 t s-'1' �tacc Catle,�
c jl�l/�—
Reviewer/Inspector Name I A2:V1_n Phone: Y161 &l % 1
Reviewer/Inspector Signature: l Date:
Page 2 of 3 12128104 Continued

'Ja1 me Z�z1 I

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes �TNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ONo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
El Waste Application Weekly Freeboard El Waste Analysis ❑ Soil Analysis [I Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking XcropYield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes D No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes 21 No
❑ NA
❑ NE
❑ Yes Z No
❑ NA
❑ NE
❑ Yes P'No
❑ NA
❑ NE
❑ Yes [2"No
❑ NA
❑ NE
❑ Yes oNo
❑ NA
; NE
❑ Yes )4No ❑ NA ❑ NE
❑ Yes ,'No ❑ NA ❑ NE
❑ Yes [io ElNA ElNE
❑ Yes "N' o ❑ NA ❑ NE
❑ Yes VNo ❑ NA ❑ NE
❑ Yes VNo ❑ NA [I NE
Additional Comments and/or Drawings:
RaIO k
�C44pad rccarols/0�
a"p 'VIe o Prorr:•�
lueell
Page 3 of 3 ]ZTV04

Division:of Water Quality
F#ijity. 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 Other ❑ Denied Access
Date of Visit: /a 0, Arrival Time: I < ` � Departure Time: County: Region: ��O
Farm Name: CYf3g Owner Email:
Owner Name:
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
❑ Gilts
Phone:
Phone No:
Integrator:
Operator Certification umber:
Back-up Certification Number:
Latitude: = o =1 Longitude: ❑ o ❑' ❑ "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
I❑ Non -La ei
Other
❑ Other —--
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
1 Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes .0 No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
12Mo
❑ NA
❑ NE
❑ Yes
O No
❑ NA
❑ NE
12128104 Continued

Facility Number: Date of Inspection
a
Reg uire►Recvords & Documents
i
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes FTNo ❑ 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 El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ❑ No ❑ NA ❑ NE
❑ Waste Application 0 Weekly Freeboard ❑ Waste Analysis A Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections OMonthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑'f10 ❑ NA ❑ NE
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 pen -nit?
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
2$. 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 reviewhrispection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
�No
❑ NA
❑ NE
Yes
❑ No
❑ NA
❑ NE
zfYes
❑ No
❑ NA
❑ NE
❑ Yes
ZNo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
'WNE
❑ Yes ZNo El NA El NE
❑ Yes Z No ❑ NA ❑ NE
❑ Yes JZ No ❑ NA ❑ NE
❑ Yes oNo ❑ NA ❑ NE
❑ Yes )ZNo ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
Additional Comments and/or Drawings:
OC(5e peep crelebaqu' v n
a q mo y
• ,/tee- c�ri�I/C'�'' eQi�
IVO soil or 7� �� a6rZO 0 S_
7Yla�
F/eze e rr�t ti
Q"Old �',eh'Al
_6 ci or'lf / ✓L- Ct 7' (71-
12128104

Date of Inspection 7 D
Facility Number: I —
r
W_ ast�Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes .2 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: A
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 1-1? ` p
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes ffNo
❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes .2rNo
❑ 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 ONo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes ,0 No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes 2rNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes JZNo
❑ NA ❑ NE
maintenancehinprovement?
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 l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable.Crop Wind/ow [:]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
ETNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ErNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%O Yes
J+No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
PNo
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name V r��i� Phone: l0 - 6 - dp
Reviewer/Inspector Signature: Date: !Aito` o
12128104 Continued

Type of Visit Z Compliance Inspection O Operation Review O lagoon Evaluation j
Reason for Visit Paoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: 1111VIOid Time: I 9vN 0 d
�. ._.. 0 Not Operational 0 Below Threshold
13 Permitted E3 Certified D Conditionally Certified Registered Date -Last Ope or Above Threshold:
2-
Farm Name: _�.GA1 ;��L�P-S �(..L�l.�-........_......... County:
Owner Name: _....... . , _- .. _ , . , _. Phone No:
Ntwhing Address:
Facility Contact:--
Onsite Representative: / (j[�� . S!i MW {�
Certified Operator.
Location of Farm:
_, Phone No:
Integrator: —
_
Operator Certification Number:
'Prg�ne ❑ Poultry ❑ Cattle ❑ Horse Latitude r—�• < " Longitude • 4 «
gn
-(.`lI[L4JZt r s I
7gn Olin t gg CmTEat
5wiiie .. '
Po'tilatianoiiltry
_
"ci Po tiara.., e.Cstde ` r on:
Feeder
=rFarrow
<r. Layer
Dairy
Finish
� Non -Layer
Non -Dairy
Wean
FeederOther
Finish
Too`Des�gn C lPSC1It
Nmaber�'L-agoons
—j
""
Discharges & StreamImpa
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b- If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes 2No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes- BNO
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ._0'No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 11-No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: _. __ . E- �A B_.. __ r.. _.
Freeboard {inches): J 0
12112103 Continued

Facility Number: —C, Date of Inspection /
5. Are there any immediate threats to the integrity of any of the structures observed? 0e/ trees, severe erosion, ❑Yes 21Ga
4 seepage, etc-)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes E!rNo
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 maintenanceJimprovement? ❑ Yes ,2 No
$. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes CINo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes 2,90
elevation markings?
Waste Application
10. Are there any buffers that need maintenancefimprovement? ❑ Yes �o
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes LR-No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Cm /'
P type Y �.7,�� / � � - �� /- fA,-,d ) , 1 O!''i?. ,
13. Do the receiving crops differ with those'esignated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 2-No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes .moo
b) Does the facility need a wettable acre determination? ❑ Yes Jallo
c) This facility is pended for a wettable acre determination? ❑ Yes allo
15. Does the receiving crop need improvement? ❑ Yes ❑No
16. Is there a lack of adequate waste application equipment? ❑ Yes Q,No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge actor below ❑ Yes .QNo
liquid level of lagoon or storage pond with no agitation?
is. Are there any dead animals not disposed of properly within 24 hours? . ❑ Yes J[3No
I9. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ji+la
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 j2NO
Air Quality representative immediately.
Feld Cove ❑ Final Notes
Reviewer/Inspector Name F, pan:. m
Reviewer/Inspector Sim: Date:
IlA 1 1-1—_1
iW af.IV✓

Facility Number: — Date of Inspection
Restuire&Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes :Q-xo
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.) ❑ Yes CPfo
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ 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 EE�No
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes .0-go
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ❑ No
27. Did Reviewer/Inspector fail to discuss reviewfmspection with on -site representative? ❑ Yes .,OWo
28. Does facility require a follow-up visit by same agency? ❑ Yes `QNo
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes .E3 No
NPDES Permitted Facilities
30. Is the facility coveted under a NPDES Permit? (If no, skip questions 31-35) .Q'Ybs ❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EMo
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes �o
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. "Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. .,O'ges ❑ No
❑ Stocking Form ,Crop Yield Form ❑ Rainfall 2�fnspecrion After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
-
CD�EniS'and[orrr
...l s.
. i....�..^_-_..r: _,..e:...®.�.,�..; ....a. ^:..r.,:a�ias,...., ^......,_.:.-._.
pleve fix '�Zo-03 /ci'e_ebazr
141,5 a
x4,
_
� �� f� /
j `, f /�l
�/r C� 7`� G✓I
3�.�..
flease- re c_ o d-G c f c
�y
fie✓' `` i 1 n S eao
c+I o n
ra) chq) 604�
12112103

Type of Visit I1.Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit V-Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number slate of Visit: EZMTime:
Not Operational 0 Below Threshold
® Permitted ELCertified 0 CoJnditionallv Certified D� Registered Date Last Operated orbove Threshold:
Farm Name: I�rl i ! ui TAM&9 )Gf,-41 County: t
Owner Name: Phone No:
Mailing Address:
Facility Contact:
Title:
Onsite Representative: /%,kev, I%oefeJ4 de-Wft
Certified Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �'0� �" Longitude
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at. El Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b_ If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure l Structure 2 Struct}Ire 3 Structure 4 Structure 5
Identifier: _ 6
Freeboard (inches): .3�`
05103101
❑ Yes EgNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes QSNo
❑ Yes Z No
❑ Yes 5�kNo
Structure 6
Continued

iv
Facility Number: 31 — 34
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvcment?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type _Z2&—&ij14 �s�"'�// G-zrliyf 6�ydnnf&f Z {O✓/ WAe�Z
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24, Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes P No
❑ Yes M No
❑ Yes MNo
❑ Yes %No
❑ Yes PfNo
❑ Yes CZ No
❑ Yes R[No
ElYes
IN No
❑ Yes
R.No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
S No
❑ Yes
V.No
❑ Yes �INo
❑ Yes 91 No
❑ Yes S No
❑ Yes 5C No
❑ Yes SNo
❑ Yes OdNo
❑ Yes ® No
❑ Yes `gNo
❑ Yes rQ No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
CDmments.(refer to T4uestioi #) Eiplaut aay YE.Sanswers and/ot' any reeouimendatmas ar any.other comments.
[Ise drawings of fadrty tii.better eiplasn situattoas: (use additron$l pages as necessary) -'
_ . �-- e❑Field Copv ❑Final NoTec
-4,oir ,r ed ,b m t L sam t of u �fv- tA e- a� � ,+- Id ��s �-
lyDic 41n , S It 6 ,e n7eS ��� ! dcGh a 7ke1W ;At 14e A1010 5 IL— -,-A r n ,
LA
— We-ed 7h f-e-P Ze- 11'tMer AM1, � a.{✓ JAIMO el/-Iror %- �.
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 Continued

FacilitF lumber: 3� 3G Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes N-INo
liquid level of lagoon or storage pond with no agitation?
27. Are there anv dead animals not disposed of properly within 24 hours? ❑ Yes �io
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt. ❑ Yes [&No
roads, building structure. and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes Z No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fanblade(s), inoperable shutters, etc.) ❑ Yes gNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 0 No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? [Iy
Yes 6 No
05103101

Facility Number 3 3 Date of Visit: $ 2 D 0 Time: �
Q Not Operational Q Below Threshold
Q Permitted [3 Certified © Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ......W
Farm Name: ........... � �.I 1.'ct" ... AL'1-�e 5...................... ......... County:.. D v49.1sn.......................................................
........
Owner Name: V V r �� i n M H. f�'1C 4 Phone No: ................................. ...... .......... 0 ....... . . . �.
Facility Contact: ............................................................................... Title:......................................... . Phone No:
......................
MailingAddress: ..................................................................................................................... ... ..........................
Al
OnsiteRepresentative:...'.!•! a,.h,Tq,.�.231 .add' ..Gav1a+7�., fl,�R�Integrator:.. �� '�i
Certified Operator: :................................................................................................................ Operator Certification umber:..........................................
P P
Location of Farm:
❑ Swine ❑ poultry ❑ Cattle ❑ Horse Latitude 0 4 it Longitude 0 d Du
Design . Current
Swine. Capacity Pafliilation
Wean to Feeder
w ❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
Gilts
❑ Boars
Numher;of Lagoons
3
❑ Subsurface Drains Present ❑ Lagoon Area
❑ Spray Field Area
Hold[ii Ponds 1 Solid Traps.
❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes JZJ`No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes ,, TNo
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
❑ Yes ZNo
c. If discharge is observed, what is the estimated flow in gal/min?
14 / 6k
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes ,fNo
2. Is there evidence of past discharge from any part of the operation?
❑ Yes RNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes ja'No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes ,ETNo
Structure 4 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: A ................... ......
............ ...........6.................... .�� ....................................................... ........................ ............
Freeboard (inches): 30 2,' , 5a 2
....................................
5/00
Continued on back

Facility umber: 3 1 — Date of Inspection 3 Q
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, [] Yes ,ETNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ YesXNo
(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 JZ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes )'No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ONO
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes EtNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ YesXNo
12. Crop type 6ee'vlLvA4) H&11 , en-tA.11 (�ra_� Goers, . W lAeett , .5.,�beAPIJ
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 'oNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes [],No
b) Does the facility need a wettable acre determination? .00yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ONO
16. Is there a lack of adequate waste application equipment? ❑ Yes IPINo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes'�;ffNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) OYes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ARM
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes A0'No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) [:]Yes ;'No
23. Did Reviewer/inspector fail to discuss review/inspection with on -site representative? ❑ Yes 'P'No
24. Does facility require a follow-up visit by same agency? ❑ Yes ONO
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?esNo
? Y� ?As .p�' ref cpencies wire note dir ig ��}s:vps�t; •Yoh .. •l�eeg.. Rio fu>�-... •
;comes deiii&abautithis visit:
Comments (rder to _ bestioa #)•:.E Isar an =YES answers and/or as recomuieadetions ac an other cammeM.v. �
_ _
Use d -a�wings of fac Lty to;;betteraexph,in situations (vse additional pages as i ecesasry)
14 . I-ke qG^ C' { 11"4 r e'e el s a w e } g b )e ae *ems de-1 c r" ;.LC+ v h done i m, e4 i a-�l y.
lso, -�kt t„ r"e. e VI; j i zct4 o. - �ta� and fecnrd keX.­%3 s td be basedOYt 4k--5- ws✓kb1e Acees de-ierex; r�a-� eh -rAe 27122if -to, erxe �r;eict
Gl4j, r✓.arc okcr'e4y is eveln i-t �he �P,'e1Ue curpe4ly.
11. iBe s u re 4a V.se t„>t,.54e o^g14S i5 do -4ed L.► �; n 60 -A"_r off' a 11; C'4 or1
c_Vei10_f O✓► -i�,P �rCr2-Z'J. 'ee! do jo ?/ ke' -SAi� Sari,,P12s A.).-
Gill �, ldf
1'ecP,'.n;-,� L✓���c i Gvrren-1% 0`12
�� r
Reviewer/Inspector Name J Q f[�l/VLi Qj 1 S - - a * s y s-
_ _ �,
Reviewer/Inspector Signature: Date: B Z 3101 s�o

,Facility Number: j J — �7 Date of Inspection 23 p 1
Odor Issues
26. 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?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes �No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑'�to
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes . 'No
M Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes 'ONO
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 'MO
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional: Comments an or mwings: -
Ne ' �rat,re'^ i�c¢d(,So sfr:j� tcr�-t.vd� cs� ���1�t�ty of isz ih so>�c A.
����, [-►a7 ��, byre a-�� a- Qnd s� '{MvGt�, �',cr�t b y
Mew k1dVSe
irec jeer mecds be svre 4v &,-ve !'eats(,"1 ava�'1a61e
actR-a 4o al? i.t v plg4e lay
Zc Trac� 7935 r7�clei s I bj Ga1� por Care
Alo G-0/0 1S cV►-heft"4)J ,.N AC14 4 tlAsrt1l Lee" -CiJI e 14194 s'tr1SO=11
CmrrL (20003 aCGe�d�' a ���cserl�ci�+ve .b c✓�1� ney be- f k-6)e-A
Far ke I.�cis �e �li Gc�� p� sa.�s 1114e.f►�e , Tl-1es� �'r'cIcQS
rte20�v e rt✓�a./¢Di -Frn�, wa 3-elgn
bd�e�;
s/00

Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date or visit: WM.
Time:
oOperational 0 Below Threshold
[] Permitted © Certified p© C,,o,,nditionally certified © Registered Date Last Operated oy�Above Threshold:
Farm Name: ....... ��..t�.hlt��..�- .............../.�...................................... County: ..................L..JL.. l..},............. ....
.:........
Owner Name: - -------------------------------------- -- ------ Phone No:... -- --
FacilityContact:...............................................................................Title:............................................................... Phone No:....................................................
Mailing Address: ......................................................
Onsite Representative l�Uk�n..`.�s�;_Q�,I....���.�,,,�Lt�! ,yOntegrator:................. �Y..............
Certified Operator:.... ...................................... .............................................................. Operator Certification Number: .........................................
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 �` « Longitude • 4 •4
Design Current
Swine Canacity Poofilation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
'TotaF LW,
Number of Lagoons ; ❑Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area
Holdin Ponds / Solid Tra s ' No Liquid Waste Management S stem
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did ii reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min? e_" WYW 4
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
Yes ❑ No
❑ Yes �(No
eyes ❑ No
WO
so Pi "in- 3C
in.
AfYes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
KV
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes V No
01 /01/01 Continued

Facility Number: 3
Date of Inspection /
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches) ........................... ..................... . ......... . .. . ........... . ... . ............... .................................... .................................... ....................................
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes . ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
17.
Are rock outcrops present?
❑ Yes
❑ No
18.
Is there a water supply well within 250 feet of the sprayfield boundary? ❑ Unknown
❑ Yes
❑ No
❑ On -site El Off -site
Required Records & Documents
19.
FaiI to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
20.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
21.
Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
22.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
23.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
24.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
❑ Yes
❑ No
25.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
26.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
27.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
Odor Issues
2$.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
29.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
❑ No
01/01/01
Continued

Facility Number: —
- Date of inspection L Z
Printed on: 1/4/2001
30.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
❑ No
roads, building structure, and/or public property)
31.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
❑ No
32.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
❑ No
33.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
❑ No
34.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
❑ No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
'V.IC 1�12l WlAA VA iA_ lAll� LV UCI.{Cf C.t Ad1li ,lAUAAAUIiJ lWC i�uW1iVJTWF4
�C.I I!J ifCiC.1.?ZAl f-
Field Copy ❑ Final Notes
000 �iQt�lS ,� fii V1 11L� � ...fl�4 O } etct Ot �t�-
� o�
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s �
r. act-► rM s w ��c� - ...�
IA,v� Vi t-� 4e, e-6
Rn
2-12l+ y bl `?,�-
�
CA-
Reviewer/Inspector Name R1
Reviewer/Inspector Signature:
rxi
01/01/01

-r _ ..-' -
9Ihvhs of of Water, hty
1biv'ision'of Soil and Watek Conservat,I
r
._ 0,9thear A_ gency
Type of Visit ACompliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up Q Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Time: Printed on: 10/26/2000
7 Q Not Operational Q Below Threshold
4permitted © Certified © Conditionally Certified © Registered Date Last Opera
�...d....o...r.....b...ove Threshold : .....................
....
aunty:1............................Farm Name:.......W �^............................................ .... C
Owner Name:........................................................................................................................... Phone No:
FacilityContact: ............................................................................ .. Title: ................................................................ Phone No:...................................................
Mailing Address:........................................
......................................................................................................................................
Onsite Representative:...�L.�E-.2'........................ Integrator:....�!'�f...................................................
Certified Operator ........... Operator Certification Number: ................ ..............
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �� 0°� Longitude •
Design Current
owme
❑ Wean to Feeder
Weeder to Finish
El Farrow to Wean
❑ Farrow to Feeder
Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I PI airy
❑ Non -Layer I I I[] Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste ]Management System
Discharges & Stream Im acts
1. Is any discharge observed from any part of the operation? ❑ Yes XNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ) El Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min`?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes JWNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes XNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes j<No
Stru -tune I
Structure 2
Structure 3 Structure 4
Structure 5 Structure 6
Identifier: ............................
................. 5..............
......._._.... G......................._.............._...................................................................................
Freeboard (inches):
5100
Continued on back

de`
IL Facility Number: e3 — 3 Date of Inspection � Printed on: 10/26/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes kNo
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
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10, Are there any buffers that need maintenance/improvement?
11. Is there evider c of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type `Vj\ ' t S� , C d wA S q mot'
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Reyuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
} yes ❑ No
❑ Yes KNo
Yes ❑ No
❑ Yes t(No
❑ Yes NrNo
❑ Yes
NNo
❑ Yes
allo
KYes
❑ No
❑ Yes
❑ No
❑ Yes
ENO
Yes
U�No&jq�
❑ Yes kNo
❑ Yes XNo
EfYes ❑ No
❑ Yes ;-No
❑ Yes XNo
❑ Yes ONO
❑ Yes �dNo
❑ Yes 4No
❑ Yes ANo
vioiafitins:or defcier�cics were noted during this;visit; You:wiil receive ric further. ;
cories orideizce: agouti this visit. • . .
Comments (refer io question #): Explainany-YES answers and/or any recommendationaor.any 'other comments:
.Use drawin gs of facility to better explain situations. (use.additioaal pages as necessary)
cn rim �Qt�� At e'l
s e\is sec A- c Y� i h2VVI
Reviewer/Inspector Name
Reviewer/Inspector Signature: \ Date: 5/00

-Ld6 CQ
Fadlity Number: 3 ` — Date of .Inspection Printed on: 10/26/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below KYes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes kNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes �No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ONo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes j No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes No
Additional Comments and/or Drawi -"
TT
A, Lam-
J
5100

tvtsion of Water Quality x ;
zu
l
�1za�
1�.-... .- _'.3.e"'--X az L..:�r .3-.y ._ SM._. ..-�_. _� ._. :.,.; ... .--::?...�._ ..L' 7.=T
.\R. _'.. _S .: Y'i-•S�� w
Type of Visit W&ompliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up Emergency Notification
O Other ❑ Denied Access
Facility Number
Date of visit: i�ne: q 30 Printed on: 7/2112000
j
Q 7Not O erational Q Below Threshold
[] Permitted 13 Certified 13 Conditionally Certified © Registered Date bast Operated
or Above Threshold: ........................
Farm Name: ; G'�M. J tMa� ..v.�'t County: ......... ti.✓....Qpr'- .....................IV '.2.0 ......
Owner Name: i..�...r:.ct ±'y........�. �g ' _5....................... Phone No: 1 0 z ,� S „ 'l I Z'
... ....... ...................... .........................................
Facility Contact: T 4
.... Title:................................................................ Phone No:....................
MailingAddress: ......................................................................................
Onsite Representative:..... D V � 0 8i•'4vt Y1 O ✓1
........................I.............. ..
Certified Operator :................................
Location of Farm:
Integrator:
Operator Certification Number: ..........................................
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude
Design Current Design Current Design Current
Swine Capacity Population Poultry Ca aci Po ulation Cattle -CapacityPopulation
❑ Wean to Feeder JCI Layer 1 ❑ Dairy
Weeder to Finish 10 Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons JE1 Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds 1 Solid Traps ❑ No Liquid Waste Management System .
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? Xyes ❑ No
Discharge originated at: ❑LagoonSpray Field ❑ Other
a. [f discharge is observed, was the conveyance Titan -made? [:]Yes >, No
b. If discharge is observed" did it reach Water of the State'? (if yes, notify DWQ) ❑ Yes KNo
c. If discharge is observed. what is the estimated '' 10+C., I
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes �(No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Str-u�ture I Structure 2 Strucrrc 3
Identifier: ............. ..�....... C~
Freeboard (inches): 3 O Z J
5/00 10
❑ Spillway ❑ Yes ❑ No
Structure 4 Structure 5 Structure h
Continued on back

Facility Number: 3 j —3G Date of Inspection p. 1 ��� Printed on: 7/21/2000
Odor issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge Wor below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑ No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ❑ No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ❑ No
32. Do the flush tanks lack a submerged fill pipe or a peimanent/temporary cover? ❑ Yes ❑ No
Additional:
• omrnents: and/orDrawings:
:
��1
G�'1 `���4� ��j r!'��p''h�
�J�p/"_''�Ol��drPpYa�i
�Y"R� • C � TS �rij/�"'�i�IJ
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C1 rid
Cl ffy '-e:, ; G ! C1
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Z„ �y
S/00

Facility Number 31 36 Date of Visit: 2/16/2004 Time: 12:15
0 Not Operational 0 Below Threshold
® Permitted 0 Certified [3 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: ............
. County:l�lullulu..........................
Farm Name: WdlAlllil�l�IuARIrS..i�'.tl[JUL.......................... ...................... �.1A2...........
.....................................................
Owner Name: 1?1?iAtlllAl.............................. jaw.$ .......................................................... Phone No: 91Q:Z.9]Z..............................
Facility Contact: .............................................................................. Title Phone No
Mailing Address: 2.47..U1gb1w.Qo.d.B.ddgc.Road...................................................... 1?[.gUwrv..NYC......... .................................................. 28966.............
Onsite Representative: Integrator: mul[ by.]FAMAly..A:Arms..................
Certified Operator:lja.Y.ld.................................. rAU,JIA.............. ............................ Operator Certification Nuinber:Z29.0,$ .............................
Location of Farm:
Southeast of Chinquapin. On South side of SR 1827 just west of intersection with SR 1830.
0 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 34OF43 ° 55 u Longitude 1 77 43 OS k
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacitv Population Cattle Capacity Population
❑ Wean to Feeder
® Feeder to Finish
6120
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 6,120
Total SSLW 826,200
Number of Lagoons 3 ❑ Subsurface Drains Present ❑ Lagoon Area I0 Spray Field Area
Holding Ponds I Solid Traps I0 No Liquid Waste Management System
Dischar2cs & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: []Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure t Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ............. hack ............. ..old............... .. ..new.........................................................................................................................
Freeboard (inches): 23 20 30
5100 Continued on back

` Facility Number: 31-36 Date of inspection 2/16/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ' ❑ Yes ❑ No
S. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste Al2RIication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
LJ No violations or deficiencies were noted during this visit. You will receive no further
correspondence about this visit.
1"indoin
omments refer:to uestion # Ex lain any YES answers_and/or gny recoiifinendat�ons or-any_othe_r-coni ts:
( q ) :._ P
_ W
e drawings of iacihty tg betier expla�n:s�tuatioas. (use additional pages as,necessary) -
Freeboard check. No one on site, read markers and left site.
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Reviewer/Inspector Name Greer McVickcr
Reviewer/Inspector Signature: Date: 5100

Faetlity Number: 31-36 Date of Inspection 2/16/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ❑ No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ❑ No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ❑ No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
�Add�tiona omments and/or Drawings =
5/00

;. Division of Soil an&Water-Conservahon _'Operation Review
D:Division of Sail and Water Cflnservahon;-,Compliance Inspecttan
gDiyisiot: of Water Quality Compliance Inspection
- -"Other. Agency- Operation Review
19 Routine 0 Complaint 0 Follow-up of DWQ inspection Follow-up of DSWC review 0 Other
Facility Number 3f 3 , t)atc of Inspection (�I �D _:1 [ Time of Inspection �24 hr. (hh:mm)
Permitted 0 Certified Q Conditionally Certified © Registered [] Not O erational Date Last Operated:
t/V � II ctV✓, JZ,,,ts, 3' - n, S ner County- Farm Name: ............................................."........--..--��..--". ............... y- . .Z?. .firl .............................
Owner Name:..... .............. ).3�.0 �5!^'L........`�6t: y!!ZP'' ................. Phone No: ..........
............................................................................
Facility Contact: ........................................".._ .: Title:.................... .... Phone No:...............
:Flailing Address:..................................................................................................................................... ..........................
Onsite Representative: ,. .?. � t GL w y+�cS �. a V ; d Nn.n0 Integrator:.... M. !1 ��!k.�y. �`t""t � � 7...��o �' 6. r..........
Certified Operator:_.... DaM ......1 �-,qo t_Oi!1........ Operator Certification 1Number :..........................................
Location of Farm:
r...................................................................."........"....---..._._...---....._....._......._........_.........._......_............................_........................................................................._...._......_...._..,
Latitude 0 ° •4 Longitude • =' 11
DesignCurrent,
- Desi Currents ' n Design Current
Swine . _ Capacity
Population :1'ouEtry` .Capacity Population ' 'Cattle' Capacity Po ulationi
❑ Wean to Feeder
❑ Layer El Dairy
]EI
Feeder to Finish
Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
"" ❑ Farrow to Feeder
❑Other -
❑Farrow to Finish
= - = Total=Design Capacity ^
-- ts r
❑Gilts
_ -
" ❑ Boars
Tota1.SSLW
Number of:Lagoons-.
❑Subsurface Drains Present ❑ Lagoan Area ❑Spray Feld Area
HoldingPonds / Solid',Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Dischargc originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Docs discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I
Structure 2
Structure 3 Structure 4
Identifier: 0,0 J,4
06 216
P03/C
Freeboard (inches): ........Z.4
33 Z
fD
❑ Yes fdNo
❑ Yes 10 No
❑ Yes ® No
M/cj
❑ Yes No
0 Yes ❑ No
❑ Yes 2SNo
.91 Yes ❑ No
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes g No
Continued on back

Facilitv.Nurnber: Date of Inspection
74. Are there structures on -site which are not property addressed and/or managed through a waste management or
closure plan?
urmm
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenarice/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste application
10. Are there any buffers that need maintenance/improvement?
1 I. Is there evidence of over application?ll ❑ Excessive
/+Ponding ❑ PAN
12. Croptype 13ev-0kv�� 1►E*l
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes 99 No
❑ Yes ,91 No
❑ Yes MI No
❑ Yes P9 No
2g Yes ❑ No
❑ Yes No
Yes ❑ No
❑ Yes O No
86 Yes ❑ No
❑ Yes n No
❑ Yes 54No
❑ Yes %No
❑ Yes 2LNo
2'Yes ❑ No
❑ Yes KNo
❑ Yes EgNo
❑ Yes 0 No
5 es'3 J9Yes t1WNo
t I Z3I�1
❑ Yes 19 No
Ll: N RAatioiis:oi- deficiencies were noted• diWirig this:visit; - Y:oi1 wi1l•r&6irei iio futther
correspondence. ahhut. this .visit.
Cl Yes A[No
❑ Yes MNo
Comments (refer to, -question##):. Explarn;any YES answers and/or any recommendations'oesany other commetnts.
Use;drawings-of facility to better explarn`sttuations' (use-additional`pages as necessary)
;
-Tk>S inSlocc-}soh r,.1aS begv�t apt JV11 1�i Gnuf
2, was o b.-ft-r v¢ d )"I d r cll 9 qd i h W 04 c r G 0 4r-re 4 Ctrs
Pi ct, �rci�hl 'ry4o
sa local �hqt B►YI [06,/19 q bilge )ead;T
LvgSrn �edqwu�nd c fGLt:q ln&d vO d "�" 1 ttf eI ul1CfL1 i.c dG✓`Ct G>��
In � k LAB e. ! he Lvne, {�e c►�kerel� �1 G�i+r- , a'qd �k✓e�lo e�Ted
Gourse L-jg4er 9va14 sarmr1CJr gkid' �,r-4Ures (,� ere 4 -en F-nnr►�I.e.r
v (,Ots aAvisee( 40 F'ail1GJ- Lens -e -Anal LVI-< S��il' 4-R-kd114q ;jq atfainO'9[
Reviewer/Inspector Name l; ;� o n e �y�r1 j '1 �, / _ :` (°1 !0Oe
^3
Reviewer/Inspector Signature. T Ito Date:
3/23/99
1

!-1
Facility.Number: - [late of Inspection
.9,
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
E4 Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes Cg No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes No
31- Do the animals feed storage bins fail to have appropriate cover?
❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
Yes ❑ No
'Additional Comments- or ravings
24-OP -P) of ;4r-„ a+'up( p�4ce i+ �CtG� 41te l et�vo#%- Glean Vr
WC-S 6e vv yt a vt 4,0 "nos, n ; .19 1 f 12-,nlq -q
It, Lqgoon 3JG �;AmJcL be- loweeeA is, ni nes�ons:
bie
ID. Fa.^—ler' �nd.Ca 4co( 4�f �o►vte w--eVgots it, -a�Gr f>a4I, whE�
Spray;iA9 - Aisp� fwo 9vnqee p4 jed ou4 need req y -lo
irrt,9c�c- TLt&s4 jvns q,�e vl�e� ou� -ate ���1�9�q4 r'
ve
svr'e
�-J� � S� r�� �► � ld - e 4e Ytte,trta r r► �d,e ! v��-c � v-f�ers
13, �r�►c� ?�3J ��c�� Z �= T3��^�U t ��y /Snti�t� Grain ;y. F)ezkA
�v-�- i� Used for row GroiOs �rae_�' /794 Z T-ie,Id5 4 � 5 fire,
��� vd�; �� y l J alb ��� �'�, i►, �vl�n bv� hQ Gvtor c vr1''Cn-H
in ��eEt- Gr��os �es; cc�-cd ih e ]car c 1 s
y �,� s�loicld M��� r p
P1�,n-led rn �`;eld . : Also.) q jr -F►e(ds
nr roe**), otos OP T;elogs +�qi r-ec,QjVc wc-s4e 4�plica+;1::41 -07oLt1d 6e,
1n 4he f�r�'r F:e41 Was-rRe j��grt .
l8► Ge-�' cof)es o-f la oor, p�est'�n! �or �'�le -two o1dcs�' 1 q,r�ool�1
An"A kee � w-,4 /1'0Gor`G�-
22. Gwroe� � ; ►-ZA +0 nod':{ T[.r1Q of erne-[ cnG s;-Ft1a � ray, as
re a, I r ed b GeVI-y""a l Pe r o ; f r11, i AC, 44 6e ; r re-'e. r-`e a
;j- tfereej'be) Above undz-- "'I".
3/23/99

D Division of Sail and=Water Conseevation Operation Review .e T ` r
' 0.DEveson nWyosK�. trmSpec on
opace
t z
h r Division of'W4tke Qu`41ity ,.Co"lianCeaDS[ieCt1Q17
'13Other
A enc ' O eraboiiRefiew - $� - s
,
.>. . .. -
0 Routine O Complaint O Follow-up of DWQ ins ection Q Follow -tip of DSWC review Other
Facility Number Date of Inspection
Time of Inspection 24 hr. (hh:mm)
© Permitted ©C,�.i ert4 ified Conditionally Certified 0 03 Registered Not Operational Date Last Operated: --,---,--
Farm Name: ... -j�+i..1.Q.m---- mm1,_.1.�.-...Jraws ............................... .-.. County: ..... ..- ... ...DM.V.f.(.1M.n'M.—M—M.......................
Owner Name: .................. .. Phone No: --. .... ...--...
FacilityContact: ........................................................................ Title: ...-..-.......................... ........-.......... -- ....... .-- Phone No: -..................................................
MailingAddress: ..................................... .... ............................................................................-............... ..... .................. ........................... ................... ..........................
Onsite Representative:........................................................................................................... Integrator: .............[..I...L......-.................................-..-......
Certified Operator:................................................................................. ........-......... Operator Certification Number:...........-..............................
Location of Farm:
Latitude �� �� ��* Longitude
Design Current - Design Current Design _Current ;
Swine Capacity Population Poeiltry_, , r Ca achy Population Cattle Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts t
❑ Boars
❑ Layer ❑ Dairy
❑ Non -Layer ❑Non -Dairy
❑ Other
__ Total Design Capactty j[
Total SSLW l
Dischar .es & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
❑ Yes
❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify'DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated flow in gal/min'!
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
❑ No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes
❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Yes
❑ No
Structure I Structure Structure 3 Structure 4 Structure 5
Identifier: OoAa �'a,r" oveto)
Structure 6
r /
#r & 2V' '7 °QA t% 413 0, �,1 t
... Freeboard (inches): .................................................................................•--............. .......................................................................... ...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
❑ No
seepage, etc.)
3/23/99 Continued on
back

F2(cility umber: — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
T Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12, Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15, Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Pail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21, Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25, Were any additional problems noted which cause noncompliance of the Certified AWMP?
N . Whtigris ;oi: deficiencies were noted• di.uring this:visit: - Yotr will •reeeiye iio Further
• C ... Sponc eitce. abouf this visit
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
[]Yes ❑ No
Coiiments (refer toquestlon #)Explaiii%anpPYES answers and/or any recommendations ocan other comments
;.
y
UseArawin of facility to better;eatplam situations (use additional wages as necessary)
_.. d: n, W _e.
aon #z (brm� rnusf �be .inlvytta�i�Z{� .
as
Nr
Reviewer/Inspector �
Nam' 1 P $.,
Reviewer/Inspector Signature: (/�i ` Date:
Ot0 31'�" — 3 5,0 i 0 3123/99

Lagoon Duke Inspection Report
Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
t)2 t ,dr04 f� S
rC./ 1 15 OJT fes �PCr%U2 in P Scc In1 n r
% r Itr"ram 1 c �..�� �7Y 7JS
a Names of Inspectors
e- Vrckb*"—
Structural Height, Feet 44 Freeboard, Feet
Lagoon Surface Area, Acres c- Top Width, Feet
Upstream Slope ,xH:1 V rS � 1 Downstream Slope, xH:1 V
Embankment Sliding? Yes 9< No
(Check One, Describe if Yes)
I
Seepage?
_Y(—Yes No_ - . cr C)S S r�
(Check One, Describe if Yes)
Sla, `1
ry e c
-e ,
Erosion?
Yes_ No
(Check One, Describe if Yes)
Condition of
S n t.✓ Sy ^�-�
�� e
a S
Vegetative Cover
(Grass, Trees)
Did Dik Ove op�
Yes No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? Yes No
Engineering Study Needed?
—)( —Yes ,�R—NQ• /) c7 4! 7 u
I t/ e
d; T TO
?a,..i Spv
cr%d gel �,
o-
Is Dam Jurisdictional to the
Dam Lawof1967? Yes
No
##Safety
l n
IQ-C
Other Comments
I IS
).e,
}
ec �rAr
�Cr e, 4f'Jv
b
+✓ v
n� ��� a
vPT
v,
P fl

rM
Lagoon Dike Inspection Report
Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
Structural Height, Feet
Lagoon Surface Area, Acres
Upstream Slope,xH.IV
Embankment Sliding?
(Check One, Describe if Yes)
_�✓ r, f 1 C•� ti G�y�� G r� 31- J C
e
1tJ1�
sf �GC Top Width, Feet
L Downstream Slope, xH: IV 2l �t1 e
s pn� dyr.-
--)-L—Yes No e I �,- C, 1
Names of Inspectors
Freeboard, Feet
Seepage? Yes No e
(Check One, Describe if Yes) j
Grd
Erosion? Yes No 1n �e L L1�4 C
(Check One, Describe if Yes) 1 , f
Condition of eqc> C), C v x
Vegetative Cover r
(Grass, Trees) A D T ,r�
Did Dike Overtop? Ye No If Ye Depth of Overtopping, Feet
Follow Up Inspection Needed? _ L Yes No C a r r? Ct q—,rD (;,10 "
a�
Engineering Study Needed. 74 Yes N(z- !�' y
a r,.C, w�� 5 �d " �lr o
Is Dam Jurisdictional to the Dam Safety Law of 1967? Yes No 0j,/ eu e---
Other Comments Y 149 r-�`i 0 �� P P _`� 01r, r j
�C
ej Ao c ce —
.k-or �6w/ � ^ nA�,�r - �dej
ev
C�
ape
e--, C7 u'— -)

.__�_._____
Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
Structural Height, Feet
Lagoon Surface Area, Acres
Upstream Slope,xH:1V
Lagoon Dike Inspection Report 30
J
p G
Names of Inspectors CA�_W 0 �
c_ LI v! Ck P�
U _s 'X Freeboard, Feet
�V �;ee kp Width, Feet
%. 1 T, Downstream Slope, xH: IV
Embankment Sliding? Yes�No
(Check One, Describe if Yes)
02.6 /l
l _
Seepage? Yes _No_ _ .L,,�J g Gi ]VQu r 5 46 h�
(Check One, Describe if Yes) ] f ] r
Erosion? Yes No
(Check One, Describe if Yes)
Condition of
Vegetative Cover
(Grass, Trees)
D' Dike Overtop? Yes No If Yes, Depth of Overtopping, Feet
cv ro �- �pp� c, 8✓cro� r n
Follow -Up Inspection Needed? Yes No t LC-S A ee A 5 t'o i ou v rP
CSpG5e-
Engineering Study Needed? Yes No
Is Dam Jurisdictional to the Dam Safety Law of 1967? Yes . No
Lf �
Other Comments 4 Gj o
a W I C /7 CC C.
n, , A—

t�- ��
`if
n

a; :[3 Division of Soil and Water Conservateon Operation Review hY
w =D Division of Soil and.Water Conservation . <Comiphaince Inspection -
W 1 D&Ision of Water Quality Compliance Inspection r
-` 13 Other Agency. Operation Review
>_ L
Q Routine Q Complaint Q Follow-up of DWQ inspection Q Follow -tip of DSWC review 00ther
Facility Number Date of Inspection
Time of Inspection 1 Q 124 hr. (hh:mm)
Permitted © Certified © Conditionally Certified 13 Registered JE3 Not Operational Date Last Operated:
w',��1 ........ '..
Farm Name: .............................. ..... ...................... .... County:....tA�.1'�..............
OwnerName:..............................................:........................................................................... Phone No: ...............-............ I ................. I ......
.. ......
FacilityContact: .Title:................................................................ Phone No: ...................................................
Mailing Address: .........
.........................................................................................................................................:......1................................. ..........................
Onsite Representative: .................................................................................. Integrator:....
Certified Operator: .................................................................. ....................... Operator Certification Number:..........................................
.
Location of Farm:
........................................................................................................................................................................................................................................................ .
Latitude 0 ° - Longitude 0 4 44
Design CurrenV, _ Deesign Ctt`rreut Design Current = "
=Swine Capacity Population Poultry , Population_- .Catte- Capacity Po ulati_on
❑
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
�Number_of Lagoons_ - ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding —Ponds/ Solid Traps 10 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑Yes ❑ No
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier:
Freeboard(inches): .......... ........... ..................... ............. �,,,,1................ ................................... ......................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
3/23/99 Continued on back
�Number_of Lagoons_ - ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding —Ponds/ Solid Traps 10 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑Yes ❑ No
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier:
Freeboard(inches): .......... ........... ..................... ............. �,,,,1................ ................................... ......................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
3/23/99 Continued on back

Facility Number: — Date of inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste jXUplication
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Rectuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24- Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
viol"atioris'0 deiicier�cies "re i►,Qfed• during �his:visit' - You will -receive Oo further
rorrespondeMe. aXiout this visit_
Coriiiilents (refer to Tqueshon #) Explali; any YES answers and/or any recoinmendahons or -any oilier comments
Ilse drawings of"facility to better"explatn sttaatians {use additional` pages as necessary)
r ,Llf
-
�,.�
3/23/99

Permitted E Certified p Conditionally Certified p Registered
Date Last Operated:
Farm Name: 1N.ilLiam..James.Farm............................................... .................................. County: Duplin WIRO
OwnerName: W..illiam.M ........................... dames.......................................................... Phone No: 9.10-285-.2912 ..........................................................
FacilityContact: ........................................................... ...Title: ... Phone No: ...................:.............................................................................................................
Mailing Address: 247B..Lightw.ond.Br1dge.RQad....................................................... Wallaca.Ac ........................................................... Z8.466 ..............
Onsite Representative: W.illiam.JamjL%.D.avid.Brannon....................................... Integrator: .i!'lurphy...Fatndy.1arms......................................
CertifiedOperator: ..................................................
Location of Farm:
Latitude ®•®6 ©41
Design Cu
Swine,Capacity-- Popi
❑ Wean to Feeder
® reeder to tnjs
p Farrow to can
❑ Farrow to Fee(er
❑ Farrow to Finis
❑ Gilts
p Boars
Operator Certification Number:..........
Longitude ©•
ri es gn -"urrent�---._­Designf Cur
Poultry Capacity Population Cattle.
Capacity To ' I
- � o_ Dairy
'; ❑Non -Dairy
❑ Other ; ` -
Tota1 Design Capacity 6,120
Total SSLW 826,200
p ayer
❑ Non -Layer
Number pf Lagoons 3 F ❑ u sur ace in
s Present ❑ Lagoon rea p pray ie rea Holding Ponds...;/ Sohd:Traps 0 - ❑ o Liquid aste Management System
llischarp,es &Stream Impacts
1. Is any discharge observed from any part of the operation? [3 Yes p No
Discharge originated at: p Lagoon ❑Spray Field p Other
a. If discharge is observed, was the conveyance man-made? p Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) [3 Yes p No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) [3 Yes p No
2. Is there evidence of past discharge from any part of the operation? p Yes p No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? [3 Yes p No
Waste Collection &Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑Spillway [3 Yes p No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
.......................................................................................................................................................................................................................
Freeboard(inches): ...........................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑Yes p No
seepage, etc.)
3/23/99 Continued on back

Facility Number: 31-36 Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
p No
(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?
p Yes
13 No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
p Yes
p No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
p Yes
p No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? p Excessive Ponding p PAN
p Yes
p No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
p Yes
p No
14. a) Does the facility lack adequate acreage for land application?
p Yes
❑ No
b) Does the facility need a wettable acre determination?
p Yes
❑ No
c) This facility is pended for a wettable acre determination?
p Yes
p No
15. Does the receiving crop need improvement?
p Yes
p No
16. Is there a lack of adequate waste application equipment?
p Yes
p No
Required Records _& Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
p Yes
p No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
p Yes
p No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample.reports)
p Yes
p No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
p Yes
p No
21. Did the facility fail to have a actively certified operator in charge?
p Yes
p No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application)
13 Yes
p No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
p Yes
p No
24. Does facility require a follow-up visit by same agency?
13 Yes
p No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
13 Yes
❑ No
CY N�:vititatioins:or �deficieneies.wei'e gated dur_ing.!" .visit.:Youvill receive pa further -
ir6fr6OO rlidek about this:visit;....::.:::.....:::::..:..::::..... .
rian Wrenn and 1 met with Mr. James and Mr. Brannon to follow-up on the: discharge that was discovered during the 3.1/19/99 ,; A�
inspection. Mr. James and Mr. Brannon had pumped the waste.that was standing in the ditch during the"previous inspection into the
iagoon,as was asked of them. Brian and I followed the unnamed tributary from the point where waste .first .entered :itto the point
here the unnamed tributary became contiguous with a blue line stream
Reviewer/Inspector Name !Sto©ewalLMathts 77
-_ _ e_.
Reviewer/Inspector Signature: Date:

Lagoon Dike Inspection Report
Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and -Telephone Number
Date of Inspection
t�e < kT e,S s .n o iv toy JS
AX
Names of Inspectors 6;1,�),ti01
Structural Height, Feet 44 Freeboard, Feet
Lagoon Surface Area, Acres E'er Top Width, Feet 0/
—� !�
Upstream Slope,xH:1 V � Y � Downstream Slope, xH:1 V
Embankment Sliding? Yes P�, No
(Check One, Describe if Yes)
l
Seepage? _Yes _
(Check One, Describe if Yes)
esa, �
No- -1%C.r po�-Sr� e. YJ,kt G.l!5: l
Ac �Jo Q.,- (9 �r, f,,V-e G
Erosion? Yes No
(Check One, Describe if Yes)
Condition of
Vegetative Cover
(Grass, Trees)
flit � 1) 4313 J &1'e �/`0 1S
Did Dike,Ove op? , Yes No If Yes, Depth of Overtopping, Feet
7191
Follow -Up Inspection Needed? Yes No �}
Engineering Study Needed? Yes .�-Na Y U a, �U
>C Spo�S
Is Dam Jurisdictional to the Dam Safety Law of 1467? Yes No
Other Comments 1--1 1 S ) I
1f r ec v b 1 U v
I -k A PC V P, P V PVIP

V
R

L, �A 6 Oo,�L) 14)--
Lagoon Dike Inspection Report
Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
Structural Height, Feet.
Lagoon Surface Area, Acres
Upstream S1ope,xH:1V
Embankment Sliding?
(Check One, Describe if Yes)
E
Names of Inspectors C1` /v 0
Freeboard, Feet 24D
SC �Gc-1� Top Width, Feet
Downstream Slope, xH:1V of Le
1kS'(OP-'- ow'--
e) j� Yes No - 4-e- t , �1 C r V
Seepage? Yes No
(Check One, Describe if Yes) l - (�
Erosion? 7 - Yes No �, KC E„te
(Check One, Describe if Yes)
elt G1 <<e
Condition of i %4t2b1� {v
Vegetative Cover I
(Grass, Trees) A D l e G
Did Dike Overtop? Ye No If Ye Depth of Overtopping, Feet
Ojev
Follow -Up Inspection Needed? ,L Yes No C D r r t C� e CDC ;,)0
Engineering Study Needed? 7C Yes
Is Dam Jurisdictional to the Dam Safety Law of 1967?
Other Comments Y! p+, � L I e I
�;)(e �Pjv,-r 5
0,0 1 r,- )Act f�,k
D_
es.
-NQ� oej �`v }opl� PlOSra `I y
Yes No �Oir/fd t�
0
l
eJ eve? -N lIV,
Xj
a
e--, C) LC— 7

R
I
a ---1 .
Jpq—

-�____... a--. __••-�...i'aX .-?..�..�=. ���f. ;.=.. r..a.�:�_,.:�'�.._.—__—'-__..._. __�.,—.�__�_. __`. ___..--r -... .y— atc. ____.. �.. ._..��5 ._sue... �..._ ._.. ._-..._-��_�.:. ...... :......
I ! t- 14#6 WN A'
a }
Lagoon Dike Inspection Report
Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
Structural Height, Feet
Lagoon Surface Area, Acres
Upstream Slope,xH:IV
Names of Inspectors 0
C_LI1C�P/
f
/�, Freeboard, Feet
it Top Width, Feet
1 Downstream Slope, xH:l V
Embankment Sliding? Yes No
(Check One, Describe if Yes)
Seepage? Yes _ P.,-5 Jc) h41-1
(Check One, Describe if Yes) } % r
�t�CQ kse t
Erosion? Yes No
(Check One, Describe if Yes)
Condition of [ o o d
Vegetative Cover
(Grass, Trees) /D''d Dike Overtop? Yes A No If Yes, Depth of Overtopping, Feet
�i . ) /,D T APn�� -� L+ aatr 1 "(
Follow -Up Inspection Needed? Yes No LGS A ,-e A s �o tic, — L tP
CSf <_ PG5c !
Engineering Study Needed? Yes No
Is Dam Jurisdictional to the Dam Safety Law of 1967? Yes No
r �
Other Comments _ S O'_� C� c� d. 1(e kJ- �l
/')l l A

I%

❑ DSWC Animal Feedlot bpet.AUo .,ReV iew r ti
A� ®DWQ�AnI<mal Feedlot Operatlon� S1te Inspechan � � `� � �� � `�
Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review Q Other
Date of Inspection 3 q
Facility Number
Time of inspection 24 hr. (hh:mm)
Total Time (in fraction of hours ^'
Farm Status: Registered []Applied for Permit (ex:1.25 for 1 hr IS min)) Spent on Review-J
❑ Certified ❑ Permitted or Inspection includes travel andprocessing)
❑ Not Operational Date Last Operated:
Farm Name: .._.._.......
Land Owner Name: ..... ..... .........._
Facility Conctact:
Title:
County:. s_ �_ ...._ .........._ ...... 1.r
Phone No: �..la! ...z .�. z l..Z . �......._ .
Phone No:
Mailing Address: _.4 �.....,c�ar� Y� ......�
Onsite Representative:.. -----_....__.... �... _ . _.
Certified Operator: _.. ....._ .................__...... _ . _ .., Operator Certification Number: 1 �.� ....._. ......_... S ....
Location of Farm:
Latitude EEII•EV5�_T 55 Longitude• ©°
Tyne of Operation and Design Canacitv
�. DesignGSirrent Design CurrentDes�gn' Current
Sw�tte Ca aci P© ulahon Poultry F �Cs aci hPo ulatiow' M �Ca aci y >Pa6a! tidn .., s-
F= ❑ Wean to Feeder ❑ La er t4 ❑ Dairy
Feeder to Finish L" ❑ Non -Layer ❑ Non-Dairy
Farrow to Wean �r
Farrow to Feeder 'T©tal Design Capacity �s
Farrow to Finish o
M.. ._ . ........ T t 1 LW L
M o S
,dx' .aP K%fie
❑ Other r v a
e Hof G goar�s I H d g Pontl Z � ��
�
❑Subsurface DrainsPresent -
Lagoon Area � ❑ pray Field Area r
❑ S
General
I. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water`? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/97 maintenance/improvement?
❑ Yes ER No
❑ Yes M No
❑ Yes ER No
❑ Yes ® No
❑ Yes
® No
❑ Yes
R1 No
❑ Yes
®No
❑ Yes
M No
Continued
on back

Facility Number . ,� �...... •—....„
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes CK No
7. Did the facility fail to have a certified operator in responsible charge?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons agd/or Folding Pond
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure I Structure 2 Structure 3
10. Is seepage observed from any of the structures?
Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-I2 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Afiplication
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type : ........ ...."34
❑ Yes ® No
❑ Yes 4 No
❑ Yes 19 No
Structure 5 Structure 6
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for Iand application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
For Certified Eacilitie5 Qnly
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes [&No
® Yes ❑ No
R,Yes ❑ No
❑ Yes §[ No
❑ Yes [.No
❑ Yes
® No
❑ Yes
®No
❑ Yes
® No
❑ Yes
ja No
❑ Yes
IN No
❑ Yes
K No
❑ Yes ® No
❑ Yes ® No
[ Yes ❑ No
Comments (refer to"ques. tion #r7 "Explain any YES answers andlor;any recomrriendatidns or any other coniments�:` us.
Use diawings-of facility to iietter explain situations ,(use aadrhonal pages as necessary} lad �►
1 j •� i2 . S o w. e s 1: In Y v v--� 2.r w t �+ . e t�.-L .....n a�� E c� �, t1 A .. � Vi 14,
Vp" o
T1, : S o�-�-�� S LPL la 2 4i r l 4. w a d' i o ,..V a I
b a- L o-� o ,., v.►a l L S 1^ 0 t-rX b -e- r ems►--�q 4 t� -d•
Z,'
i�..,
�
L y 5 L
� `L wb S -� 0-V O V-Q^r O-U v- Q I L 6 `CV_Q-j Q"VV'6 v "'- ,
A l s o, lt-c S v r-e 1 try -v nit c.v ,r v- e.ti t, tr S o
a
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
cc: Division of Water duality, Water Quality Section, Facility Assessment Unit 4/30197

Site Requires Immediate Attention:
Facility No. 31 `
DIVISION OF ENVIRONMENTAL MANAGEMENT
j ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 4 , 1995
Time: 1
Farm Name/Owner: 2+^1 --:5 -Zrh of
Mailing Address: 24-72 L�ctuy-md �J., n Kc L - W Zj [-.Ce Off- Z8
County:
Integrator. HOrl2bU Phone: 9V)_ 2rQ_9Q J
On Site Representative: I`'i1 _ e Sho-17t'" Phone:
Physical Address/Location: NC- 4--( , t*R5 r'Gh f og S a 19Z7 4t) Pi,j 4Dcf ,
PC- M; - 2rM �14. 00\ r�rhf'
Type of Operation: Swine JL,-" Poultry Cattle f3'1 14-ay-
Design Capacity: G2 ( 2O Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 34- 4- 22, SS.(P'Z Longitude: '20 ' U 5X+Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon hav sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes r No Actual Freeboard: 3 Ft. � Inches
Was any seepage observed from the oon(s)? Yes o I o Was any erosion observed? es r No
Is adequate land available for spray? Yes r No Is the cover crop adequate? Yes r o
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings?6r No
100 Feet from Wells? Yes or No?
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes o No
i Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or 60? If Yes, Please Explain.
►:
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No ?
Additional Comments: it1 o GIl S1 U-)
? SG 2e v
L . L eAAA'5
Inspector Name
AfQL - - -
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

Site Requires Immediate Attention:
} Facility No. �31-3&—
DIVISION OF ENVIRONMENTAL MANAGEMENT
i� ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
• Time: J
Farm Name/Owns
Mailing Address:
County:.e
Integrator.
r.
On Site Representative: ;�� e 5
Physical Address/Location: SZrnx- -4 C
3
Phone:
Phone: 9to—
Type of Operation: Swine Poultry Cattle F7� 5 -a--
Design Capacity: Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: +' ' ¢ 3' ¢ i. " Longitude: ° 4 Z9 Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Gor No Actual Freeboard: 2 Ft 0 Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? fe,�)r No 3
�-
SIs adequate land available for spray? e or No Is the cover crop adequate? Ye r No
Crop(s) being utilized: Z
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? es r No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or&
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes o CINO)
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes 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)? Yes o No k�pf ccl� S
Additional Comments: H t Me e b5i Lr 0n 5 6,oO . - o f ar--
Inspector Name
4RL=__
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

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