310043_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

Wa ter Resources
ENVIRONMENTAL DUALITY
July 8, 2016
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Maxwell Foods LLC
Jordan Farm
PO Box 10009
Goldsboro, NC27532-7532
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secretary
S. JAY ZIMMERMAN
RECEIVED/NMENRIMWR Drrecrar
JUL 2 2016
Water Quality Regional
. Operations Section
Wilmington Regional Office
Subject: Notice of Deficiency
Jordan Farm
Permit Number AWS310043
Duplin County
Dear Permittee,
As of this date, our records indicate that the above -referenced permit issued to your facility has
overdue fees. It is both a condition of your permit and required by Rule I SA NCAC 2T .0105(e) (2) to pay
the annual administering and compliance fee within thirty (30) days of being billed by this Division.
The following invoices are outstanding:
Invoice Number
Fee for Years
Due Date
Outstanding Fee ($
. 2015PR003777
2013
5/24/2015
180
20.15PR004850
2014
6/7/2015
180
Failure to pay the fee accordingly may result in the Division initiating enforcement actions, to
include the assessment of civil penalties. Failure to comply with conditions in a permit may result in a
recommendation of enforcement action, to the Director of the Division of Water Resources who may issue
a civil penalty assessment of not more that twenty-five thousand ($25,000) dollars against any "person"
who violates or fails to act in accordance with the terms, conditions, or requirements of a permit under
authority of G.S. 143-215.6A. Therefore, it is imperative that you submit the appropriate fee as requested
within thirty (30) days of this Notice of Deficiency.
Please remit the payment, made payable to the North Carolina Department of Environmental
Quality (NCDEQ}, in the above amount. Please include Permit Number on your check and mail this
payment to:
Division of Water Resources — Budget Office
Attn: Teresa Revis
1617 Mail Service Center
Raleigh, NC 27699-1617
Phone: [phone]
-contd.-
State of North Carolina I Envirodrnental Quality I Water Resources/Water Quality Regional Operations
1636 Mail service Center j Raleigh, North Carolina 27699-1636
919 907 6464

If you ,have any .questions concerning this Notice, please contact Animal Feeding Operations
Program staff at [phone].
Sincerely,
aJ
Debra J. Watts, Supervisor
Animal Feeding Operation, and
Ground Water Protection Branch
cc: Wilmington Regional Office, Water Quality Regional Operations Section
WQROS Central File (Permit No AWS310043)

AN
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Maxwell Foods Inc
Jordan Farm
PO Box 10009
Goldsboro, NC 27532
Dear Maxwell Foods Inc:
John E. Skvarla, III
Secretary
December 30, 2014
Subject: Certificate of Coverage No. AWS310043
Jordan Farm
Swine Waste Collection, Treatment,
Storage and Application System
Duplin County
In accordance with your Decemeer 22, 2014 request for a change in operation type without exceeding the
permitted steady state live weight, we are hereby forwarding to you this Certificate of Coverage (COC)
issued to Maxwell Foods Inc, authorizing the operation of the subject animal waste management system
in accordance with General Permit AWG100000.
This approval shall consist of the operation of this system including, but not limited to, the management
and land application of animal waste as specified in the facility's Certified Animal Waste Management
Plan (CAWMP) for Jordan Farm, located in Duplin County, with a swine animal capacity of no greater
than the following annual averages:
Wean to Finish: Feeder to Finish: 5760 Boar/Stud:
Wean to Feeder: Farrow to Wean: Gilts:
Farrow to Finish: harrow to Feeder: Other:
If this is a Farrow to Wean or Farrow to Feeder operation, there may be one boar for each 15 sows. Where
boars are unnecessary, they may be replaced by an equivalent number of sows. Any of the sows may be
replaced by gilts at a rate of 4 gilts for every 3 sows.
This COC shall be effective from the date of issuance until September 30, 2019, and shall hereby void
Certificate of Coverage Number AWS310043 dated October 1, 2014. Pursuant to this COC, you are
authorized and required to operate the system in'conformity with the conditions and limitations as
specified in the General Permit, the facility's CAWMP, and this COC. An adequate system for collecting
and maintaining the required monitoring data and operational information must be established for this
facility. Any increase in waste production greater than the certified design capacity or increase in number
of animals authorized by this COC (as provided above) will require a modification to the CAWMP and
this COC and must be completed prior to actual increase in either wastewater flow or number of animals.
Please read this COC and the enclosed State General Permit carefully. Please pav careful attention to the
record keeping and monitoring conditions in this permit. Record keeping forms are unchanged with this
General Permit. Please continue to use the same record keeping forms.
FC 1= EVE
1636 Mail Service Center, Raleigh, North Carolina 27599-1636
Phone: [phone] Internet: http:11www.ncdenr.gov/
An Equal Opporturity l Affirmative Adion Employer —"Jade in part oy recycled palper
i3Y:

If your Waste Utilization Plan (WUP) has been developed based on site -specific information, careful
evaluation of future samples is necessary. Should your records show that the current WUP is inaccurate
-you-will-need to -have -a new-WUP-developed.-
The issuance of this COC does not excuse the Permittee from the obligation to comply with all applicable
laws, rules, standards, and ordinances (local, state, and federal), nor does issuance of a COC to operate
under this permit convey any property rights in either real or personal property.
Per NRCS standards a I00-foot separation shall be maintained between water supply wells and any
lagoon, storage pond, or any wetted area of a spray field.
Please be advised that any violation of the terms and conditions specified in this COC, the General Permit
or the CAWMP may result in the revocation of this COC, or penalties in accordance with NCGS 143-
215.6A through 143-215.6C including civil penalties, criminal penalties, and injunctive relief.
If any parts, requirements, or limitations contained in this COC are unacceptable, you have the right to
apply for an individual permit by contacting.the Animal Feeding Operations Program for information on
this process. Unless such a request is made within 30 days, this COC shall be final and binding.
In accordance with Condition H.22 of the General Permit, waste application shall cease within four (4)
hours of the time that the National Weather Service issues a Hurricane Warning, Tropical Storm Warning,
or a Flood Watch associated with a tropical system for the county in which the facility is located. You
may find detailed watch/warning information for your county by calling the Newport/Morehead City, NC
National Weather Service office at [phone], or by visiting their website at:
hqp://www.weather.gov/mh
This facility is located in a county covered by our Wilmington Regional Office. The Regional Office staff
may be reached at 910-796-7215. If you need additional information concerning this COC or the General
Permit, please contact the Animal Feeding Operations Program staff at [phone].
Sincerely,
for Thomas A. Reeder
Director, Division of Water Resources
Enclosure (General Permit AWG100000)
cc: (Certificate of Coverage only for all ccs)
Wilrnirgtgn Regional Office, Water Quality Regional Operations Section
Duplin County Health Department
Duplin County Soil and Water Conservation District
WQROS Central Files (Permit No. AWS310043)
AFO Notebooks
Maxwell Foods Inc

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
January 9, 2009
Maxwell Foods, Inc.
Jordan Farm
P.O. Box 10009
Goldsboro, NC 27532
Subject:
Dear Maxwell Foods, Inc.:
0A N 12 1009
EY:
Certificate of Coverage No. AW S310043
Jordan Farm
Animal Waste Management System
Duplin County
In accordance with your request for facility name change received on January 7, 2009, we are hereby
forwarding to you this Certificate of Coverage (COC) issued to Maxwell Foods, Inc., authorizing the
operation of the subject animal waste management system in accordance with General Permit
AWG 100000.
This approval shall consist of the operation of this system including, but not limited to, the management
and land application of animal waste as specified in the facility's Certified Animal Waste Management
Plan (CAWMP) for the Jordan Farm, located in Duplin County, with an animal capacity of no greater
than the following swine annual averages:
Wean to Finish: 0 Feeder to Finish: 0 Boar/Stud: 0
Wean to Feeder: 25920 Farrow to Wean: 0 Gilts: 0
Farrow to Finish: 0 Farrow to Feeder: 0
If this is a Farrow to Wean or Farrow to Feeder operation, there may also be one boar for each 1S sows.
Where boars are unneccessary, they may be replaced by an equivalent number of sows. Any of the sows
may be replaced by gilts at a rate of 4 gilts for every 3 sows.
The COC shall be effective from the date of issuance until September 30, 2009 and replaces COC No.
AWS310043 dated July 1, 2007. You are required to continue conducting annual surveys of sludge
accumulation in all lagoons at your facility; the one-year extension in Condition 11119 does not apply.
Pursuant to this COC, you are authorized and required to operate the system in conformity with the
conditions and limitations as specified in the General Permit, the facility's CAWMP, and this COC. An
adequate system for collecting and maintaining the required monitoring data and operational information
must be established for this facility. Any increase in waste production greater than the certified design
capacity or increase in number of animals authorized by this COC (as provided above) will require a
modification to the CAWMP and this COC and must be completed prior to actual increase in either
wastewater flow or number of animals.
Please carefully read this COC and the enclosed State General Permit. Enclosed for your convenience is
a package containing the new and revised forms used for record keeping and reporting. Please pay
careful attention to the record keenine and monitorinn conditions in this hermit.
If your Waste Utilization Plan has been developed based on site -specific information, careful evaluation
of future samples is necessary. Should your records show that the current Waste Utilization Plan is
inaccurate you will need to have a new Waste Utilization Plan developed.
Aquifer Protection Section 1636 Mail Service Center
Internet: www,ncwaterguali!Y.00rg Location: 2728 Capital Boulevard
An Equal Opportunity/Affirmative Acton Employer— 50%Recyded110°% Post Consumer Paper
I Carolina
Natura*
Raleigh, NC 27699-1636 Telephone: [phone]
Raleigh, NC 27604 Fax l: [phone]
Fax 2: [phone]
Customer Service: [phone]

The issuance of this COC does not excuse the Permittee from the obligation to comply with all applicable
laws, rules, standards, and ordinances (local, state, and federal), nor does issuance of a COC to operate
under this permit convey any property rights in either real or personal property.
Upon abandonment or depopulation for a period of four years or more, the Permittee must submit
documentation to the Division demonstrating that all current NRCS standards are met prior to restocking
of the facility.
Per 15A NCAC 02T .0111(c) a compliance boundary is provided for the facility and no new water supply
wells shall be constructed within the compliance boundary., . Per NRCS, standards a 100-foot separation
shall be maintained between water supply wells and any lagoon, storage -pond, or any wetted area of a
spray field.
Per 15A NCAC 02T .1306, any containment basin, such as a lagoon or waste storage structure, shall
continue to be subject to the conditions and requirements of the facility's permit until closed to NRCS
standards and the permit is rescinded by the Division.
Please be advised that any violation of the terms and conditions specified in this COC, the General Permit
or the CAWMP may result in the revocation of this COC, or penalties in accordance with NCGS 143-
215.6A through 143-215.6C including civil penalties, criminal penalties, and injunctive relief.
If you wish to continue the activity permitted under the General Permit after the expiration date of the
General Permit, an application for renewal must be filed at least 180 days prior to expiration.
This COC is not automatically transferable. A name/ownership change application must be submitted to
the Division prior to a name change or change in ownership.
If any parts, requirements, or limitations contained in this COC are unacceptable, you have the right to
apply for an individual permit by contacting the staff member listed below for information on this
process. Unless such a request is made within 30 days, this COC shall be final and binding.
This facility is located in a county covered by our Wilmington Regional Office. The Regional Office
Aquifer Protection staff may be reached at 910-796-7215. If you need additional information concerning
this COC or the General Permit, please contact the Animal Feeding Operations Unit staff at (919) 733-
3221.
Sincerely,
for Coleen H. Sullins
Enclosures (General Permit, AWG 100000, Record Keeping and Reporting Package)
cc: (Certificate of Coverage only for all cc's)
Duplin County Health Department
Duplin County Soil and Water Conservation District
Wilmington Regional Office, Aquifer Protection Section
AFO Unit Central Files
'Permit File AWS310043

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water Quality
July 1, 2007 RECEIVED
Maxwell Foods Inc
Case Farm JUN S 6 2007
PO Box 10009
Goldsboro, NC 27532 BY:
Subject: Certificate of Coverage No. AWS310043
Case Farm
Animal Waste Management System
Duplin County
Dear Maxwell Foods Inc:
In accordance with your application received on 4-Jan-07, we are hereby forwarding to you this
Certificate of Coverage (COC) issued to Maxwell Foods Inc, authorizing the operation of the subject
animal waste management system in accordance with General Permit AWG100000.
This approval shall consist of the operation of this system including, but not limited to, the management
and land application of animal waste as specified in -the facility's Certified Animal Waste Management
Plan (CAWMP) for the Case Farm, located in Duplin County, with an animal capacity of no greater than
the following swine annual averages:
Wean to Finish: 0 Feeder to Finish: 0 Boar/Stud: 0
Wean to Feeder: 25920 Farrow to Wean: 0 Gilts: 0
Farrow to Finish: 0 Farrow to Feeder: 0
If this is a Farrow to Wean or Farrow to Feeder operation, there may also be one boar for each 15 sows.
Where boars are unneccessary, they may be replaced by an equivalent number of sows. Any of the sows
may be replaced by gilts at a rate of 4 gilts for every 3 sows
The COC shall be effective from the date of issuance until September 30, 2009 and replaces the NPDES
COC issued to this facility with an expiration date of July 1, 2007. You are required to continue
conducting annual surveys of sludge accumulation in all lagoons at your facility; the one-year extension
in Condition M.19 does not apply.
Pursuant to this COC, you are authorized and required to operate the system in conformity with the
conditions and limitations as specified in the General Permit, the facility's CAWMP, and this COC. An
adequate system for collecting and maintaining the required monitoring data and operational information
must be established for this facility. Any increase in waste production greater than the certified design
capacity or increase in number of animals authorized by this COC (as provided above) will require a
modification to the CAWMP and this COC and must be completed prior to actual increase in either
wastewater flow or number of animals.
Please carefully read this COC and the enclosed State General Permit. Enclosed for your convenience is
a package containing the new and revised forms used for record keeping and reporting. Please pay
careful attention to the record keeping and monitoring conditions in this permit.
Aquifer Protection Section 1636 Mail Service Center
Internet: www.newaterguality.org Ucation: 2728 Capital Boulevard
An Equal Opportun4lAffirmative Action Employer— 50% Recyded110% Post Consumer Paper
One
N""o�rtnhCarolina
dvaturgll
Raleigh, NC 27699-1636 Telephone: [phone]
Raleigh, NC 27604 Fax 1: [phone]
Fax 2: [phone]
Customer Service: [phone]

If your Waste Utilization Plan has been developed based on site -specific information, careful evaluation
of future samples is necessary. Should your records show that the current Waste Utilization Plan is
inaccurate you will need to have a new Waste Utilization Plan developed.
The issuance of this COC does not excuse the Permittee from the obligation to comply with all applicable
laws, rules,, standards,_ and ordinances (local, state, and federal), nor does issuance of a COC to operate
under this permit convey any property rights in either real or personal property.
Upon abandonment or depopulation for a period of four years or more, the Permittee must submit
documentation to the Division demonstrating that all current NRCS standards are met prior to restocking
, y
of the facility. t '.-° '
Per 15A NCAC 02T .0111(c) a compliance boundary is provided for the facility and no new water supply
wells shall be constructed within the compliance boundary. Per NRCS standards a 100-foot separation
shall be maintained between water supply wells and any lagoon, storage pond, or any wetted area of a
spray field.
Per 15A NCAC 02T .1306, any containment basin, such as a lagoon or waste storage structure, shall
continue to be subject to the conditions and requirements of the facility's permit until closed to NRCS
standards and the permit is rescinded by the Division.
Please be advised that any violation of the terms and conditions specified in this COC, the General Permit
or the CAWMP may result in the revocation of this COC, or penalties in accordance with NCGS 143-
215.6A through 143-215.6C including civil penalties, criminal penalties, and injunctive relief.
If you wish to continue the activity permitted under the General Permit after the expiration date of the
General Permit, an application for renewal must be filed at least 180 days prior to expiration.
This COC is not automatically transferable. A name/ownership change application must be submitted to
the Division prior to a name change or change in ownership.
If any parts, requirements, or limitations contained in this COC are unacceptable, you have the right to
apply for an individual permit by contacting the staff member listed below for information on this
process. Unless such a request is made within 30 days, this COC shall be final and binding.
This facility is located in a county covered by our Wilmington Regional Office. The Regional Office
Aquifer Protection staff maybe reached at 910-395'-3900. If you need additional information concerning
this COC or the General Permit, please contact the Animal Feeding Operations Unit staff at (919) 133-
3221.
Sincerely,
for Coleen H. Sullins
Enclosures (General Permit AWG100000, Record Keeping and Reporting Package)
cc: (Certificate of Coverage only for all cc's)
Duplin County Health Department
Duplin County Soil and Water Conservation District
Wilmington Regional Office, Aquifer Protection Section
AFO Unit Central Files
Permit File AW S310043

ANIMAL WASTE MANAGEMENT SYSTEM
OPERATOR IN CHARGE
DESIGNATION FORM
ANIMAL WASTE MANAGEMENT SYSTEM:
Case
Facility ID Number: 3143 County: DuPlin
OPERATOR IN CHARGE Rod Harvey Vinson
Home Mailing Address: 1441 Conner Lane
City: Kinston State: NC Zip: 28504
Certificate #: 26081 Social Security #: 239-39-3709
Work Phone: [phone]
SignaturZ�0�--
OWNER Maxwell Foods, Inc.
Mailing Address: PO Box 10009
State: NC Zip: 27532
Signature
Home Phone: [phone]
Date A.2�r- D 7
City: Goldsboro
Telephone #.- 919-778-3130
Date 2•bl-0
Please Mail to: WPCSOCC
Division of Water Quality
1618 Mail Service Center
Raleigh, NC 27699-1618 RECEI'VV-L'
:-Ed 2 8 2007

ANIMAL FACILITY ANNUAL CERTIFICATION FORM
Certificate of Coverage or Permit Number NCA231043 County Duplin
Facility Name (as shown on Certificate of Coverage or Permit)
Operator in Charge for this Facility
Case Farm
Kynwood Holland Certification # 16535
Year 2006
Land application of animal waste as allowed by the above permit occurred during the past calendar year
X YES NO. If NO, skip Part I and Part II and proceed to the certification. Also, if animal
waste was generated but not land applied, please attach an explanation on how the animal waste was handled.
Part I : Facility Information:
1. Total number of application Fields or pulls ^ (please check the appropriate box) in the
Certified Animal Waste Management Plan (CAWMP): 10
Total Useable Acres approved in the CAWMP:
36.08
2. Total number of application Fields or pulls u (please check the appropriate box) on which
land application occurred during the year: 9 Total Acres on which waste was applied 34.7
3. Total pounds of Plant Available Nitrogen (PAN) applied during the year for all application sites:
5.334.09
4. Total pounds of Plant Available Nitrogen (PAN) allowed to be land applied annually by the CAWMP and
the permit: 13,530
5. Estimated amount of total manure, litter and process wastewater sold or given to other persons and taken
off site during the year NIA tons or gallons
(please check the appropriate box)
Annual average number of animals by type at this facility during the previous year:
5,478
7. Largest and smallest number of animals by type at this facility at any one time during the previous year:
Largest 10,701
Smallest 2,066
(These numbers are for informational purposes only since the only permit limit on the number of ani
at the facility is the annual average numbers) RF,C91-V D
Facility's Integrator if applicable: NIA MAR O 2007
Part II: Facility Status:
IF THE ANSWER TO ANY STATEMENT BELOW IS "NO", PLEASE PROVIDE A WRITTEN
DESCRIPTION AS TO WHY THE FACILITY WAS NOT COMPLIANT, THE DATES OF ANY NON
COMPLIANCE, AND EXPLAIN CORRECTIVE ACTION TAKEN OR PROPOSED TO BE TAKEN TO
BRING THIS FACILITY BACK INTO COMPLIANCE
1. Only animal waste generated at this facility was applied to the permitted sites 0 Yes No
during the past calendar year.

ANIMAL FACILITY ANNUAL CERTIFICATION FORM
2. The facility was operated in such a way that there was no direct runoff of waste from
Yes
No
the facility (including the houses, lagoons/storage ponds and the application sites)
during the past calendar year.
3. There was no discharge of waste to surface water from this facility during the past
U Yes o
No
calendar year.
4. There was no freeboard violation in any lagoons or storage ponds at this facility during
0 Yes
No
the past calendar year.
5. There was no PAN application to any fields or crops at this facility greater than the
Yes
No
levels specified in this facility's CAWMP during the past calendar year.
6. Ali land application equipment was calibrated at least once during the past calendar
L ^ Yes
No
year.
_1
7. Sludge accumulation in all lagoons did not exceed the volume for which the lagoon
i�l Yes 0
No
was designed or reduce the lagoon's minimum treatment volume to less than the
volume for which the lagoon was designed.
8. A copy of the Annual Sludge Survey Form for this facility is attached to this
0 Yes
No
Certification.
9. Annual soils analysis were performed on each field receiving animal waste during the
Yes No
past calendar year.
10. Soil pH was maintained as specified in the permit during the past calendar Year?
0 Yes No
11. All required monitoring and reporting was performed in accordance with the facility's
Yes No
permit during the past calendar year.
12. All operations and maintenance requirements in the permit were complied with during
^• Yes No
the past calendar year or, in the case of a deviation, prior authorization was received
from the Division of Water Quality.
13. Crops as specified in the CAWMP were maintained during the past calendar year on
E Yes No
all sites receiving animal waste and the crops grown were removed in accordance with
_
the facility's permit.
14. All buffer requirements as specified on the permit and the CAWMP for this facility
Yes No
were maintained during each application of animal waste during the past calendar year.
I certify under penalty of law that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of
my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
-T?Z`;1DVNr
Permi a Name and Title (type or -print)
)nature Or Operator in Unar
( if different from permittee)
26 Ffe, 07
Date
Date

ANIMAL FACILITY ANNUAL CERTIFICATION FORM
Certificate of Coverage or Permit Number NCA231043
Facility Name (as shown on Certificate of Coverage or Permit)
County Duplin
Case Farm
Operator in Charge for this Facility Kynwood Holland Certification # 16535
Year 2005
Land application of animal waste as allowed by the above permit occurred during the past calendar year
X YES NO. If NO, skip Part I and Part II and proceed to the certification. Also, if animal
waste was generated but not land applied, please attach an explanation on how the animal waste was handled.
Part I : Facility Information:
Total number of application Fields or pulls (please check the appropriate box) in the
Certified Animal Waste Management Plan (CAWMP): 10
Total Useable Acres approved in the CAWMP:
36.08
2. Total number of application Fields or pulls (please check the appropriate box) on which
land application occurred during the year: 9 Total Acres on which waste was applied 34.7
3. Total pounds of Plant Available Nitrogen (PAN) applied during the year for all application sites:
5.121.49
4. Total pounds of Plant Available Nitrogen (PAN) allowed to be land applied annually by the CAWMP and
the permit: 13,530
5_ Estimated amount of total manure, litter and process wastewater sold or given to other persons and taken
off site during the year NIA tons 0 or gallons
(please check the appropriate box)
6. Annual average number of animals by type at this facility during the previous year:
6,082
7. Largest and smallest number of animals by type at this facility at any one time during the previous year:
Largest 10,745
Smallest 2,546
(These numbers are for informational purposes only since the only permit limit on the number of animals
at the facility is the annual average numbers)
8. Facility's Integrator if applicable: NIA
Part II: Facility Status:
IF THE ANSWER TO ANY STATEMENT BELOW IS "NO", PLEASE PROVIDE A WRITTEN
DESCRIPTION AS TO WHY THE FACILITY WAS NOT COMPLIANT, THE DATES OF ANY NON
COMPLIANCE, AND EXPLAIN CORRECTIVE ACTION TAKEN OR PROPOSED TO BE TAKEN TO
BRING THIS FACILITY BACK INTO COMPLIANCE
Only animal waste generated at this facility was applied to the permitted sites 0 Yes 0 No
during the past calendar year. RECEIVED
FEB 2 4 NO

ANIMAL FACILITY ANNUAL CERTIFICATION FORM
2. The facility was operated in such a way that there was no direct runoff of waste from
L ^ J Yes 0
No
the facility (including the houses, lagoons/storage ponds and the application sites)
during the past calendar year.
3. There was no discharge of waste to surface water from this facility during the past
U Yes
No
calendar year.
4. There was no freeboard violation in any lagoons or storage ponds at this facility during
0 Yes 0
No
the past calendar year.
5. There was no PAN application to any fields or crops at this facility greater than the
!� Yes 0
No
levels specified in this facility's CAWMP during the past calendar year.
6. All land application equipment was calibrated at least once during the past calendar
_J Yes
No
year.
7. Sludge accumulation in all lagoons did not exceed the volume for which the lagoon
Yes 0
No
was designed or reduce the lagoon's minimum treatment volume to less than the
volume for which the lagoon was designed.
8. A copy of the Annual Sludge Survey Form for this facility is attached to this
0 Yes 0
No
Certification.
9. Annual soils analysis were performed on each field receiving animal waste during the 0 Yes No
past calendar year.
10. Soil pH was maintained as specified in the permit during the past calendar Year?
Yes No
11. All required monitoring and reporting was performed in accordance with the facility's
0 Yes No
permit during the past calendar year.
12. All operations and maintenance requirements in the permit were complied with during
0 Yes 0 No
the past calendar year or, in the case of a deviation, prior authorization was received
from the Division of Water Quality.
13. Crops as specified in the CAWMP were maintained during the past calendar year on
0 Yes No
all sites receiving animal waste and the crops grown were removed in accordance with
the facility's permit.
14. All buffer requirements as specified on the permit and the CAWMP for this facility
L,.•^ Yes u No
were maintained during each application of animal waste during the past calendar year.
"I certify under penalty of law that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of
my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
Pervittee Name an itle (type or print) J
Ll�? &I `vs Lo
Signature of permittee Date
-k�� r V� I -�>—C'
Signature of Operator in Charge RECEIVED Date
' ( if different from permittee)
FEB 1 4 ZA

ANIMAL FACILITY ANNUAL
Certificate of Coverage or Permit Number NCA231043 _
Facility Name (as shown on Certificate of Coverage or Permit)
CERTIFICATION FORM
County Duplin _ Year 2004
Case Farm
Operator in Charge for this Facility Kynwood Holland Certification
Land application of animal waste as allowed by the above permit occurred during the past calendar
ar y 2 $ LI,US
X YES NO. If NO, skip Part I and Part II and proceed tote ce%tion. Also, if a
waste was generated but not land applied, please attach an explanation on how the animal waswas handled.
Part I : Facility Information:
1. Total number of application Fields or pulls (please check the appropriate box) in the
Certified Animal Waste Management Plan (CAWMP): 10
Total Useable Acres approved in the CAWMP:
36.08
2. Total number of application Fields or pulls 0(please check the appropriate box) on which
land application occurred during the year: 9 Total Acres on which waste was applied 34.7
3. Total pounds of Plant Available Nitrogen (PAN) applied during the year for all application sites:
5,068.67
4. Total pounds of Plant Available Nitrogen (PAN) allowed to be land applied annually by the CAWMP and
the permit: 13,530
5. Estimated amount of total manure, litter and process wastewater sold or given to other persons and taken
off site during the year NIA tons or gallons
(please check the appropriate box)
Annual average number of animals by type at this facility during the previous year:
4,197
Largest and smallest number of animals by type at this facility at any one time during the previous year:
Largest 1,604
Smallest 0
(These numbers are for informational purposes only since the only permit limit on the number of animals
at the facility is the annual average numbers)
8. Facility's Integrator if applicable: N/A
Part III: Facility Status:
IF THE ANSWER TO ANY STATEMENT BELOW IS "NO", PLEASE PROVIDE A WRITTEN
DESCRIPTION AS TO WHY THE FACILITY WAS NOT COMPLIANT, THE DATES OF ANY NON
COMPLIANCE, AND EXPLAIN CORRECTIVE ACTION TAKEN OR PROPOSED TO BE TAKEN TO
BRING THIS FACILITY BACK INTO COMPLIANCE
1. Only animal waste generated at this facility was applied to the permitted sites 0 Yes No
during the past calendar year.

ANIMAL FACILITY ANNUAL CERTIFICATION FORM
2. The facility was operated in such a way that there was no direct runoff of waste from
0 Yes 0
No
the facility (including the houses, lagoons/storage ponds and the application sites)
during the past calendar year.
3. There was no discharge of waste to surface water from this facility during the past
0 Yes
No
calendar year.
4. There was no freeboard violation in any lagoons or storage ponds at this facility during
0 Yes
No
the past calendar year.
5. There was no PAN application to any fields or crops at this facility greater than the
l_ Yes 0
No
levels specified in this facility's CAWMP during the past calendar year.
6. All land application equipment Was calibrated at least once during the past calendar
0 Yes
No
year.
7. Sludge accumulation in all lagoons did not exceed the volume for which the lagoon
0 Yes
No
was designed or reduce the lagoon's minimum treatment volume to less than the
volume for which the lagoon was designed.
8. A copy of the Annual Sludge Survey Form for this facility is attached to this
0 Yes
No
Certification.
9. Annual soils analysis were performed on each field receiving animal waste during the 0 Yes 0 No
past calendar year.
10. Soil pH was maintained as specified in the permit during the past calendar Year? I� Yes 0 No
11. All required monitoring and reporting was performed in accordance with the facility's Yes No
permit during the past calendar year.
12. All operations and maintenance requirements in the permit were complied with during 1� Yes No
the past calendar year or, in the case of a deviation, prior authorization was received
from the Division of Water Quality.
13. Crops as specified in the CAWMP were maintained during the past calendar year on 0 Yes 0 No
all sites receiving animal waste and the crops grown were removed in accordance with
the facility's permit.
14. All buffer requirements as specified on the permit and the CAWMP for this facility 0 Yes No
were maintained during each application of animal waste during the past calendar year.
"I certify under penalty of law that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of
my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false infop�tion, including the possibility of fines and imprisonment for knowing violations."
4 Title Noe or or'
Signature f permittee
ignature of Operator in Charge
( if different from permittee)
-" jo,�-
(.
to
2-21-wl�-
Date

�J
�OF wATE
�O G
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
February 28, 2005 RECEIVED
Goldsboro Hog Farms 1 F E B Z 4 I WO
Case Farm
P O Box 10009� 3Y:
Goldsboro, NC 27532
Subject: Certificate of Coverage No. NCA231043
Case Farm
Swine Waste Collection, Treatment,
Storage and Application System
Duplin County
Dear Goldsboro Hog Farms:
In accordance with your request to Change in Operation Type received on January 18, 2005 we are
hereby forwarding to you this Certificate of Coverage (COC) issued to Goldsboro Hog Farms, authorizing
the operation of the subject animal waste collection, treatment, storage and land application system in
accordance with General Permit NCA200000.
This approval shall consist of the operation of this system including, but not limited to, the management
of animal waste from the Case Farm, located in Duplin County, with an animal capacity of no greater than
an annual average of 25920 Wean to Feeder swine and the application to land as specified in the
facility's Certified Animal Waste Management Plan (CAWMP). If this is a Farrow to Wean or Farrow to
Feeder operation, there may also be one boar for each 15 sows. Where boars are unneccessary, they may
be replaced by an equivalent number of sows. Any of the sows may be replaced by gilts at a rate of 4
gilts for every 3 sows
The COC shall be effective from the date of issuance until July 1, 2007, and shall hereby void Certificate
of Coverage Number NCA231043 dated April 9, 2003 and shall be subject to the conditions and
limitations as specified therein. Pursuant to this COC, you are authorized and required to operate the
system in conformity with the conditions and limitations as specified in the General Permit, the facility's
CAWMP, and this COC. An adequate system for collecting and maintaining the required monitoring data
and operational information must be established for this facility. Any increase in waste production
greater than the certified design capacity or increase in number of animals authorized by this COC (as
provided above) will require a modification to the CAWMP and this COC and must be completed prior to
actual increase in either wastewater flow or number of animals.
Please carefully read this COC and the enclosed General Permit. Since this is a new joint State and
Federal general permit it contains many new requirements in addition to most of the conditions contained
in the current State general permit. Enclosed for your convenience is a package containing the new and
revised forms used for record keeping and reporting. Please pay careful attention to the record keening
and monitorine conditions in this hermit. The Devices to Automatically Stoh Irritation Events Form
must be returned to the Division of Water Quality no later than 120 days following receipt of the
Certificate „of Coverage. The Animal Facility Annual Certification Form must be completed and returned
to the Division of Water Quality by no later than March 1st of each year.
tCaro ' a
O
Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Phone [phone] Customer Service
Internet: http://h2o.enr.state.nc.us 2728 Capital Boulevard Raleigh, NC 27604 Fax [phone]
Fax [phone]
An Equal Opportun4/AHirmative Action Employer— 50% Recydedl10% Post Consumer Paper

l
If your Waste Utilization Plan has been developed based on site specific information, careful evaluation
of future samples is necessary. Should your records show that the current Waste Utilization Plan is
inaccurate you will need to have a new Waste Utilization Plan developed.
The issuance of this COC does not excuse the Permittee from the obligation to comply with all applicable
laws, rules, standards, and ordinances (local, state, and federal), nor does issuance of a COC to operate
under this permit convey any property rights in either real or personal property.
Upon abandonment or depopulation for a period of four years or more, the Permittee must submit
documentation to the Division demonstrating that all current NRCS standards are met prior to restocking
of the facility.
Per 15A NCAC 2H .0225(c) a compliance boundary is provided for the facility and no new water supply
wells shall be constructed within the compliance boundary. Per NRCS standards a 100 foot separation
shall be maintained between water supply wells and any lagoon, storage pond, or any wetted area of a
spray field.
Please be advised that any violation of the terms and conditions specified in this COC, the General Permit
or the CAWMP may result in the revocation of this COC, or penalties in accordance with NCGS 143-
215.6A through 143-215.6C, the Clean Water Act and 40 CFR 122.41 including civil penalties, criminal
penalties, and injunctive relief.
If you wish to continue the activity permitted under the General Permit after the expiration date of the
General Permit, an application for renewal must be filed at least 180 days prior to expiration.
This COC is not automatically transferable. A namelownership change application must be submitted to
the Division prior to a name change or change in ownership.
If any parts, requirements, or limitations contained in this COC are unacceptable, you have the right to
apply for an individual permit by contacting the staff member listed below for information on this
process. Unless such a request is made within 30 days, this COC shall be final and binding.
This facility is located in a county covered by our Wilmington Regional Office. The Regional Office
Aquifer Protection Staff may be reached at [phone]. If you need additional information
concerning this COC or the General Permit, please contact J. R. Joshi at [phone].
Sincerely,
for Alan W. Klimek, P.E.
Enclosures (General Permit NCA200000)
cc: (Certificate of Coverage only for all
WAmingtonRegional_Office,.Aqu� erferf Protecti� S on
Duplin County Health Department
Duplin County Soil and Water Conservation District
APS Permit File NCA231043
AFO Files

4?
1 !1 1�� 0
ANIMAL FACILITY ANNUAL CERTIFICATION FORM
Certificate of Coverage or Permit Number NCA231043 County Duplin Year 200 3
Facility Name (as shown on Certificate of Coverage or
���
Permit) Case Farm
Operator in Charge for this Facility _ Lynwood Holland Certification MAR 0 1 2004
# 16535
SEGY10h
Land application of animal waste as allowed by the above permit occurred during the pal ca�l�Oa years �l
X YES NO, If NO, skip Part I and Part 11 and proceed to the certification '" .'!Ajso, mammal
waste was generated but not land applied, please attach an explanation on how the animal waste was handled.
Part 1 : Facility Information:
1. Total number of application Fields ❑ or Pulls® (please check the appropriate box) in the Certified Animal
Waste Management Plan (CAWMP): 10 Total Useable Acres approved in the CAWMP
36.08
2. Total number of Fields ❑ or Pullfc (please check the appropriate box) on which land application occurred
during the year: 9 Total Acres on which waste was applied 34.7
3. Total pounds of Plant Available Nitrogen (PAN) applied during the year for all application sites:
6,288.6
4. Total pounds of Plant Available Nitrogen (PAN) allowed to be land applied annually by the CAWMP and
the permit: 13,530
5. Estimated amount of total manure, litter and process wastewater sold or given to other persons and taken
off site during the year NIA tons ❑ or gallons ❑ (please check the appropriate box)
6_ Annual average number of animals by type at this facility during the previous year:
4,394
7. Largest and smallest number of animals by type at this facility at anyone time during the previous year:
Largest 6,040
Smallest 1,440
(These numbers are for informational purposes only since the only permit limit on the number of animals
at the facility is the annual average numbers)
8. Facility's Integrator if applicable: NIA
Part U: Facility Status:
IF THE ANSWER TO ANY STATEMENT BELOW IS "NO", PLEASE PROVIDE A WRITTEN
DESCRIPTION AS TO WHY THE FACILITY WAS NOT COMPLIANT, THE DATES OF ANY NON
COMPLIANCE, AND EXPLAIN CORRECTIVE ACTION TAKEN OR PROPOSED TO BE TAKEN TO
BRING THIS FACILITY BACK INTO COMPLIANCE.
1. Only animal waste generated at this facility was applied to the permitted sites during ® Yes ❑ No
the past calendar year.
2. The facility was operated in such a way that there was no direct runoff of waste from ® Yes ❑ No
AFACF 3-14-03 1

the facility (including the houses, lagoons/storage ponds and the application sites) during
the past calendar year.
3.
There was no discharge of waste to surface water from this facility during the past
® Yes ❑ No
calendar year.
4.
There was no freeboard violation in any lagoons or storage ponds at this facility during
® Yes ❑ No
the past calendar year.
5.
There was no PAN application to any fields or crops at this facility greater than the
® Yes ❑ No
levels specified in this facility's CAWMP during the past calendar year.
6.
All land application equipment was calibrated at least once during the past calendar year.
❑ Yes N No
7.
Sludge accumulation in all lagoons did not exceed the volume for which the lagoon
❑ Yes ❑ No
was designed or reduce the lagoon's minimum treatment volume to less than the volume
NJA
for which the lagoon was designed.
8.
A copy of the Annual Sludge Survey Form for this facility is attached to this Certification.
❑ Yes ® No
9.
Annual soils analysis were performed on each field receiving animal waste during the
® Yes ❑ No
past calendar year.
10.
Soil pH was maintained as specified in the permit during the past calendar Year?
® Yes ❑ No
11.
All required monitoring and reporting was performed in accordance with the facility's
® Yes ❑ No
permit during the past calendar year.
12.
All operations and maintenance requirements in the permit were complied with during
® Yes ❑ No
the past calendar year or, in the case of a deviation, prior authorization was received
from the Division of Water Quality.
13.
Crops as specified in the CAWMP were maintained during the past calendar year on all
® Yes ❑ No
sites receiving animal waste and the crops grown were removed in accordance with
the facility's permit.
14.
All buffer requirements as specified on the permit and the CAWMP for this facility were
® Yes ❑ No
maintained during each application of animal waste during the past calendar year.
"I certify under penalty of law that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of
my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
N 061 F-X r s
e (type or print
;mature of Uptrator in Ch
different from Permittee)
Date
-
ate
AFACF 3.14-03 2

CASE
)�, 11. 6. Calibration will be completed by 4/9/04.
11. 7,8. The sludge survey will be completed by 4/9iO4.

EXH Brr D-1
IRRIGATION SYSTEM DESIGN PARAMETERS
Landowner/Operator Name, G0L22§ff 2 NDG FAA- 's — Co"e 61E County: - M"PLIN
Address: t' O. Etc t v40e1
C-Vf,%VDRO, NG 2-7532 Date: l5 POD `lq
Telephone: G119.'T78-3130
TABLE ]! - Field Specifications
Fieldl
Number
Approxtmale
Maximum
Useable She
of Field
(acres)
Solt Type
Slope
VA)
Crop(s)(
Mexlmwn
Applleatlon
ROO
M!(Inches)
Maximum
Application
per Irr gallon
Cycle
Comments
Al
2 -118
AUTRYVILLV
A(-L
iWWWU VA wIY SM.
- bo
1.00
A
rj. iR
11
11 /1
A 3
A
2.20
q
II
11 11 11 y
11
•,
A 5
64
A6
q.
3.72
1,
1,
,1 N 11 11
11
61
A7
3. J L
11
11
4 ♦ ,1 x
M.
11
A a
Aq
4 .CI b
B6
I See attached map.
2Total field acreage minus required buffer areas.
3Refer to N. C. Irrigation Guide, Field Office Technical Guide, Section H G. Annual application must not exceed the agronomic rates for the soil and crop used.
MRCS, NC
3LTNE; .1996

1,
FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
3-A1
6
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 31 - 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mmldd/yr)
Irrigation
Waste Analysis
PAN`
(lb11000 gal)
PAN Applied
(iblacre)
(8) x (9)
1000
Nitrogen
Balance"
(lb/acre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gallmin)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7) / (A)
B= 50
215199
8:30
15:30
300
1
245
73500
12250.00
1.9
23.28
26.73
Crop Cycle Totals 735001 23.28
Owner's Signature Operator's Signature O
Certified Operator (Print) AJ Linton Operator's Certification No. V 18625
* NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
** Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
3-A2
5
Goldsboro Hp_g Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 1 31 - 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mmlddlyr)
Irrigation
Waste Analysis
PAN*
(lb11000 gal)
PAN Applied
(lb/acre)
(8) x (9)
1000
Nitrogen
Balance**
(lb/acre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gallacre)
(7)1(A)
B= 50
215199
8:30
15:30
420
1
245
102900
20580.00
1.9
39.10
10.90
Crop Cycle Totals 102900 9.10
Owner's Signature Operator's Signature
Certified Operator (Print) AJ Linton Operator's Certification No. 41 18625
* NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
"Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
1 Field #
2-A3
4.2
Goldsboro Ho Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 1 31 -1 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (Iblacre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) 0 1)
Date
(mmldd/yr)
Irri ation
Waste Analysis
PAN'
(Ib11000 gal)
PAN Applied
(lb/acre)
$ x 9
1000
Nitrogen
Balance**
(lb/acre)
A - 00)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7)1(A)
B= 50
2/8/99
7:30
12:30
300
1
245
73500
17500.00
1.9
33.25
16.75
Crop Cycle Totals 73500� oif�- 33.25
Owner's Signature f/lP ` Operator's Signature
Certified Operator (Print) AJ Linton Operator's Certification No. / 18625
* NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
**Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
2-A4
3.4
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 1 31 - 1 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (Iblacre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) 0 1)
Date
(mmlddlyr)
Irrigation
Waste Analysis
PAN*
(lb11000 gal)
PAN Applied
(Iblacre)
8 x 9
1000
Nitrogen
Balance**
(Iblacre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gallmin)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7)1 (A)
B= 50
218199
7:30
12:00
270
1
245
66150
19455.88
1.9
36.97
13.03
/J/ Crop Cycle Totals[ 66150J 6.97
001.
Owner's Signature fig 51 Operator's Signature
Certified Operator (Print) AJ Linton Operator's Certification No. 18625
* NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
"Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70608
Field #
2-A5
1.2
Goldsboro Hog Farms CA5
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 1 31 -1 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
1 =:1 Loading (lb/acre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mmlddlyr)
Irrigation
Waste Analysis
PAN"
(lb11000 gal)
PAN Applied
(lb/acre)
8 x 9
1000
Nitrogen
Balance"
(lb/acre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7)1(A)
B= 50
Crop Cycle Totals 0� :00
Owner's Signature Operator's Signature '
Certified Operator (Print) AJ Linton Operator's Certification No. 18625
* NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
** Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808 Field #
3-A6
3.5
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 31 - 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mm/ddlyr)
Irrigation
Waste Analysis
PAN*
(lb11000 gal)
PAN Applied
(lb/acre)
(8) x (9)
1000
Nitrogen
Balance**
(lb/acre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gallmin)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gallacre)
(7) / (A)
B= 50
215199
16:30
21:30
300
1
245
73500
21000.00
1.9
39.90
10.10
Crop Cycle Totalsi 735001 . 9:90
Owner's Signature Operator's Signature o,
Certified Operator (Print) AJ Linton Operator's Certification No. 18625
* NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
"Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
11-A7
4.3
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 1 31 - 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mm/dd/yr)
Irrigation
Waste Analysis
PAN"
(lb/1000 gal)
PAN Applied
(lb/acre)
8 x 9
1000
Nitrogen
Balance"
(lb/acre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7)1(A)
B= 50
2/5/99
16.30
21:30
300
1
245
73500
17093.02
1.9
32.48
17.52
/f� Crop Cycle Totals 735001 3 48
Owner's Signature-, Operator's Signature
Certified Operator (Print) AJ Linton Operator's Certification No. 18625
" NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
"Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
11-A8
4.6
Goldsboro Hog Farms(CAS)
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 31 - 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mmlddlyr)
Irri ation
Waste Analysis
PAN*
(Ib11000 gal)
PAN Applied
(lb/acre)
8 x 9
1000
Nitrogen
Balance"
(lb/acre)
(13) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7)1(A)
B= 50
2/6/99
7:30
12:30
300
1
245
73500
15978.26
1.9
30.36
19.64
Crop Cycle Totalsi 735001 36
Owner's Signature Operator's Signature
Certified Operator (Print) AJ Linton Operator's Certification No. 18625
" NCDA Waste Anayisis or Equivalent or NRCS Estimate, Technical Guide Section 633.
"Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
11-A9
3.7
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 1 31 - 1 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mm/dd/yr)
Irrigation
Waste Analysis
PAN"
(lb/1000 gal)
PAN Applied
(lb/acre)
8 x 9
1000
Nitrogen
Balance*"
(lb/acre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7) / (A)
B= 50
2/6/99
13:00
18:00
360
1
245
73500
19864.86
1.9
37.74
12.26
5
Crop Cycle Totals 735001 37.74 __
Owner's Signature Operator's Signature
Certified Operator (Print) AJ Linton Operator's Certification No. 18625
* NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
** Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
3-B6
5.9
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 1 31 -1 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (g) (10) (11)
Date
(mm/dd/yr)
Irrigation
Waste Analysis
PAN'
(lb/1000 gal)
PAN Applied
(lb/acre)
$ x 9
1000
Nitrogen
Balance**
(lb/acre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7)1(A)
B= 50
216199
7:30
12:30
300
1
245
73500
12457.63
1.9
23.67
26.33
Crop Cycle Totals 73500�
Owner's Signature ikgcOperator's Signature
Certified Operator (Print) AJ Linton Operator's Certification No. 18625
* NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
** Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

NCDAA ";nnamic Dlvision 4300 ReedCreek Roa Rai i N,C. 2..7607b'4'65, 919M3=265.5 R+�rt Nn: W04'1.90 WA
Grower.- Goldsboro Hog Farms Copies To: USDA-NRCS-Duplin
PO Box 10009 EMS
Goldsboro, NC 27532
Wste A nal sisRe ort Farm..Case
yIV
2/10/99 Duplin County
Sam l Ljifo:
aborato . Results
rtsx r �aillloa.aaless otbie wise antedRoom
Sample ID:
OEM
Waste Code:
ALS
Description:
Swine Lagoon Liq.
N
P K Ca M
S
Fe
Mn
Zn
Cu
B Mo CI C
Total 444 M
IN -N
-NH4
-NO3
OR-N
Urea
67.2 593 86.2 21.0 16.7 3.24 0.19 0.35 0.69
M M M M M M M M M
0.48
M
Na Ni Cd A Al Se Li pH IS
ON DM% CCE% ALE al
150 7.62
M

I. r —�
, E%+ ,tee°Co —lks
FORM IRR-2 FS�
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
1 Field #
3-A1
6
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 31 -1 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mm/dd/yr)
Irrigation
Waste Analysis
PAN*
(lb11000 gal)
PAN Applied
(lb/acre)
8 x 9
1000
Nitrogen
Balance**
(lb/acre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7)1(A)
B= 50
215199
8:30
15:30
300
1
245
73500
12250.00
2.4
29.40
20.60
Crop Cycle Totals 73500 29.40
Owner's Signature Operator's Signature C3
Certified Operator (Print) AJ Linton Operator's Certification No. V18625
* NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
"Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
3-A2
5
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 1 311-1 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (Iblacre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mmlddlyr)
Irrigation
Waste Analysis
PAN"
(lb11000 gal)
PAN Applied
(lb/acre)
8( ) x (9)
1000
Nitrogen
Balance"
(Iblacre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7) I (A)
B= 50
215199
8:30
15:30
420
1
245
102900
20580.00
2.4
49.39
0.61
Crop Cycle Totalsl 1029001 1 49.39
Owner's Signature _ Operator's Signature
Certified Operator (Print) Ai Linton Operator's Certification No. 18625
" NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
"Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
2-A3
4.2
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 1 31 -1 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
(�) (2) (3) (a) (5) (6) (7) (8) (9) (10) (11)
Date
(mmldd/yr)
Irrigation
Waste Analysis
PAN`
(lb11000 gal)
PAN Applied
(lb/acre)
8 x 9
1000
Nitrogen
Balance`*
(lb/acre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gallacre)
(7)1(A)
$= 50
2/8/99
7:30
12:30
300
1
245
73500
17500.00
2.4
42.00
8.00
Crop Cycle Totals 735001 1 42.00
Owner's Signature Operator's Signature Q
Certified Operator (Print) AJ Linton U Operator's Certification No. 18625
* NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
"Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
2-A4
3.4
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 31 - 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mmlddlyr)
Irrig ation
Waste Analysis
PAN'
(lb11000 gal)
PAN Applied
(lb/acre)
8 x 9
1000
Nitrogen
Balance"
(lb/acre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7)1(A)
6= 50
2/8/99
7:30
12:00
270
1
245
66150
19455.88
2.4
46.69
3.31
Crop Cycle Totalsi 661501 46.69
Owner's Signature Operator's Signature a
Certified Operator (Print) AJ Linton Operator's Certification No. r 18625
" NCDA Waste Anaylsis or Equivalent or MRCS Estimate, Technical Guide Section 633.
"` Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
2-A5
1.2
Goldsboro Hog Farms(CAS)
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number I 31 - 1 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
0) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mm/ddlyr)
Irrigation
Waste Analysis
PAN•
(lb11000 gal)
PAN Applied
(lb/acre)
(8) x (9)
1000
Nitrogen
Balance—
(lb/acre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7)1 (A)
B= 50
90
1
245
22050
18375.00
2.4
44.10
5.90
Crop Cycle Totals 220501 1 44.10
Owner's Signature Operator's Signature
Certified Operator (Print) AJ Linton UOperator's Certification No. 18625
* NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
"" Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
1 Field #
3-A6
3.5
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility dumber 1 31 - 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mm/ddlyr)
Irrigation
Waste Analysis
PAN'
(lb/1000 gal)
PAN Applied
(lb/acre)
8 x 9
1000
Nitrogen
Balance**
(lb/acre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7) / (A)
B= 50
2/5/99
16:30
21:30
300
1
245
73500
21000.00
2.4
50.40
-0.40
Crop Cycle Totals 735001 50.40
Owner's Signature Operator's Signature
Certified Operator (Print) AJ Linton Operator's Certification No. 18625
NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
** Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
1-A7
4.3
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 1 31 - 1 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
(1} (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mm/dd/yr)
Irrigation
Waste Analysis
PAN*
(ib11000 gal)
PAN Applied
(lb/acre)
8 x 9
1000
Nitrogen
Balance"
(lblacre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7)1 (A)
B= 50
215199
16:30
21:30
300
1
245
73500
17093.02
2.4
41.02
8.98
Crop Cycle Totals 73500 41.02
Owner's Signature Operator's Signature a
�
Owner's Signature_,���Certified Operator (Print) AJ Linton Operator's Certification No. / 18625
* NCDA Waste Anaylsis or Equivalent or MRCS Estimate, Technical Guide Section 633.
"Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
11-A8
4.6
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 1 31 - 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) 0 1)
Date
(mmlddlyr) I
Irrigation
Waste Analysis
PAN"
(lb11000 gal)
PAN Applied
(lb/acre)
8 x 9
1000
Nitrogen
Balance"
(lb/acre)
A - 00)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7)1(A)
8= 50
216199
7:30
12:30
300
1
245
73500
15978.26
2.4
38.35
11.65
Crop Cycle Totals 735001 1 38.35
Owner's Signature Operator's Signature
Certified Operator (Print) Ai Linton _ Operator's Certification No. 18625
NCDA Waste Anaylsis or Equivalent or MRCS Estimate, Technical Guide Section 633.
" Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM IRR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
11-A9
3.7
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number 1 31 - 43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type r
mall Grain Recommended PAN 50
.7� Loading (lb/acre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mmlddlyr)
Irrigation
Waste Analysis
PAN'
(Ib/1000 gal)
PAN Applied
(lb/acre)
8 x 9
1000
Nitrogen
Balance"
(Iblacre)
A - 00)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7)1(A)
B= 50
2/6199
13:00
18:00
300
1
245
73500
19864.86
2.4
47.68
2.32
/�� Crop Cycle Totals 73500 47.68
Owner's Signature ` �Y51Operator's Signature
Certified Operator (Print) AJ Linton U Operator's Certification No. 18625
" NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
"Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

FORM [RR-2
Tract #
Field Size (acres) = (A)
Farm Owner
Owner's Address
Owner's Phone #
Lagoon Liquid Irrigation Fields Record
One Form for Each Field per Crop Cycle
70808
Field #
3-136
5.9
Goldsboro Hog Farms CAS
PO Box 10009
Goldsboro,NC 27534
919-778-3130
Facility Number I - I43
Irrigation Operator AJ Linton
Irrigation Operator's PO Box 10009
Address Goldsboro,NC 27534
Operator's Phone # [phone]
From Waste Utilization Plan
Crop Type Small Grain Recommended PAN 50
Loading (lb/acre) = (B)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Date
(mmlddlyr)
Irrigation
Waste Analysis
PAN*
(lb11000 gal)
PAN Applied
(lb/acre)
8 x 9
1000
Nitrogen
Balance"
(lb/acre)
(B) - (10)
Start
Time
End
Time
Total
Minutes
(3) - (2)
# of
Sprinklers
Operating
Flow
Rate
(gal/min)
Total Volume
(gallons)
(6) x (5) x (4)
Volume
per Acre
(gal/acre)
(7)1 (A)
B= 50
216199
7.30
12:30
300
1
245
73500
12457.63
2.4
29.90
20.10
Crop Cycle Totals 73500� 29.90
., ...
Owner's Signature Operator's Signature
Certified Operator (Print) AJ Linton tv Operator's Certification No. 18625
* NCDA Waste Anaylsis or Equivalent or NRCS Estimate, Technical Guide Section 633.
"Enter the value received by subtracting column (10) from (B). Continue subtracting column (10) from column (11) following each irrigation event.

=4L1i1__
Revised January 22, 1999
�r
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number - Operation is flagged for a wettable
Farm Name: acre determination due to failure of
On -Site Representative: Part H eligibility items) F1 F2 F3 F4
Inspector/Reviewer's Name:
Date of site visit: a t
Date of most recent WUP:
Operation not required to secure WA
determination at this time based on
exemption E1 E2Q E4
Annual farm PAN deficit: pounds
Irrigation System(s) - circle #Ohard-hose traveler, 2. center -pivot system; 3. linear -move system;
4. stationary sprinkler system wlpermanent pipe; 5. stationary sprinkler system w/portable pipe;
6. stationary gun system wlpermanent pipe; 7. stationary gun system w/portable pipe
PART I. WA Determination Exemptions (Eligibility failure, Part 11, overrides Part I exemption.)
El Adequate irrigation design, including map depicting wettable acres, is complete
and signed by an I or PE.
E2 Adequate D, and D2I1)3 irrigation operating parameter sheets, including map
f depicting wettable acres, is complete and signed by an I or PE.
E3 Adequate D, irrigation operating parameter sheet, including. map depicting
wettable acres, is complete and signed by a WUP.
E4 75% rule exemption as verified in Part Ill. (NOTE: 75 % exemption cannot be
applied to farms that fail the eligibility checklist in Part 11. Complete eligibility
checklist, Part If - F1 F2 F3, before'completing computational table in Part 111).
PART 11. 75% Rule Eligibility Checklist and Documentation of WA Determination
Requirements. WA Determination required because operation fails one of the eligibility
requirements listed below:
F_ 1 Lack of acreage which resulted in over application of wastewater (PAN) on spray
field(s) according to farm's last two years of irrigation records.
F2 Unclear, illegible, or lack of information/map.
F3 Obvious field limitations (numerous ditches; failure to deduct required
buffer/setback acreage; or 25% of total acreage identified in CAWMP includes
small, irregularly shaped fields - fields less than 5 acres for travelers or less than
2 acres for stationary sprinklers).
F4 WA determination required because CAWMP credits field(s)'s acreage in excess
of 75% of the respective field's total acreage as noted in table in Part 111.

Revisrd .lama-;v 22, 1999
Facility Number -
Part Ill. Field by Field Determination of 75% Exemption Rule for WA Determination
TRACT FIELD TYPE OF I TOTAL CAWMP FIELD I COMMENTS3
NUMBER NUMBER' IRRIGATION ACRES ACRES %
SYSTEM
P_ _ I _ 1 1 _
FIELr) N[IMRI=RI - hvdrant niill 7nnQ. nr noint numbers may be used in place of field numbf-m denandinn nn rAWMP
and type of irrigation system. If pulls, etc. cross more than one field, inspector/reviewer will have to combine fields to
calculate 75% field by field determination for exemption if possible; otherwise operation will be subject to WA
determination.
FIELD NUMBER' - must be clearly delineated on map.
COMMENTS' - back-up fields with CAWMP acreage exceeding 75% of its total acres and having received less than 50%
of its annual PAN as documented in the farm's previous two years' (1997 & 1998) of irrigation records, cannot serve as the
sole basis for requiring a WA Determination. Back-up fields must be noted in the comment section and must be accessible
by irrigation system.

Revised January 22. 1999
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number ` - 3
Farm Name -
On -Site Representative: 1�Q .
Ins oectorlReviewer's Name:
Date of site visit: al- [ * q
Date of most recent WUP:4-)�Icw
V Operation is flagged for a wettable
acre determination due to failure of
Part 11 eligibility item(s) F7 F2 F3 F4
Operation not required to secure WA
determination at this time based on
exemption El E2 E3 E4
Annual -farm PAN deficit: 339 pounds
Irrigation System(s) - circle #0 hard -hose traveler; 2. center -pivot system; 3. linear -move system;
4. stationary sprinkler system w/permanent pipe; 5. stationary sprinkler system wlportable pipe;
6. stationary gun system wlpermanent pipe; 7. stationary gun system wlportable pipe
PART 1. WA Determination Exemptions (Eligibility failure, Part II, overrides Part I exemption.)
E l , Adequate irrigation design, including map depicting wettable acres,. is complete
and signed by an I or PE.
E2 Adequate D, and D21D3 irrigation operating parameter sheets, including map
depicting wettable acres, is complete and signed by an I or PE.
E3 Adequate D, irrigation operating parameter sheet, including map depicting
wettable acres, is complete and signed by a WUP.
E4 75% rule exemption as verified in Part Ill. (NOTE: 75 % exemption cannot be
applied to farms that fail the eligibility checklist in Part if. Complete eligibility
checklist, Part 11 - F1 F2 F3, before'completing computational table in Part 111).
PART 11. 75% Rule Eligibility Checklist and Documentation of WA Determination
Requirements. WA Determination required because operation fails one of the eligibility
requirements listed below:
F1 Lack of acreage which resulted in over application of wastewater (PAN) on spray
field(s) according to farm's last two years of irrigation records.
F2 Unclear, illegible, or lack of information/map.
F3 Obvious field limitations (numerous ditches; failure t6 deduct required
buffer/setback acreage; or 25% of total acreage identified in CAWMP includes
small, irregularly shaped fields - fields less than 5 acres for travelers or less than
/ 2 acres for stationary sprinklers).
�! F4 WA determination required because CAWMP credits field(s)'s acreage in excess
of 75% of the respective field's total acreage as noted in table in Part Ill.

Revised January 22, 19r
Facility Number -31 -
Part Ill. Field by Field Determination of 75% Exemption Rule for WA Determination
TRACT
NUMBER
FIELD
NUMBER',2
TYPE OF
IRRIGATION
SYSTEM
TOTAL
ACRES
CAWMP
ACRES
FIELD
%
I COMMENTS3
i;
T�6�r�
!POp
!
�R3
L),.�
C► .
I�.
ITO
49p-, s
?(. q
460 .7)
"Ile �.
r� l`
i
i
i
f
3i
k
,I
FIELD NUMBER'
- hydrant pull zone or point numbers may be used in place of field numbers depending on CAWMP
and type of irrigation system. If pulls, etc. cross more than one field, inspector/reviewer will have to combine fields to
calculate 75% field by field determination for exemption if possible; otherwise operation will be subject to WA
determination.
FIELD NUMBER2 - must be clearly delineated on map.
COMMENTS' - back-up fields with CAWMP acreage exceeding 75% of its total acres and having received less than 50%
of its annual PAN` as documented in the farm's previous two years' (1997 & 1998) of irrigation records, cannot serve as'the
sole basis for requiring a WA Determination. Back-up fields must be noted in the comment section and must be accessible
by irrigation system.

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
Goldsboro Hog Farms
Case Farm
PO Box 10009
Goldsboro NC 27532
Dear Goldsboro Hog Farms:
1 � •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RE:souRCES
December 30, 1999
Subject: Fertilizer Application Recordkeeping
Animal Waste Management System
Facility Number 31-43
Duplin County
This letter is being sent to clarify the mcordkeeping requirement for Plant Available Nitrogen (PAN)
application on fields that are part of your Certified Animal Waste Management Plan.
In order to show that the agronomic loading rates for the crops being grown are not being exceeded, you
must keep records of all sources of nitrogen that are being added to these sites. This would include nitrogen
from all types of animal waste as well as municipal and industrial sludges/residuals, and commercial fertilizers.
Beginning January 1, 2000, all nitrogen sources applied to land receiving animal waste are required to
be kept on the appropriate recordkeeping forms (i.e. 1RR1, IRR2, DRY1, DRY2, DRY3, SLUR], SLUR2,
SLD1, and SLD2) and maintained in the facility records for review. The Division of Water Quality (DWQ)
compliance inspectors and Division of Soil and Water operation reviewers will review all recordkeeping during
routine inspections. Facilities not documenting all sources of nitrogen application will be subject to an
appropriate enforcement action.
Please be advised that nothing in -this letter should be taken as removing from you the responsibility or
liability for failure to comply with any State Rule, State Statute, Local County Ordinance, or permitting
requirement_ -
If you have any questions regarding this letter, please do not hesitate to contact Ms. Sonya Avant of the
DWQ staff at [phone] ext. 571.
Sincerely,
a .
Kerr T. Stevens, Director
Division of Water Quality
cc: Wilmington Regional Office
Duplin County Soil and Water Conservation District
Facility File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper

State of North Carolina
Department of Environment RECEIVE
and Natural Resources
Division of Water Quality JUL 0 2 1�98
James B. Hunt, Jr., Govemor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E.,
Goldsboro Hog Farms
Case Farm
PO Box 10009
Goldsboro NC 27532
Dear Goldsboro Hog Farms:
Director
June 26, 1998
* •
IT
A&4 qf NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
Subject: Reissuance of Certificate of Coverage
No.AWS310043
Case Farm
Swine Waste Collection, Treatment, Storage and
Application System
Duplin County
The Division of Water Quality modified the Swine Waste Operation General Permit originally issued to
this facility on August 4, 1997. In accordance with the issuance of the revised General Permit, we are
forwarding this Certificate of Coverage (COC) to Goldsboro Hog Farms, authorizing the operation of
the subject animal waste collection, treatment, storage and land application system in accordance with
General Permit AWG100000_ This approval shall consist of the operation of this system including, but
not limited to, the management of animal waste from the Case Farm, located in Duplin County, with an
animal capacity of no greater than 5760 Feeder to Finish and the application to land as specified in the
Certified Animal Waste Management Plan (CAWMP).
The COC shall be effective from the date of issuance until April 30, 2003, and shall hereby void
COC No AWS310043 dated August 4, 1997. The COC shall hereby incorporate by reference any
specific conditions of the previous COC issued to this facility. The purpose of this COC is to allow
coverage under the revised General Permit. Please review the revised General Permit (enclosed) and pay
particular attention to Condition II.10 regarding tree removal from lagoon embankments, Condition III -I
regarding inspection frequency of the waste treatment, storage and collection system and Condition II1.6
regarding notification requirements for system failures, spills and emergencies. Pursuant to this COC,
you are authorized and required to operate the system in conformity with the conditions and limitations
as specified in the General Permit, the facility's CAWMP, and this COC, with no discharge of.wastes to
surface waters. An adequate system for collecting and maintaining the required monitoring data and
operational information must be established for this farm. Any increase in waste production greater than
the certified design capacity or increase in number of stocked animals above the number authorized by
this COC will require a modification to the CAWMP and this COC and shall be completed prior to
actual increase in either wastewater flow or number of animals.
Please be advised that any violation of the terms and conditions specified in this COC, the
General Permit or the CAWMP may result in the revocation of this COC, or penalties in accordance
with NCGS 143-215.6A through 143-215.6C including civil penalties, criminal penalties, and injunctive
relief.
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Certificate of Coverage AWS310043
Case Farm
Page 2
Upon notification by the Division of this COC's expiration, you shall apply for its renewal. This
request shall be made within 30 days of notification by the Division.
This COC is not automatically transferable. A name/ownership change application must be
submitted to the DWQ prior to a name change or change in ownership.
If any parts, requirements, or limitations contained in this COC are unacceptable, you have the
right to apply for an individual non -discharge permit by contacting the engineer listed below for
information on this process. Unless such a request is made within 30 days, this COC shall be final and
binding.
The subject farm is located in the Wilmington Regional Office. The Regional Office Water
Quality Staff may be reached at [phone]. If you need additional information concerning this
COC or the General Permit, please contact J. R. Joshi at [phone] ext. 363.
Sincerely
for A. Preston Howard, Jr., P.E.
cc: (Certificate of Coverage only for all cc's)
Duplin County Health Department
Wilmington Regional Office, Water Quality Section
Duplin County Soil and Water Conservation District
Permit File

WASTE UTILIZATION PLAN
Goldsboro Hog Farms, Inc. C-y (1
Friday, May 22, 1998 !/
Producer: Maxwell Foods, Inc.
Farm Name : Case Farm
PO Box 10009
Goldsboro,NC 27532
Telephone # : [phone]
Type of Operation : Farrow to Weanling Swine
Number of Animals: 25920 sows design capacity
Application Method: irrtg-ation
The waste from your animal facility must be land applied at a specified rate to prevent
pollution of surface and/or groundwater. The plant nutrients in the animal waste should be
used to reduce the amount of commercial fertilizer required for the crops in the fields where
waste is to be applied. This waste utilization plan uses nitrogen as the limiting nutrient.
Waste should be analyzed before each application cycle. Annual soil tests are strongly
encouraged so that all plant nutrients can be balanced for realistic yields of the crop to be
grown.
Several factors are important in implementing your waste utilization plan in order to
maximize the fertilizer value of the waste and to ensure that it is applied in an
environmentally safe manner. Always apply waste based on the needs of the crop to be
grown and the nutrient contents of the waste. Do not apply more nitrogen than the crop
can utilize. Soil types are important as they have different infiltration rates, leaching
potentials, cation exchange capacities, and avaialable water holding capacities. Normally
waste shall not be applied to land eroding at greater than 5 tons per acre per year. With
special pre -cautions, waste may be applied to land eroding at up to 10 tons per acre per
year. Do not apply waste on saturated soils, when it is raining, or when time surface is frozen.
Either of these conditions may result in runoff to surface waters which is not allowed under
DEM regulations. Wind conditions should also be considered to avoid drift and downwind
odor problems. To maximize the value of the nutrients for crop production and to reduce the
potential for pollution, the waste should be applied to a growing crop or applied to bare
ground not more than 30 days prior to planting. Injecting the waste or disking will conserve
nutrients and reduce odor problems. This plan is based on waste application through
irrigation for this is the manner in which you have chosen to apply your waste. If you choose
to inject the waste in the future, you need to revise this plan. Nutrient levels for injecting
waste and irrigating waste are not the same.
The estimated acres needed to apply the animal waste is based on typical nutrient content
for this type of facility. Acreage requirements should be based on the waste analysis report
from your waste management facility. Attached you will find information on proper sampling
techniques, preparation, and transfer of waste samples to the lab for ananlysis. This waste
utilization plan, if carried out, meets the requirements for compliance with 15A NCAC
2H.0217 adopted by the Environmental Management Commission.
Page 1

AMOUNT OF WASTE PRODUCED PER YEAR (gallons, ft3, tons, etc.)
25920 pigs X 0.4 tons wastelpigslyear = 10368 tons
AMOUNT OF PLANT AVAILABLE NITROGEN (PAN) PRODUCED PER YEAR
25920 pigs X 0.48 Ibs PAN/pigslyear = 12441.6 PANlyear
Applying the above amount of waste is a big job. You should plan time and have
appropriate equipment to apply the waste in a timely manner.
The following acreage will be needed for waste application based on the crop to be grown,
soil type and suface application.
TABLE 1 : ACRES OWNED BY PRODUCER
TRACT FIELD SOIL TYPE &CLASS- CROP YIELD LBS AW COMM ACRES^ LBS AW APPLIC.
DETERMINING PHASE CODE NIACRE NIACRE USED TIME
70808
1A
AUTRYVILLE ALL
BH
5.5
275
0
5.58
1534.5
MAR-SEP
708W
1A
AUTRYVILLE ALL
SG
1
100
0
5.58
558
SEP-MAR
708D8
I
AUTRYVILLE ALL
BH
5.5
275
0
5.24
1441
MAR-SEP
70808
1 B
AUTRYVILLE ALL
SG
1
100
0
5.24
524
SEP- MAR
708DB
I
AUTRYVILLE ALL
BH
5.5
2
0
3.28
902
MAR-SEP
70808
1C
AUTRYVILLE ALL
SG
1
100
0
3.
328
SEP-MAR
70808
2A
AUTRYVILLE ALL
BH
5-5
275
0
2-85
783.7
MAR-SEP
708W,
-- ..2A
AUTRYVILLE ALL
SG
1
100
0
2-85
285
SEP-MAR
70808
2B
AUTRYVILLE ALL
BH
5.5
275
0
2-76
759
MAR-SEP
708M
- 28
AUTRYVILLE ALL
SG
1
100
0
2.76
276
SEP-MAR
70808
2C
AUTRYVILLE ALL
BH
5.5
275
0
1 _
379.
MAR-SEP
708M
- 2C
AUTRYVILLE ALL
SG
0
1.38
138
SEP-MAR
708M
3A
AUTRYVILLE ALL
8H
575
0
4-7
1309
MAR-SEP
70M
- 3A
AUTRYVILLE ALL
SG
00
Vil
0
4.7
476
SEP-MAR
70B08
3B
AUTRYVILLE ALL
BH
575
0
4.57
1256.75
MAR-SEP
70808
- 3B
AUTRYVILLE ALL
SG
00
0
4.57
457
SEP MAR
70808
3C
AUTRYVILLE ALL
BH
5.5
275
0
1.94
533.5
MAR-SEP
708W
- 3C
AUTRYVILLE ALL
SG
1
100
0
1.94
194
SE P MAR
70808
3D
AUTRYVILLE ALL
BH
5.5
275
0
3.72
1023
MAR-SEP
708DB
- 30
AUTRYVILLE ALL
SG
1
100
0
3.72
372
SEP-MAR
TOTALS: 13530
Indicates that this field is being overseeded (i.e. interplanted) or winter annuals follow
summer annuals.
Indicates a Crop Rotation
NOTE: The applicator is cautioned that P and K may be over applied while meeting the N
requirments. Beginning in 1996 the Coastal Zone Management Act will require farmers in
some eastern counties of NC to have a nutrient management plan that addresses all
nutrients. This plan only addresses Nitrogen.
Page 2

TABLE 2: ACRES WITH AGREEMENT OR LONG TERM LEAS
(Agreement with adjacent landowners must be attached_)
(Required only if operator does not own adequate land. See required specifications 2.)
There are no Acres Leased
-- Indicates that this field is being overseeded (i.e. interplanted) or winter annuals follow
summer annuals.
Indicates a Crop Rotation
Acreage figures may exceed total acreage in field due to overseeding.
**labs AW N (animal waste nitrogen) equals total required nitrogen less any commercial
nitrogen (COMM N) supplied.
The following legend explains the crop codes used in TABLES 1 and 2 above:
CROP CODE CROP UNITS LBS NIUNrr
BH
HYBRID BERMUDAGRASS-HAY TONS
50
SG
SMALL GRAIN OVERSEEDED AC
50
Page 3

TOTALS FROM TABLES 1 AND
ACRES L13S AW
N USED
TABLE 1 !36.
�13
,534
TOTALS: 08 ,53D
AMOUNT OF N PRODUCED_ 12,442
* BALANCE -1,088
*** This number must be less than or equal to 0 in order to fully utilize the animal waste
N produced.
Acres show in each of the preceeding tables are considered to be the usable acres
excluding required buffers, filter strips along ditches, odd areas unable to be irrigated, and
perimeter areas not receiving full application rates due to equipment limitations. Actual total
acres in the fields listed may, and most likely will be, more than the acres shown in the
tables.
NOTE: The Waste Utilization Plan must contain provisions for periodic land application of
sludge at agronomic rates. The sludge will be nurturient rich and will require precautionary
measures to prevent over application of nutrients or other elements_ Your production facility
will produce approximately 1969.92 pounds of plant available nitrogen (PAN) per year in the
sludge that will need to be removed on a periodic basis. This figure is PAN when
broadcasting the sludge. Please be aware that additional acres of land, as well special
equipment, may be needed when you remove this sludge.
See the attached map sh6wing the fields to be'used for the utilization of waste water
APPLICATION OF WASTE BY IRRIGATION
The irrigation application rate should not exceed the intake rate of the soil at the time of
irrigation such that runoff or ponding occurs. This rate is limited by initial soil moisture
content, soil structure, soil texture, water droplet size, and organic solids. The application
amount should not exceed the available water holding capacity of the soil at the time of
irrigation 'nor should the plant available nitrogen applied exceed the nitrogen needs of the
crop.
Your facility is designed for 180 days of temporary storage and the temporary storage must
be removed on.the average of once every 5,92 months_ In no instance should the volume
of waste being stored in your structure be within 1.63 feet of the top of the dike.
If surface irrigation is the method of land application for this plan, it is the responsiblity of the
producer and irrigation designer to ensure that an irrigation system is installed to properly
irrigate the acres shown in Tables 1 and 2_ Failure to apply the recommended rates and
amounts of Nitrogen shown in the tables may make this plan invalid.
The following table is provided as a guide for establishing application rates and amounts.
APPLICATION APPLICATION
TRACT FIELD SOIL TYPE CROP RATE ('Whr) AMT (inches)
308 IC,--2A4-2B,-2C.--3A,-- AUTRYVILIE ALL so 0.60 '1
308 B, IC, 2& 2B, 2C, 3,, 38_ AALJTRYVILLE ALL BH 0.60 ' 1
* This is the maximum application amount allowed for the soil assuming the amount of
nitrogen allowed for the crop is not over applied. In many situations, the application
amount shown cannot be applied because the nitrogen limitation_ The maximum
application amount shown can be applied under optimum soil conditions.
Page 4

NARRATIVE OF OPERATION
This WUP has been amended 2/15199 per guidance by Dean Hunkele, DWQ/WiRO, to
reflect wettable acres_ The most current available map has been used and shows irrigation
pulls and calculations and acres per pull. The WUP uses the irrigation pulls in Table 1
instead of field numbers. All of the required data on a D1 is shown in the Waste Plan.
This plan utilizes the 100 lb. option for overseeded small grain in bermuda with the following
conditions: (1) the last application of animal waste applied to bermuda must be on or before
August 31, (2) split application of PAN may be applied between Sept 15 and Oct 31, and in
Feb -Mar, (3) harvest of the small grain is required prior to April 7.
This guidance provided by NCSU Forage Production Workgroup_
This WUP was amended to reflect wean to feeder pigs on 12/31/04. No changes were
made to any of the crops or irrigation pulls or acres_
Page 5

PLANS & SPECIFICATIONS
1. Animal waste shall not reach surface waters of the state by runoff, drift, manmade
conveyances, direct application, or direct discharge during operation or land application. Any
discharge of waste which reaches surface water is prohibited. Illegal discharges are subject
to assessment of civil penalties of $10,000 per day by the Division of Water Quality for
every day the discharge continues.
2. The Field Office must have documentation in the design folder that the producer either
owns or has long term access to adequate land to properly dispose of waste. If the producer
does not own adequate land to properly dispose of waste, he shall provide NRCS with a
copy of a written agreement with a landowner who is within a reasonable proximity, allowing
hirn/her the use of the land for waste application for the life expectancy of the production
facility. It is the responsibility of the owner of the facility to secure an update of the Waste
Utilization Plan when there is a change in the operation, increase in the number of animals,
method of utilization, or available land.
3. Animal waste shall be applied to meet, but not exceed, the Nitrogen needs for realistic
crop yields based on soil type, available moisture, historical data, climate conditions, and
level of management, unless there are regulations that restrict the rate of application for
other nutrients-
4- Animal waste may be applied to land that has a Resource Management System (RMS) or
an Alternative Conservation System_(ACS)_ If an ACS is used the soil loss shall be no
greater than ' 10 tons per acre per year and apprripnate filter strips will be used where runoff
leaves the field. These filter strips will be in addition to "Buffers" required by DEM_ (See
FOTG Stantard 393 - Filter Strips and Standard 390 Interim Riparian Forest Buffers).
5. Odors can be reduced by injecting the waste or disking after waste application_ Waste
should not be applied when there is danger of drift from the irrigation field.
6. When animal waste is to be applied on acres subject to flooding, it will be soil
incorporated on conventionally tilled cropland. When applied to conservation tilled -crops or
grassland, the waste may be broadcast provided the application does not occur during a
season prone to flooding. (See "Weather and Climate in North Carolina" in the NRCS
Technical Reference - Environment file for guidance.)
*7. Liquid waste shall be applied at rates not to exceed the soil infiltration rate such that
runoff does not occur offsite or to surface waters and in a method which does not cause drift
from the site during application. No ponding should occur in order to control conditions
conducive to odor or flies and to provide uniformity of application.
8. Animal waste shall not be applied to saturated soils, during rainfall events, or when the
surface is frozen.
9. Animal waste shall be applied on actively growing crops in such a manner that the crop is
not covered with waste to a depth that would inhibit growth.
10. Waste nutrients shall not be applied in fall or winter for spring planted crops on soils with
a high potential for leaching. Waste nutrient loading rates on these soils should be held to a
minimum and a suitable winter cover crop planted to take up released nutrients. Waste shall
not be applied more than 30 days prior to planting of a crop on bare soil_
11. Any new swine facility sited on or after October 1, 1995 shall comply with the following:
the outer perimeter of the land area onto which waste is applied from a lagoon that is a
Page 6

component of a swine farm shall be at least 50 feet from any residential property boundary
and from any perennial stream or river (other that an irrigation ditch or canal. Animal waste
other than swine waste from facilities sited on or after October 1, 1995), shall not be applied
closer than 25 feet to perennial waters. (See Standard 393 - Filter Strips)
12. Animal waste shall not be applied closer than 100 feet to wells.
13. Animal Waste shall not be applied closer than 200 feet of dwellings other than those
owned by the landownwer.
14. Waste shall be applied in a manner not to reach other property and public right - of ways.
15. Animal waste shall not be discharged into surface waters, drainageways, or wetlands by
discharge or by over -spraying. Animal waste may be applied to prior converted croplands
provided they have been approved as a land application site by a "technical specialist'.
Animal waste should not be applied on grassed waterways that discharge directly into water
courses, except when applied at agronomic rates and the application causes no runoff or
drift from the site.
*16. Domestic and industrial waste from washdown facilities, showers, toilets, sinks, etc.,
shall not be discharged into the animal waste management system.
*17. A protective cover of appropriate vegetation will be established on all disturbed areas
(lagoon embankments, berms, pipe -runs, etc:). If needed,. special -vegetation shall be
provided for these areas and shall be fenced, as necessary, to protect the vegetation.
Vegetation such as trees,. shrubs, and other woody species, etc. are limited to areas where
considered appropriate. Lagoon areas should be kept mowed and accessible. Lagoon
berms and structures should be inspected regularly for evidence of erosion, leakage or
discharge.
*18. If animal production at the facility is to be suspended or terminated, the owner is
responsible for obtaining and implementing a "closure plan" which will eliminate_ the
possibility of an illegal discharge, pollution and erosion.
*19. Waste handling structures, -piping, -pumps, reels, etc., should be inspected on a regular
basis to prevent breakdowns, leaks, and spills. A regular maintenance checklist should be
kept on site.
20. Animal waste can be used in a rotation that includes vegetables and other crops for
direct human consumption. However, if animal waste is used on crops for direct human
consumption, it should only be applied as a preemergence with no other applications of
animal waste during the crop season.
*21. Highly visible markers shall be installed to mark the top and bottom elevations of the
temporary storage (pumping volume) of all waste treatment lagoons. Pumping shall be
managed to maintain the liquid level between the markers. A marker will be required to mark
the maximum storage volume fpr waste storage ponds.
22. Waste shall be tested within 60 days of utilization and soil shall be tested at least
annually at crop sites where waste products are applied. Nitrogen shall be the rate -
determining element. Zinc and copper levels in the soils shall be monitored and alternative
crop sites shall be used when these metals approach excessive levels. pH shall be adjusted
for optimum crop production amd maintained. Soil and waste analysis records shall be kept
for five (5) years. Poultry dry waste application records shall be maintained for three (3)
years. Waste application records for all other waste shall be maintained for five (5) years.
Page 7

23. Dead animals will be disposed of in a manner that meets North Carolina Department of
Agriculture regulations-
* Liquid Systems
Page 8

NAME OF FARM: Case Farm
OWNER / MANAGER AGREEMENT
I (we) understand and will follow and implement the specifications and the operation and
maintenance precedures estalished in the approved animal waste utilization plan for the
farm named above. I (we) know that any expansion to the existing design capacity of the
waste treatment and/or storage system or construction of new facilities will require a new
utilization plan and a new certification to be submitted to DEM before the new animals are
stocked.
I (we) understand that I must own or have acces to equipment, primarily irrigation
equipment, to land apply the animal waste described in this waste utilization plan. This
equipment must be available at the appropriate pumping time such that no discharge occurs
from the lagoon in a 25-year 1-day storm event. I also certify that the waste will be applied
on the land according to this plan at the appropriate times and at rates that no runoff occurs.
NAME OF FACILI ER: Ma ods, Inc.
SIGNATURE- DATE:
NAME OF MANAGER (if different from owner):
please print
SIGNATURE: DATE:
NAME OF TECHNICAL SPECIALIST: George H. Pettus
AFFILIATION: Maxwell Foods, Inc.
ADDRESS (AGENCY): PO Box 10009
Goldsboro, NC 27532
[phone]
SIGNATURE: DATE: 7A VFW- o6
Page 9

J.L. MAXWELL, JR., cHxAw-
H.G. MAXWELL. III,PRFsDE.T
J.W. PELLETIER. III, SCE PREVDENT
State Road 1713 - P.O. Box 10009 - Goldsboro NC 27532
Phone [phone] - Fax [phone]
May 14, 1997
David Holsinger
DEHNR / DWQ
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
Dear David:
' IEE T 1
,� ED
if
J.L. IL 0, L, III, NZT*R: TA E"-_ �
# MILTIW HENORfXSGN, HUTR-c•ac
�� Y-i.'(NICK)WEAVER,—GERsc=�:.�
I called and talked to Brenda this morning and have left you messages on your voice mail.
As of nud-afternoon, I haven't heard from you. I will furnish you a report on the two
facilities with minor discharges that I was called to this morning.
Facility .# 31-56 (C & C Farms ) had a discharge out of the front fill pipes of two pit
recharge buildings resulting in a dispersion of effluent over an area in front of and between
the buildings and following a surface water rill that was previously made from an earlier
rainstorm into a grown up ditch on the farm that eventually leads to Maple Branch. I took
a sample from the area of impact and an area down the ditch and had our lab run nitrite
and nitrate levels. Enclosed is a copy of the lab results. State waters were not impacted
and all effluent was contained on the farm. I discussed preventions with the operator and
the importance of being on the farm when refilling the buildings as well as the possibility of
putting timers on the recycle pumps. Warsaw Builders representative was on the farm by
9:30 am sealing and resealing around the fill pipes on the two buildings and checking all
buildings while on site.
Facility # 31-43 ( Case Farm ) had a discharge out of the back of the house # 8 at or
around the outlet pipe at the building resulting in a dispersion of effluent over an area at the
back of the building and into the waste application field- Estimate no more than 500
gallons discharge and no area other than field impacted. No surface water or State water
impacted and all effluent contained on site. G & M 5aies representative on site by 9:00 am
and working to repair leak.
At both facilities, flow was stopped immediately when discovered. Pump at C & C was
cut off and the plug pulled at Case to empty the building. Emergency Action Plans were
followed and DWQ notified. If I can be of further assistance, please call me at 919-778-
3130.
Sincerely
m�
H. Pettus
enta111danagement
Goldsboro Hog Farms
GOLDSBORO MULLING COMPANY SLEEPY CREEK FARMS SLEEPY CREEK TURKEYS BEAR CREEK FARMS GOLDSBORO MULLING GRAIN
FEED PRODtCTr()I T ' rUME-1c.— tV�-t- teY:l•'-•—, fb+.-_ of P—f �..WYMC T
MAXWELL FARMS COLD CREEK FARMS GOLDSBORO HOG FARMS G. S L. PROCESSING CAROLINA TURKEYS CAROLINA TURKEYS OF VIRGIMA
i µwfflMl��WW � —r.. r.-. hf .a.lv—�F&—v R—I rl fl PfC S P 1

r!IiRIT'E: Q .J1; 2, IF, F, ,s
R,

State pf North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, .ir., P.E., Director
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Goldsboro Hog Farms
Case Farm
PO Box 10009
Goldsboro NC 27532
Farm Number. 3143
Dear Goldsboro Hog Farms :
F.'ECE,11VED' LTW*WA
JUL 18 1997 '46i •
BY:
July 16, 1997
You are hereby notified that Case Farm, in accordance with G.S. 143-215.1OC, must apply for
coverage under an Animal Waste Operation General Permit. Upon receipt of this letter, your farm has
thirty 30 days to submit the attached application and all supporting documentation. In -accordance
with Chapter 626 of 1995 Session Laws (Regular Session 1996), Section 19(c)(2), any
owner or operator who fails to submit an application by the date specified by the
Department SHALL NOT OPERATE the animal waste system after the specified date.
Your application must be returned within thirty (30) days of receipt of this letter. Failure to submit the
application as required may also subject your facility to a civil penalty and other enforcement actions for
each day the facility is operated following the due date of the application.
The attached application has been partially completed using information listed in your Animal
Waste Management Plan Certification Form. If any of the general or operation information listed is
incorrect please make corrections as noted on the application before returning the application package. The
signed original application, one copy of the signed application, two copies of a general location map, and
two copies of the Certified Animal Waste Management Plan must be returned to complete the application
package. The completed package should be sent to the following address:
North Carolina Division of Water Quality
Water Quality Section
Permits and Engineering Unit
Post Office Box 29535
Raleigh, NC 27626-0535
If you have any question concerning this letter, please call Mike L:ewandowski ar(919) 733-5083
extension 362 or Dave Holsinger with the Wilmington Regional Office at [phone].
Sincerely,
foi A. Preston Howard, Jr., P.E.
cc: Permit File (w/o encI.)
Wilmington Regional Office (w/o encl.)
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

State of North Carolina IT I
Department of Environment,LTKMA
Health and Natural Resources • •
Division of Water Quality rI
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary p E H N FI
A. Preston Howard, Jr., P.E., Director
August 4, 1997
George Pettus
Case Farm
PO Box 10009
Goldsboro NC 27532
Subject: Certificate of Coverage No. AWS310043
Case Farm
Swine Waste Collection, Treatment, Storage
and Application System
Duplin County
Dear George Pettus:
In accordance with your application received on July 28, 1997, we are forwarding this Certificate
of Coverage (COC) to Farm No. 3143, authorizing the operation of an animal waste collection, treatment,
storage and land application system in accordance with the State's General Permit (attached). This
approval shall consist of the operation of this system including, but not limited to, the management of
animal waste from the Case Farm, located in Duplin County, with an animal capacity of no greater than
5760 Feeder to Finish and the application to a minimum of 45 acres of land as specified in the Certified
Animal Waste Management Plan (CAWMP).
The COC shall be effective from the date of issuance until December 31, 2001. Pursuant to this
COC, you are authorized and required to operate the system in conformity with- the conditions and
limitations as specified in the General Permit, the facility's CAWMP, and this COC, with no discharge of
wastes to surface waters. An adequate system for collecting and maintaining the required monitoring data
and operational information must be established for this farm. Any increase in waste production greater
than the certified design capacity or increase in number of stocked animals above the number authorized by
this COC will require a modification to the CAWMP and this COC and shall be completed prior to actual
increase in either wastewater flow or number of animals.
In accordance with General Statue 143-215.10C, Animal Waste Management Plans shall include
the following components:
- A checklist of odor sources and best management practices to minimize these sources.
- A checklist of insect sources and best management practices to minimize these sources.
- Provisions set forth for acceptable methods of disposing of mortalities.
- Provisions regarding emergency action plans.
Your existing Certified Animal Waste Management Plan must include the above elements, by
December 31, 1998. Documentation of the certification must be available to inspectors onsite. Submittal
of the amended certification statement shall be required upon renewal of your permit coverage in 2001.
Please be advised that any. violation of the terms and conditions specified in this COC, the General
Permit or the CAWMP may result in the revocation of this COC.
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

Upon notification by the Division of this COC's expiration, you shall apply for its renewal. This
,request shall be made within 30 days of notification by the Division.
This COC is not automatically transferable. A name/ownership change application must be
submitted to the DWQ prior to a name change or change in ownership.
If any parts, requirements, or limitations contained in this COC are unacceptable, you have the
right to apply for an individual non -discharge permit by contacting the engineer listed below for
information on this process. Unless such a request is made within 30 days, this COC shall be final and
binding.
The subject -farm is -located in the Wilmington Regional Office. The Regional Office Water Quality
Staff may be reached at [phone]. If you need additional information concerning this COC or the
General Permit, please contact J R Joshi at [phone] ext. 363.
Sincerely,
�/_A. Preston Howard, Jr., P.E.
cc: (Certificate of Coverage only for all cc's) =R.LiC—"Duplin County Health Department
cW.i}nungton:Regional:Office-Water-Quality-Section � Duplin County Soil and Water Conservation District
Permit File

WS I V-
43
State of North Carolina w �O
Department of Environment, Health and Natural Resources
Division of Water Quality
Non -Discharge Permit Application Form / Survey
(THIS FORM MAY BE PHOTOCOPIED FOR USE AS AN ORIGINAL)
General Permit - Liquid Animal Waste Operations
The following questions have been completed utilizinginformation on file with the
p
-i
Please review the information for completeness and make any correction
Division. Plea
which are appropriate. If a question has not been completed by the Division, please
-
complete as best as possible. Do not leave any- A.swered.
IV
_
e�,
LD
Application Date: 23 Tk L1( -17 AUG 4 6 1991
�+
REQUIRED ITEMS CHECKLIST - -
Please indicate that you have included the following required items by signing your initials in the space provided next to each
item.
Annlicants Initials
1. One completed and signed original and one copy of the application for General Permit -Animal
Waste Operations;
2. Two copies of a general location map indicating the location of the animal waste facilities and
kte
field locations where animal waste is disposed;
3. Two copies of the Certified Animal Waste Management Plan (CAWMP). If the facility does
not have a CAWMP, one must be completed prior to submittal of a general permit application
for animal waste operations.
II. GENERAL INFORMATION:
1. Farm's name: Case Farm
2. Print Land Owner's name: Goldsboro Hoe Farms
3. Land Owner's Mailing address: PO Box 10009
4
5
6
7
31 - 43
City: Goldsboro NC Zip: 27532
Telephone Number: 778-3130_
County where farm is located: Duplin
Farm Location (Directions from nearest major highway. Please include SR numbers for state roads. Please include a copy
of a county road map with the location of the farm identified):
Print Farm Manager's name (if different from Land Owner):
Lessee's / Integrator's name (if applicable; please circle which type is listed): _Goldsboro Hog Farm
FORM: AWO-G-E 2/26/97 Page 1 of 3

III. OPERATION INFORMATION:
1. Farm No.: 3 l -43
2. Operation Description: Swine operation
Feeder to Finish
5850 - Certified Design Capacity
Is the above information correct? Ejyes; 23no. If no, correct below using the design capacity of the facility
Tyne of Swine No. of Animals Type of Poultry No. of Animals Tvoe of Cattle No. of Animals
0 Wean to Feeder 0 Layer 0 Dairy
0 Feeder to Finish 5?b0 0 Non -Layer 0 Beef
0 Farrow to Wean (# sow) 0 Turkey
0 Farrow to Feeder (# sow)
0 Farrow to Finish (# sow)
Other Type of Livestock on the farm: No. of Animals:
3. Acreage cleared and available for application. _; Required Acreage (as listed in the CAWMP): -6907- 45. 0
4. Number of Lagoons: f ; Total Capacity: f, 14a, 703 Cubic Feet (ft3)
Number of Storage Ponds: ; Total Capacity: Cubic Feet (ft3)
5. Is animal waste being applied on any field which has subsurface drains? YES or NO (please circle one)
6. Are subsurface drains present in the vicinity of or under the lagoon? YES o NO (please circle one)
I V . APPLICANT'S CERTIFICATION:
1, 6yLT 5,R1W NDG FA-xm S
(Land Owner's name listed in question II.2), attest that
this application for cA.; t< t AAy4-i (Farm name listed in question II.1)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information and attachments are not included, this application package
will be returned to me as incomplete.
Signature V DWV• "'tft Date 23 SkLY 47
V . MAN S CERTIFICATION: (complete only if different from the Land Owner)
I,
(Managers name listed in question II.6), attest that this
application for (Farm name listed in question II.1)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information and attachments are not included, this application package
will be returned as incomplete.
Signature
Date
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING INFORMATION AND MATERIALS,
SHOULD BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DIVISION OF WATER QUALITY
WATER QUALITY SECTION
PERMITS AND ENGINEERING UNIT
POST OFFICE BOX 29535
RALEIGH, NORTH CAROLINA 27626-0535
TELEPHONE NUMBER: [phone]
FORM: AWO-G-E 2/26/97 Page 2 of 3

FAC4IgY � 3 1 - 43
ArAST3 KA-IUGZ��ZN PLAX C3R_ST:CAT!CN ZCR XZW CR Z=IX =) ?_BDLOTS
Please rat == the camplated fog to she DIvisien of aX=aga=aat at
the ae'd.=asa on the rnve=se side of this roc=.
Name of farm (Please print):
Address : __ F.O. ft)( (0004 �
GOL-Ve-- p t4ov FAi�rvr4,,Iue. - CA6F, FARA4
Phone No.:_ 0114-Ti9-313O _
County: --- PUP QK-
Fazpl location: Latitude and Long itude:'5� a �j /17 5- L3. (required) . A1so,
please attach a copy of a county road map with location identified.
Type of operation (swine, layer, dairy, etc •): 5wINE- rrI►JISN1N&
Design capacity (number of animals):_ -I
Average size of operation (12 month population avg.): P5100
Average acreage needed for lard application or waste (acres) :- S
--��Y33»i�3Y=Y.Z�Y3SJa'i3 :SY3�J��II3i3Ya-J3Ja 3`1`�^J�-=YY393�33a3J�J3�3Y 333^1J3��� �3';
Tsch=lcal, specialist ce-rtificatioa
As a technical specialist designated by the_ North Carolina Soil and Water
Conser-,ration Commission pursuant to 15A NCAC 6F .0005, I certify that the new or
expanded animal waste management systeme as installed for the farm named above
has an anyral waste management plan that meets the design, cons==uc__cn,
operation and maintenance standards and specifications of the Division of
Zzvironmental Management and the USDA -Soil Conservaticn Service and/or the North
Carolina Soil and Water Corse= ration Commission pursuant to 15A NCAC 2H.0217 and
15A NCAC 6F .0001-.0005. The following Awments and their corresponding mini_mura
c,iteria-haue"been verified by me or other designated technical specialists and
are included in the plan as applicable: mini=um separations (buffers) ; liners. or
equivalent for lagoons or waste storage ponds; waste storage capacity; adequate
quantity and amount of lard for waste utilization (or use of third party) ; access
or ownership of proper waste application equipment; schedule for timing of
applications; application -rates; loading rates; and the control of the discharge
of pollutants from stormwate, runoff everts less severe than the 25-_year, 24-hour•
storm.
Nape of sech=ical Specialist (Please Print) N• Urns
Affiliation: ENVIWMOWTAL EN&INEEIZ- &OLV:;;,WIZO Holy FAW"Q a QQ -
.address (agency) : o• PioX tcoo 6ot�58oRo W 2-T537 Phone No. qIq-77a•313o
Signature: Data:- Ill SEPTgIf_ -
3�s�mn==ems=�a�sY 3 3�-1'J'93333=Y 33YY==a3 �sa33 i33a.-f793Y.-i ��3=33Y37'.37J.�i�3a1
Owner/tSaaaser Ag= n:z
I (we) understand W a operation and maintenance procedures established in the
approved animal waste management plan for the farm named above and will Lmplement
these procedures. I (we) ticnaw that any additional expansion to the existing
design capacity of the waste treatment and storage system or const=uction of new
facilities will require a new certification to.be submitted to the Division of
Environmental Management before the new animals are stocked. I (we) also
understand that there :rust be no discharge of animal waste from this system to
surface waters of the state either through a man-made conveyance or through,
runoff from a storm event less severe than the 25-year, 24-hour store. The
approved plan will be filed at the farm and at the office of the local Soil and
Water Conservation District. HPA
Na=* cf Land o• er (vI ease Print) _Knw& voila? , UW%VVOM2QL6 4
Signature: Date: triC��
Name of xa.--agar, ifferent from owner (Please print):
Signature: . Date:_
NaIQ: A change in land ownership requires notification or a
(if the approved plan is changed) to be submitted to
Environ.:,e-nta? Management within 50 days of a title transfer.
DE E USE ONLY:ACNZWz
new certification
the Division of

Deportment of Environment,
Hed h end Neturci Resources
Division of Envircnr; ien,tcl'MCncCement -:—
Jcmes B. Hunt, Jr., Governor
Jonathan B. Howes. _ecretcry
A. Preston Howcrd, Jr., P: ;-Director------
�FRT1F?C± TY N FOR =_a OR ?XFANDaD ANIMA ; . FEEDLOTS
Is`iSTRUCTIdNS FOR C R— TI77-CATT_ON OF APPROVED ANIM_I, riAS'1~' MA<NAGM� ?i,-",IS FOR
NEW OR EXPANDED ANAL WASTE SYSTEMS SERV:'_VG LOTS
l
In order to be deemed permitted by the Division of Environmental Management
(nMI) , the owner of any new or expanded junimal waste mar.age.^.lert system
constructed after ..►anua:f 1, 1994 which is designed to serve gweater than or
equal to the animal populations listed below is required to submit a signed
certification for_•a to DES e3 fore the rew anLmals are stocked an t e farm.
Pasture operations are exe-,npt from the requirement to be certified.
100 head of cattla
75 ho-aea
2s0 awL-an
1,000 sheep
30,000 bi--da with a liquid wants system;
The certification must be signed by the owner of the feedlot (and manager if
different from the owner) and by any tec'.nical specialist designated by the Soil
and Water Conservation Comm, ission' pursuaat to 15A NCAC 6F .0001-.0005. A
technical specialist must verify by an on -site inspection that all applicable
design and construction standazds and specifications are met as instilled and
that all applicable ope,ation and maintenance standazds and specifications can
be met.
Although the actual number of animals at the facility may vary f,om tLie to time,
the design capacity of the waste handling system should be used to determine if
a farm is subject to the certification requirement. For example, if the waste
system for a feedlot is designed to handle 300 hogs but the average population
will be 200 hogs, then the waste management system requires a certification.
This certification is required by regulations governing animal waste management
systems adopted by the Enviror—mental Management Commission (EMC) on December 10,
1992 (Title 15A NCAC 2H .0217).
C7TT7 T�'r1m Y0:� ,XoFlzi
On the reverse side of this page is the certification form which must be
submitted to DE:M before new animals are stocked on the fart. Assistance in
completing the form can be obtained from one of the local agricultural agencies
such as the soil and water conservation district, the USDA -Soil Conservation
Service, or the N.C. Cooperative Extension Ser-rice. The form should he sent to:
Depart=ent of Envi=omment, health and
Division of Environmental Management
Water Quality Section, Planning Branch
P.O. Box 29535
Raleigh, N.C. 27626-0535
Phone: [phone]
Form ID: AC:r�Loi0194
Natural Resources
V_L
Steve W. Tedder, Chief
Water Quality Section
Date: 11r, .Z /113
P.O. Bcx 29535, Rcleish. Ncrh Ccsorn z 27626-C 35 Telephone [phone] FAX [phone]
An Equc! Cr-per-unity A: w•m�ive Ac:icn Employer • 50, 4 recyc!et/ 1 C°.e post-ccns mer Yccer
1.
a

%aa jjj•1 United slates Sod
., Oeoarment al conservellon
Ag-CuttUre Service
cp ukATOR : trot 1,0q J 140G - CASE V-44
please review the attached plan and specificaticns carefully. Retain
this plan for your use and records. It is strongly recommended that you,
ycur contractor, and Sail Conservation Service personnel are in agreement
as *to how the waste lagoon is to be constructed. The Soil Conservation
Service personnel will meet with alr concerned parties and walk over the
sine to explain all flags and markings: It is important that everyone
_nderstand what is -expected so that final construction meets plans oral
specification and the job can be certified for payment (if cost -sharing
is involved).
The pad dimensions and grades are the best estimate. The BUILDER cr
CONTRACTOR is -RESPONSIBLE for final layout and design of the pads. The
Soil Conservation Service personnel will assist in a limited capacity,
as its major concern is the proper design and eonstruet.i.on of the waste
crsa tment lagoon.
The actual amount of material required for pads and dam may vary from'the
estimates. The design -will attempt to balance cuts and fills as close as
pcssible. If additional material is required after construction is complete
on the lagoon, the contractor and'ewner will negotiate on the price and
location of borrow area.
NOTE: Design Requirement: i14o703 cu.fc. - cu.yds.
Estimate of Excavation; cu.ft. - 36535 cu.yds.
Estimate or Pad Like: cu.fc. = 251s2cu.yds.
Ration
Jab Class Y 23 iu rz44 4Lf
�a [e
Designed By .�
a
Design Approval 4,_Z21- `
Name
Date
SCS DOES NOT CERTIFY THAT
EXCAVATION AND FILL
VOLUMES ARE CORRECT
•nl �1 A�:.�y.[yl•

Operator:GHF - Case County: Duplin Date: 04/05/94
Distance to nearest residence (other than owner): 1000.0 feet
1. AVERAGE LIVE WEIGHT (ALW)
0
sows
(farrow to
finish)
x
1417
lbs.
= 0
lbs
0
sows
(farrow to
feeder)
x
522
lbs.
= 0
lbs
5760
head
(finishing
only)
x
135
lbs.
= 777600
lbs
0
sows
(farrow to
wean)
x
433
lbs.
- 0
lbs
0
head
(wean to feeder)
x
30
lbs. -
0
lbs
Describe other :
0.
Total Average Live Weight = 777600.1bs
2. MINIMUM REQUIRED TREATMENT VOLUME OF LAGOON
Volume = 777600 lbs. ALW x Treatment Volume(CF)/lb. ALW
Treatment Volume(CF)/lb. ALW = 1 CF/1b. ALW
Volume = 777600 cubic feet
3. STORAGE VOLUME
FOR SLUDGE ACCUMULATION Not cc,-�-h-dr
4t J.a,o(,j
%„vf-.
Volume =
0.0 cubic feet Slvd5t fo 5e
rao4p jot al
necdo
4. TOTAL DESIGNED VOLUME
Inside top length ( feet) ------------------------ 500.0
Inside top width (feet)---------------------- 260.0
Top of dike elevation (feet)----------------- 47.9
Bottom of lagoon elevation (feet)------------ 35.7
Freeboard (feet)------------------------------ 1.0
Side slopes (inside lagoon)------------------ 3.0 : 1
Total design volume using prismoidal formula
SS/END1 SS/END2 SS/SIDE1 SS/SIDE2 LENGTH WIDTH DEPTH
3.0 3.0 3.0 3.0 494.0 254.0 11.2
AREA OF TOP
LENGTH * WIDTH =
494.0 254.0 125476 (AREA OF TOP)
AREA OF BOTTOM
LENGTH * WIDTH =
426.8 186.8 79726 (AREA OF BOTTOM)
AREA OF MIDSECTION
LENGTH * WIDTH * 4
460.4 220.4 405889 (AREA OF MIDSECTION * 4)
CU. FT. _ [AREA TOP + (4*AREA MIDSECTION) + AREA BOTTOM] * DEPTH/6
125476.0 405888.6 79726.2 1.9
Total Designed Volume Available = 1140703 CU. FT.

5. TEMPORARY STORAGE REQUIRED
DRAINAGE AREA:
Lagoon (top of dike)
Length * Width =
500.0 260.0 130000.0 square feet
Buildings (roof and lot water)
0.0 square feet
TOTAL DA 130000.0 square feet
Design temporary storage period to be
5A. Volume of waste produced
Describe this area.
180 days.
Feces & urine production in gal./day per 135 lb. ALW 1.37
Volume = 777600 lbs. ALW/135 lbs. ALW * 1.37 gal/day 180 days
Volume = 1420416 gals.. or 189895.2 cubic feet
5B. Volume of wash water
This is the amount of fresh water used for washing floors•or volume
of fresh water used for a flush system. Flush systems that recirculate
the lagoon water are accounted for in 5A.
Volume = 0.0 gallons/day *
Volume = 0.0 cubic feet
180 days storage/7.48 gallons
per CF-
5C. Volume of rainfall in excess of evaporation
Use period of time when rainfall exceeds evaporation by largest amount.
180 days excess rainfall = 7.0 inches
Volume = 7.0 in * DA / 12 inches per foot
Volume = 75833.3 cubic feet

5D. Volume of 25 year - 24 hour storm -
Volume = 7.5 inches f 12 inches per foot * DA
Volume = 81250.0 cubic feet
TOTAL REQUIRED TEMPORARY STORAGE
5A.
189895
cubic
feet
5B.
0
cubic
feet
5C.
75833
cubic
feet
5D.
81250
cubic
feet
TOTAL 346979 cubic feet
6. SUMMARY
Temporary storage period====================> 180 days
Rainfall in excess -of evaporation===========> 7.0 inches
25 year - 24 hour rainfall==================> 7.5 inches -
Freeboard===================================> 1.0 feet
Side slopes=================================> 3.0 . 1
Inside top length===========================> 500.0 feet
Inside top width============================> 260.0 feet
Top of dike elevation=====__________________> 47.9 feet
Bottom of lagoon elevation==================> 35.7 feet
Total required_ volume=======================> 1124579 cu. ft.
Actual design volume=========== ===========> 1140703 cu. ft.
Seasonal high watertable elevation (SHWT)===> 43-2-feet.
Stop pumping elev.__________________________> 43.9 feet
Must be > or = to the SHWT elev.==========> 43:2 feet:
Must be > or = to min. req. treatment el.=> .41.7 feet
Required minimum treatment volume===========> 777600 cu. ft,.
Volume at stop pumping elevation============> 784147 cu. ft.
Start pumping elev__________________________> 46-.2 feet
Must be at bottoi;i of freeboard &.25 yr. rainfall
Actual volume less 25 yr.- 24 hr. rainfall==> 1059453 cu. ft.
Volume at start pumping elevation===========> 1053965 cu. ft.
Required volume to be pumped================> 265729 cu. ft.
Actual volume planned to be pumped==========> 269818 cu. ft.
Min. thickness of soil liner when required==> 1.8 feet
N y
7. DESIGNED BY: � � APPROVED BY: DATE: --7 DATE:
NOTE: SEE ATTACHED WASTE UTILIZATION PLAN
COMMENTS:
SCS DOES NOT CERTIFY THAT
EXCAVATION AND FILL
VOLUMES ARE CORRECT

SHEET 1 OF 2
OPERATION AND MAINTENANCE PLAN
------------------------
This lagoon is designed for waste treatment (permanent storage) and -
180 days of temporary storage. The time required for the planned
fluid level (permanent and temporary storage) to be reached may vary
due to site conditions, weather, flushing operations, and the amount
of fresh water added to the system.
The designed temporary storage consists of 180 days storage for:
(1) waste from animals and (2) excess rainfall after evaporation. Also
included is storage for the 25 year - 24 hour storm for the location.
The volume of waste generated from a given number of animals will be
fairly constant throughout the year and from year to year, but excess
rainfall will vary from year to year. The 25 year rainfall will not
be a factor to consider in an annual pumping cycle, but this storage
volume must always be available.
A maximum elevation is determined in each design to begin
pumping and this is usually the outlet invert of pipe(s) from
building(s). If the outlet pipe is not installed at the elevation to
begin pumping, a permanent marker must be installed at this elevation
to indicate when pumping should begin. An elevation must be established
to stop pumping to maintain lagoon treatment depth.
Pumping can be started or stopped at any time between these two ,
elevations for operating convenience as site conditions permit, such as
weather, soils, crop, and equipment in order to apply waste without
runoff or leaching.
Land application of waste water is recognized as an acceptable
method of disposal. Methods of application include solid set,
center pivot, guns, and traveling gun irrigation. Care should be
taken when applying waste"to prevent damage to crops.
The following items are to be carried out:
1. It is strongly recommended that the treatment lagoon be pre -
charged to 1/2 its capacity to prevent excessive odors during
start-up. Pre -charging reduces the concentration of the initial
waste entering the lagoon thereby reducing odors. Solids should be
covered with effluent at all times. When precharging is complete,
flush buildings with recycled lagoon liquid. Fresh water should not
be used for flushing after initial filling.
2. The attached waste utilization plan shall be followed. This
plan recommends sampling and testing of waste (see attachment)
before land application_
3. Begin temporary storage pump -out of the lagoon when fluid level
reaches the elevation 46.2 as marked by permanent marker. Stop pump -
out when the fluid level reaches elevation 43.9 . This temporary
storage, less 25 yr- 24 hr storm, contains 265729 cubic feet or
1987649 gallons.

SHEET 2 OF 2
4. The recommended maximum amount to apply per irrigation is
one (1) inch and the recommended maximum application rate is 0.3
inch per hour. Refer to the waste utilization plan for further details. -
5. Keep vegetation on the embankment and areas adjacent to the
lagoon mowed annually. Vegetation should be fertilized as needed
to maintain a vigorous stand.
6. Repair any eroded areas or areas damaged by rodents and
establish in vegetation.
7. All surface runoff is to be diverted from the lagoon to stable
outlets.
S. Keep a minimum of 25 feet of grass vegetated buffer around
waste utilization fields adjacent to perennial streams., Waste will
not be applied in open ditches. Do not pump within 200 feet of a
residence or within 100 feet of a well. Waste shall be applied in a
manner not to reach other property and public right-of-ways.
9. The Clean Water Act of'1977 prohibits the discharge of
pollutants into waters of the United States. The Department of
Environment, Health, and Natural Resources, Division of Environ-
mental Management, has the responsibility for enforcing this law.

SHEET 1 OF 2
SPECIFICATIONS FpR CONSTRUCTION OF WASTE TREATMENT LAGOONS
FOUNDATION PREPARATION:
-----------------------
The foundation area of the lagoon embankment and building pad shall be
cleared of trees, logs, stumps, roots, brush, boulders,sod and rubbish.
Satisfactory disposition will be made of all debris. The topsoil from
the lagoon and pad area should be stripped and stockpiled for use on
the dike and pad areas. After stripping, the foundation area of the
lagoon embankment and building pad shall be thoroughly loosened prior
to placing the first lift of fill material to get a good bond.
EXCAVATION AND EARTHFILL PLACEMENT: -----------------------------------
-
The completed excavation and earthfill shall conform to the lines,
grades, and elevations shown on the plans. Earthfill material shall
be free of material such as. sod, roots, frozen soil, stones over
fi inches in diameter, and other objectionable material. To the extent
they are suitable, excavated materials can be used as fall. The fill
shall be brought up in approximately horizontal layers not to exceed 9
inches in thickness when loose and prior to compaction. Each layer
will be compacted by complete coverage with the hauling and spreading
equipment or standard tamping roller or other equivalent method.
Compaction will be considered adequate when fill material is observed
to consolidate to the point that settlement is not readily detectible.
NOTE THE SPECIAL REQUIREMENTS FOR PLACEMENT OF LINERS IN THE LINER
SECTION OF THIS SPECIFICATION. The embankment of the lagoon shall be
installed using the more impervious materials from the required
excavations. Construction of fill heights shall include 5 percent for
settlement. Dikes over 15 feet in height and with an impoundment
capacity of 10 acre-feet or more fall under the jurisdiction of the NC
Dam Safety Law. The height is defined as the difference in elevation
from the constructed height to the downstream toe of the dike.
Precautions shall be taken during construction to prevent excessive
erosion and sedimentation.
LINER: THE MINIMUM REQUIRED THICKNESS SHALL BE 1.8 ft.
NOTE: LINERS (PARTIAL OR FULL) ARE REQUIRED WHEN THE ATTACHED SOILS
INVESTIGATION REPORT'SO INDICATES OR WHEN UNSUITABLE MATERIAL IS
ENCOUNTERED DURING CONSTRUCTION. A TYPICAL CROSS SECTION OF THE LINER
IS INCLUDED IN THE DESIGN WHEN LINERS ARE REQUIRED BY THE SOILS REPORT.
When areas of unsuitable material are encountered, they will be over -
excavated below finish grade to the specified depth as measured
perpendicular to the finish grade. The foundation shall be backfilled
as specified to grade with a SCS approved material (ie -- CL,SC,CH).-
REFER TO THE SOILS INVESTIGATION INFORMATION IN THE PLANS FOR SPECIAL
CONSIDERATIONS.

SHEET 2 OF 2
Soil liner material shall come from an approved borrow area. The
minimum water content of -the liner material shall be optimum moisture
content which relates to that moisture content when the soil is kneaded
in the hand it will form a ball which does not readily separate. Water
shall be added to borrow as necessary to insure proper moisture content
during placement of the liner. The moisture content of the liner
material shall not be less than optimum water content during placement.
The maximum water content relates to the soil material being too wet
for efficient use of hauling equipment and proper compaction. Proper
compaction of the liner includes placement in 9 inch lifts and
compacted to at least 90 percent of the maximum ASTM D698 Dry Unit
Weight of the liner material. When smooth or hard, the previous lift
shall be scarified and moistened as needed before placement of the next
lift.
The single most important factor affecting the overall compacted perme-
ability of a clay liner, other than the type of clay used for the
liner, is the efficient construction processing of the compacted liner.
The sequence of equipment use and the routing of:equipment in an estab-
lished pattern helps assure uniformity in the whole placement and
compaction process. For most clay soils, a tamping or sheepsfoot
roller is the preferable type of compaction equipment.
The soil liner shall be protected from the discharge of waste outlet
pipes. This can be done by using some type of energy dissipator(rocks)
or using flexible outlets on waste pipes.
Alternatives to soil liners are synthetic liners and bentonite sealant.
When these are specified, additional construction specifications are.
included with this Construction Specification.
CUTOFF TRENCH:
--------------
A cutoff trench shall be constructed under the embankment area when
shown on a typical cross section in the plans. The final depth of the
cutoff trench shall be determined by observation of the foundation
materials.
VEGETATION:
All exposed embankment and other bare constructed areas shall be seeded
to the planned type of vegetation as soon as possible after construc-
tion according to the seeding specifications. Topsoil should be placed
on areas of the dike and pad to be seeded. Temporary seeding or mulch
shall be used if the recommended permanent vegetation is out of season
dates for seeding. Permanent vegetation should be established as soon
as possible during the next period of approved seeding dates.
REMOVAL OF EXISTING TILE DRAINS
-------------------------------
When tile drains are encountered, the tile will be removed to a minimum
of 10 feet beyond the outside toe of slope of the dike. The tile
trench shall be backfilled and compacted with good material such as
SC, CL, or CH.

SEEDING SPECIFICATIONS
----------------------
AREA TO BE SEEDED: 3.2 ACRES -
USE THE SEED MIXTURE INDICATED AS FOLLOWS:.
0.0 LBS. FESCUE GRASS AT 60 LBS./ACRE
(BEST SUITED ON CLAYEY OR WET SOIL CONDITIONS)
SEEDING DATES: SEPTEMBER 1 TO NOVEMBER 30
FEBRUARY 1 TO MARCH 30
0.0 LBS. RYE GRAIN AT 30 LBS./ACRE (NURSERY FOR FESCUE)
0.0 LBS. 'PENSACOLA' BAHIA GRASS AT 60 LBS./ACRE
(SEE FOOTNOTE NO. 1)
SEEDING DATES: MARCH 15 TO JUNE 15
25.6 LBS. HULLED COMMON BERMUDA GRASS AT 8 LBS./ACRE
(SUITED FOR MOST SOIL'CONDITIONS)
SEEDING. -DATES: APRIL 1 TO JULY 31
0.0 LBS. UNHULLED COMMON BERMUDA GRASS AT 10 LBS./ACRE
SEEDING DATES: JANUARY 1 TO MARCH 30
128.0 LBS. RYE GRASS AT 40 LBS./ACRE (TEMPORARY VEGETATION)
SEEDING DATES: DECEMBER 1 TO MARCH 30
LBS.
APPLY THE FOLLOWING:
3200.0 LBS. OF 10-10-10 FERTILIZER (1000 LBS./ACRE)
6.4 TONS OF DOLOMITIC LIME (2 TONS/ACRE)
320.0 BALES OF SMALL GRAIN STRAW (100 BALES/ACRE)
ALL SURFACE DRAINS SHOULD BE INSTALLED PRIOR TO SEEDING. SHAPE
ALL DISTURBED AREA IMMEDIATELY AFTER EARTH MOVING IS COMPLETED.
APPLY LIME AND FERTILIZER THEN DISK TO PREPARE A 3 TO 4 INCH
SMOOTH SEEDBED. APPLY SEED AND FIRM SEEDBED WITH A CULTIPACKER
OR SIMILAR EQUIPMENT. APPLY MULCH AND SECURE WITH A MULCH
ANCHORING TOOL OR NETTING.
1. PENSACOLA BAHIAGRASS IS SLOWER TO ESTABLISH THAN COMMON
BERMUDA GRASS. WHEN USING BAHIA' IT IS RECOMMENDED THAT 8
LBS./ACRE OF COMMON BERMUDA BE INCLUDED TO PROVIDE COVER
UNTIL BAHIAGRASS IS ESTABLISHED.

Total Volumes by Project
(combined volumes for each drawing)
Project: Case Farm'
Drawing: Drawing 1
Number: GHF042
Location: Duplin
Bid Date:
Engineer: G. Pettus
Owner: GHF, Inc.
Estimator:
Prepared by: GOLDSBORO HOG FARM using SITEWORK
Date: 03/22/94 Time: 20:23:31
Drawing: Drawing 1
Grid cell size: 5.02 by 5.03 Original drawing scale: 100.00 ft/in
IExCUTded ( ExFILLed CUT FILL I
-------------------------------- -----------w------------------------------------__
Balanced 36535.32 25152.42 36535.32 31440.53
Existing I I I ( 0.00%)I ( 25.00%)
-------------------------------i--11382.90 ---_-50------! -----
94-
Net:
Project: Case Farm
CUT I FILL I ExCUTded I Expanded
---------------------------------------------------------------------------------
Project Totals: I36535.32 25152.42I 36535.321 31440.53
Average Shrink/Swell Percent 0.00%)( 25.00%)
--------------------------------------------
Project Net: 1 11382.901 ! 5094.791 -___

Site Balance Report
Grid cell size: 5.02 by 5.03
Original drawing scale: 100.00 ft/in
Project: Case Farm
Drawing: Drawing 1
Number: GHF042
Location: Duplin
Bid Date:
Engineer: G. Pettus
Owner: ' GHF, Inc.
Estimator:
Prepared by: GOLDSBORO HOG FARM using SITEWORK
Date: 03/22/94 Time: 20:20:06
Final surface: Proposed
Initial surface: Existing
There are no "Proposed" structures.
Fill shrink/swell percent: 25.00 Cut shrink/swell percent: 0.00
"Proposed" raised by 0.700 feet
delta . Cut
0.000 40006.16
0.700 36535.32
Raise ".Proposed" by 0.700 feet.
Fill Cut - Fill
23117.08 .16889.08
31440.52 5094.80

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UNITED STATES. SOIL
DEPARTMENT OF CONSERVATION
AGRICULTURE SERVICE
------------------------------------------------------------
WASTE MANAGEMENT FACILITY SITE EVALUATION
GENERAL INFORMATION
NAME fa2-Ld E��rc_ Iry_ a!✓ r-_-___
oozy
TELEPHONE ��- 2'7F ='�--------
�-f---
2� -----------^—
SIZE OPERATION-1-q-L°------------------
-
LOCATION DATA
DISTANCE FPOOM NEAREST RESIDENCE NOT OWNED BY
PRODUCER -LL--FT.(s"i,,d
IS SITE WITHIN 100-YEAR FLOOD PLAIN? YES----- No ----
.If yes, SCS cannot provide assistance.
IS SITE AT LEAST 100 FT. FROM A "BLUE LINE"
PERENNIAL STREAM? YES----- NO ----
If no, site must be reloca ed.
IS SITE WITHIN 1 MILE ZONING'JURISDICTION
OF A MUNICIPALITY? YES----- NO ----
If yes, landowner should consult with local zoning board
about required permits. Permits must be obtained prior
to design approval.
Are utilities in construction area? YES----- N0=/ If yes, see Part 503 of the National Engineering Manual
and follow policy.
(Copies of maps or other reference materials may be
attached to site evaluation.)
Page 1

a
WETLANDS
WILL SITE INVOLVE CLEARING WOODLAND OR ANY
NON -CROPLAND? YES----- NO -
If yes, producer trust complete a Form AD-1026.
WILL ACTION RESULT IN SWAMPBUSTING? YES-_-- NO=� IF WETLANDS ARE INVOLVED, IT IS THE RESPONSIBILITY OF THE
PRODUCER TO CONTACT THE US ARMY CORP OF ENGINEERS AND THE
DIVISION OF ENVIRONMENTAL MANAGEMENT TO DETERMINE IF
ADDITIONAL PERMITS ARE REQUIRED. NO WETLANDS SHOULD BE
ALTERED UNTIL PRODUCER RECEIVES WRITTEN APPROVAL FROM SCS,
US ARMY CORP OF ENGINEERS AND NC DIVISION OF ENVIRONMENTAL
MANAGEMENT.
(A copy of AD-1026 and CPA-026 should be attached to
site evaluation.)
OTHER ENVIRONMENTAL FACTORS
IS ENDANGERED AND/OR THREATENED SPECIES HABITAT
PRESENT? YES----- NO ----
IS A DESIGNATED NATURAL SCENIC AREA INCLUDED IN THE
PLANNING AREA OR WILL PLANNED ACTIONS IMPACT ON AN
ADJACENT NATURAL SCENIC AREA? YES---- NO ----
IS AN ARCHAEOLOGICAL OR HISTORICAL SITE LOCATED IN THE
PLANNED AREA? YES---- NO-- -
ARE THERE PRIME, UNIQUE, STATE OR LOCALLY IMPORTANT
FARMLANDS IN THE OPERATING UNIT? qvC3 YES---- NO -----
WILL THE ACTION RESULT IN SODBUSTING? YES----- NO`� -
If yes to any oV these quest'ons, refer to form NC--CPA-16
for policy sources. The form does not need to be
completed.
ODOR CONTROL
HAS ODOR CONTROL BEEN DISCUSSED WITH PRODUCER.........
.........PREDOMINANT WIND DIRECTION? YES---- NO ----
........POSSIBLE EXPANSION OF TREATMENT
VOLUME FROM 1 CU.FT. UPWARDS TO
3 CU. FT. /LB. OF ANIMAL? YES----- NO-----
........PRECHARGING LAGOON WITH FRESH
WATER TO AT LEAST 1/2 OF THE ✓
CAPACITY? YES---- NO----
........USING GOOD SOUND JUDGMENT IN
LAND APPLICATION OF WASTE? YES---- NO ----
Page 2

WASTE MANAGEMENT
DOES PRODUCER OWN ENOUGH LAND TO PROPERLY LAND
APPLY WASTE? YES - NO ----
IF NO, DOES PRODUCER HAVE ACCESS TO
MORE LAND? YES---- NO----
IFLAND IS NOT OWNED BY PRODUCER,
CAN PRODUCER GET AGREEMENT ON LAND
ON WHICH TO APPLY WASTE? YES---- NO ----
(Attach Waste Utilization Plan to site evaluation.)
SOIL INVESTIGATION -- VALID ONLY IF
SHEET ATTACHED
IS SOIL SUITABLE FOR LAGOON?
IS A CLAY LINER REQUIRED?
IF YES, IS CLAY AVAILABLE ONSITE?
IS A CORE TRENCH REQUIRED?
(Attach soil investigation sheet
SOIL INVESTIGATION
YES NO NO ------
YES- Z -- NO ------
YES-- -- NO------
QUESTIONABLE--------
YES------ NO-'l --
to site evaluation.)
SITE APPROVED YES-L,--- - NO------ CONDITIONAL-----
COMMENTS -
- ----------f-------------Q-------------------------------
THIS SITE INVESTIGATION IS VALID AS LONG AS THE DESIGN AND
CONSTRUCTION OF LAGOON CONTINUES IN REASONABLE TIME
PERIOD. UNDUE DELAYS OR HESITANCY IN CONSTRUCTION MAY
REQUIRE THAT SITE EVALUATION BE INVALIDATED.
%3-3o-Q
SIGNAT[FRE- - - - -'-`-- ------ DATE--
Page 3

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I. SA-11PLC COLLECTION .
A. Liquid Manure Slurry
I. Under -slotted --floor pit
a. Use a length of 1/2" conduit open on one end and that can be
easily sealed on the other end (e.g., by placing one's thumb
over the end of the conduit).
b_ With both ends of the conduit open, extend -i t into the. manure
to the pit floor.
c. Seal the upper end of the conduit trapping the manure that has
entered the lower end, remove and empty into a bucket or container.
c_ Collect samples from at least 5 locations or at least enough
for a total of 1 Quart of slurry.
e. Thoroughly mix this slurry and empty approximately 1/2 pint
into sample container.
2. Exterior storage basin or tank Y
a. hake sure the manure has been well mixed or homogenized with a
liquid manure chopper -agitator pump or propeller agitator.
b. Take samples from approximately 5 locations in the pit, from the
agitator pump.,' or from the,mpa ure spreader and place•in a bucket_
c.-': Thoroughly mix and empty IV2- pint into sample container.
II. SAr•IPLE PREPARATION AND TRANSFER
A. Place the sample for analysis into a flexible or expandable container that
can be sealed. The container should be rinsed clean with water and free
of any residues but should not be chlorinated or treated in any other way.
Dry litter may also be placed in a sealed plastic bag such as a freezer bag.
B. The sample should be refrigerated, iced or cooled, if possible, or trans-
ferred to the lab immediately.
C. }land -delivery is the most reliable way of sample transfer, but it can also'
be mailed.
D. If mailed, sample container should first be protected with a packing material
such as newspaper, then boxed or packaged with wrapping paper and taped.
E. The NCDA Plant Analysis Lab provides this service for a nominal fee of
S4'per sample which should be forwarded along with the sample.

PSWCD 1
1. Address: IN. C. Departi:�enz cz Agriculture
Plant Analysis Lab
Agronomic Division
Blue Ridge Road Center
Raleigh, NC 27611
Ph: [phone]
Attn: Dr. Ray Campbell
F. Request that as a minimum the following analyses be performed:
1. Total nitrogen (TO)
2. Ammonia nitrogen (HH H)
"3. Total phosphorus .(TP33 =
4. Potassium .(K)
S. Dry litter samples should also include a total solids (TS) analysis.
G. Other analyses performed at no extra cost by.,NCOK include trace minerals.

PSVCD 2
L. Lagoon Liquid J`
1. Collect approximately 1/2 pint of recycled lagoon liquid from the
inflow pipe to the flush tanks.
2. From lagoon
a. Place a small bottle (1/2 pint or less) on the end of a l'0-15
foot long pole.
b. Extend the bottle 10-15 feet away from the bank edge.
c. Brush away any floating scum or debris so it is not collected
with sample. `
d. Submerge the bottle wtithin 1 footof .the liquid surface'.
e. Repeat at approximately 5 locations around the lagoon, place
into a bucket, thoroughly mix, and empty 1 pint into sample
container.
3. From a multi --stage lagoon system collect sample from lagoon that
is going to be irrigated from. _
II. SA411PLE PREPARATION AND TRANSFER
A. Place the sample for analysis into a flexible or expandable container that
can 'be sealed. The container should be rinsed clean with water and free
of any residues but .should not be chl on hated or treated • i n any other way..
Dry litter may al�o'be placed in a S.eal-ed plastic bag such as a freezer bag.
•5
B. The sample should be refrigerated, iced or cooled, if possible, or trans-
ferred to the lab immediately.
C. Hand -delivery is the most reliable way of sample transfer, but it can also
be mailed.
D. If mailed, sample container should first be protected with a packing material
such as. newspaper, then .boxed or packaged with wrapping paper and taped.
E_ The RCDA Plant Analysis -Lab provides this service for a -nominal fee of
$4 per sample which should be forwarded along with the sample.
1. Address: I.I. C. Department of Agriculture
Plant Analysis Lab
Agronomic Division
Blue Ridge Road Center
Raleigh, NC 2.7611
Ph: [phone]
4.
..^.ttn: Dr. °;.a Campbell
Mi

PSWCD 2
-. Request ghat as a i::lnimu`:+ the following ana bses be pee oriued:
1. Total nitrogen (TKN)
'2. Ammonia nitrogen SHIM)
3. Total phosphorus (TP)
4. Potassium (K)
5. Dry litter samples should also include a total solids (TS) analysis.
G. Other analyses performed at no extra cost by NCDA include trace minerals.

SC:-ENG-538 U. S. DEPARTMENT OF AGRICULTURC
Rcr. 5-70 SOIL CONSERVATION SERVICE
SOIL INVESTIGATION TO DETERMINE SUITABILITY OF PROPOSED POND SITE
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�;1�1e�lelele�l®l�lef�l/1�lelele
�e�1�31e��1�1®i�le�ele�lefeEetefefelele
M101mut
mlemlelemmm
t�
f ���el�lel�iilelele
l®leee
�ei��e
11-1' q / 5 M 5 m
1344 /j/ � C �117`Ui�r � 4�r-Seu yr,r, � m
`' M

TYPES OF NiATERIAL ENCOUNTERED IN BORINGS
(Use one of systems below)
UNIFIED CLASSIFICATION
USDA CLASSIFICATION
GW- Well graded gravels; gravel, sand mix
g-gravel
GP -Poorly graded gravels
s -.sand
GM -Silty gravels; gravel -sand -silt mix
vfs-very fine sand
GC -Clayey gravels; gravel -sand -clay mix
sl - sandy loam
SW- Well graded sands; sand-grivei mix
fsI -fine sandy .loam
SP -Poorly graded sands
1- loam
SM -Silty sand
gl - gravelly loam
SC -Clayey sands; sand -clay mixtures
si-silt
ML- Silts; silty,v.fine sands; sandy orclayey silt
sil-silt loam
CL-Clays of low to medium plasticity
cl-clay loam
CH -Inorganic clays of high plasticity
sicl- silty clay loam
MH-Elastic silts
scl-sandy clay loam
OL-Organic silts and silty clays, low plasticity
sic -silty clay
OH -Organic clays, medium to high plasticity
c-clay
1. Suitable material for embankment is available Flea 0 No (Indicate where tx=tea an tht sketch ore
rwm"w side)
REMARKS:
'2/ 00l .-ss 0 r .r" Cvle �.�/O/� tF' 5? N L %
lei 0/-
2. Explain bazards requiring special attention in design {Seepage, sP&w..rock etc.)
S-�oC'r P le .�C %%14 ��vrq l 4,01 f d-j olor-% e 1( C~ J4 �/O� did
.1a � oe,.1 �3e � o.a-- � Si �Y
GENERAL REMARKS_
24
5
6
27
23129130131
32
M
1l
3
35
36
37
38
3914011410421143'
44
45
46
47148149
50
51
!iI
ItII
II
I1II
I
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Il
II
II
II
II
III
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4

WASTE UTILIZATION PLAN
FOR
CASE FARM Goldsboro Hog Farms
PO Box 10009
Goldsboro NC 27532
Marc-h 28, 1994
Your animal waste utilization plan has been specifically
developed for your 5760 FEEDER TO FINISH SWINE operation.
The plan is based on the sail types, crops to be grown, and
method of application for your par-tic"rlar operation. The waste
mr_rst be land applied at a specified rate to prevent pollution
of surface and/or groundwater. The. plant nutrients in the
animal waste should be used to reduce the amount of commercial
fertilizer required for the crops in the fields where the waste
is to be applied. This waste '_ttiliZation plan '.lses nitrogen as
the limiting nutrient. Waste should be analyzed before each
appl iced ion and -annual soil tests are encouraged so that all
plant nutrients and lime can be balanced far realistic yield
of the crops to be grown.
Several factors are important in implementing your waste
utilization plan in order to maximize the fertilizer value
of the waste and to ensure that it is applied in an environ—
mentally safe manner. Always apply waste based on the needs
of the crop to be grown and the nutrient content: of the waste.
The amount of available nitrogen far' p1aT;t ,�.zse is dependant or,
the method of application. Soil type is important due to
different leaching potential and yield potential. Waste shall
not be applied to land eroding at greater than 5 tans per acre
per~ year~. Do not apply waste on saturated soils or. on land
Mier; the surface is frozen;. Either of these c-0riditian5 may
result in runoff to surface: waters. Wirid.cc, nditions s hGr.1d
also be considered to avoid drift and downwind odor- problems.
iG lllai il"i1Ze i".lie 'Jci1�_le G1' tlr£ n�itY'ients for~ CrUp production and
reduce the potential for pollution, waste should tie applied to
a Cir-GVJ1f�lg crop .." i'iGt IT10'rr 'fI-i��T'i 30 days pr•1Gr~ = j:�1:=.nt1!-iG.
So l inc-orporat i or, of the waste will coils e- ve nLitrient; and
reduce odor problems.
The «eves needed to apply the animal waste cr--e based on
typics l nutrient content for t.Fii.s type of f ,ci l ity. Annual
acreayE r'erll_lir~ener;ts nlay be mor-e or lets deperiding on the
specific waste anKly�is r~epor-t for- your facil i t'. at the tine:
nf irrigation.

Your waste utilization plan is based on the following:
TABLE A. AMOUNT OF WASTE PRODUCED PER YEAR
1 NUMBER OF I I TONS WASTE PER I TONS WANE I
I ANIMALS I TYPE OF ANIMALS 1 1000 ANIMALS I PER YEAR I
I----------- I _-------------------------- -----1--------------- I ------------ I
1 5760 1 FEEDER TO FINISH 1 1900 1 10944 1
TABLE B.
SUMMARY
OF CROPS
BY FIELD
----------------------------------------------------------------------------
TRACT
I FIELD
I SOIL
1 ACRES I CROP 1CROPCODE1
1---------
1 70808
I -- -----
1 1--3
1 - ------
1 AuB
k _ ______ 1-----_—_---_..----__----------------- i------.----;
145.0 1 HYBRID BERMUDAGRASS HAY I BH E
1 70808
----------------------------------------------------------------------------
1 1-3
1 AUB
115.O 'I SMALL GRAIN PASTURE I SGP 1
TABLE C. SUMMARY OF CROWS, YIELD, AND NUTRIENT REQUIREMENTS BY SOIL TYPE
------------------------------------------------------------------------------
I CROP ISOILIYIELD1UNITS1TOTAL N1 *TOTAL P I *TOTAL K I
1---------------------------- 1 ---- I ------ 1 --- -- 1 — --- __ 1------------ I ------------ 1
I HYBRID BERMUDAGRASS HAY I AuB 15. 5 1 TONS 127 10 1 140 — 160 1
I SMALL GRAIN PASTURE I AuB 1 1. E' I TONS 160 130 - 50 150 - 70 1
#- Total phosphate and potash amaze, -Its should be confir-med with a soil test:.
� sx &-x 2.7 S ( 2 37 5-
TABLE D. WASTE M;ANAGEM ENT BY FIELD I� i-7
-------------------------------------------------------------- )--------------------
I I Cf:OR I WA7STE APPL I TYPE I WASTE N i COMMA My 1 MIONTHS TO AFIF-IL `s` ;
-9 1::CiCT � F IE=LD I C^L>E-_; METHOD I t• rA :TE 1 LIER/ A�-' I LB/AC AINIMAL wASTE !
---- - - i ----- !------; --- ---- - - I - ------ I - - -� _ _ 1 ___ -_ i _----_-_----------------
170806 1 1-3 1 BH 1IRRIGATE ISWINE 1 275 k' I APRIL I'D OCT I
1706031 1 1 1 SGP -1 IRRIGATE ISWINE I& 0. L FEB--Ni-`laC

The acres, crops, and application method shown in the preceding tables will
accommodate approximately 5771.7 animals of the type shown in Table A.
If more commercial fertilizer is used than is shown in Table D, then -
additional acres of land will be needed. A 10 — E53 feet wide permanent
grass filter- strip should be seeded along all ditches in fields that
receive animal waste.
The acres shown in Table B are the usable acres in the field shown. Usable
acres ar-e the acres that must be able to receive animal waste. Puffer areas
along ditches, houses, property lines, etc. have been subtracted from the
total field acreages to arrive at the Disable acres. The total acres shown
on the attached reap is needed for land application in order to have the
proper buffer~ areas. A combination of land application equipment or
irrigation equipment may be needed in order to properly land apply waste to
all parts of the fields listed. It is the responsibility of the producer to
acquire whatever equipment is needed to properly land apply the waste.
ADDITIONAL COMMENTS
Prepar-ed by: _ Title
X LT
r- -
GGncu'rred i n by- �O � T �.(.•.� Date
l

U. S. Department of Agriculture NC-ENG-34
Soil Conservation Service September 1980
File Code: 210
HAZARD CLASSIFICATION DATA SHEET FOR'B�tS
Landowner CQ5,-, E;rn �Ge�rb��o lay FArr;_� County C., 1F'
Community or Group No. N E -10 Conservation Plan No.
9-S
Estimated Depth of Water to Top of Dam_Ft. Length of Flood Pool sooFt.
Date of Field Hazard Investigation
Evaluation by reach of flood plain downstream to the point of estimated minor effect
from sudden dam failure.
.-
Est. Elev.:Est.
Elevation
Kind of
:Improvements:
of Breach
Reach: Length: Width:
Slope: Land -Use
Improvements
Above :Floodwater Above
Flood Plain:
Flood Plain
Ft..
X:
Ft.
Ft.
.-Ft.
-
�
2
.
/Opp
3
Describe potential for
-
loss of life and
i
damage to existing
or probable future downstream
improvements from a sudden breach
;OV 6,�n
_p +r;bhp�
PoL,
Hazard Classification of Dam 0, b, c) (see NEM-Part 520.21)
1-2.>>4'
-Dam Classification
By
n
(I, II, III, I1l,(V
title
Concurred By`�. 4
name V U (title
140TE: 1. Instructions on reverse side.
2. Attach additional sheets as needed.
Date -qu-
Date `f S�•�'

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F
DIETZGEN CORPORATION NO. asrl�.-7O
.rwoc Iw U.....

f,'t k.
NUH I H UAHULINA
Department of Environmental Qual
II

GIM%slon of Water Resources
FaCI((l'`Number 3/ 4/� g;' 0 Division OtSoll and Water,COn5ervahonl l
( j '� ..
ill _ Other �A enc
Type of Visit: omplia Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1 T Arrival Time: o o Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: J Z_ v�
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Certification Number:
Certification Number:
Longitude:
design
Current
tC
Design Current
Design Current -
Swine
Capacity
Pop.
:Wet Poultry.
Capacity `-,,!Pop
���
Cattle
Capacity 'Poor.
jE
{ ,
R`}@e
Wean to Finish
Layer
ry
�}
Design, Current
D .rPoultry � 1�
ca ui I' Po
Farrow to Finish
�
3
E Other
Other
Other
Other
Y
Farrow to Wean
Gilts
Non -La er
Lavers
Non -Layers
Turkeys
Turkey Pouets
�
Dai Caw
Dischar gs and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes O'1Vo ❑ 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)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No NA ❑ NE
❑Yes ❑NA ❑NE
❑Yes ❑No ❑NA ❑NE
Page I of 3 2/4/2015 Continued

[Facility Number: - S Date of Inspection:
Waste Collection & Treatment
4. Is'storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑Yes
No ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
th t, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ 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 ffNo ❑ 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 O<o 0 NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy -Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or t0 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
Q No ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Io ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
fo ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Required Records & Documents
<NoEO
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Ej NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Ej<o ❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑il o ❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers ❑ Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
No NA
❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[—]Yes
la Q NA
❑ NE
Page 2 of 3
21412015 Continued

Facility Number: IDate of Inspection:
a
24. Did the facility fail to calibrate waste application equipment as required by the permit.
[] Yes
No ❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
❑ Ko'�[:] NA
❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
No ❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[-]Yes
[:]No iA [] NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
❑moo ❑ 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
❑>v--n NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No ❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
EfNo ❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[:]No NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No ❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Q>o-""❑ NA
❑ NE
Reviewer/Inspector Signature: Date: �l�/%
Page 3 of 3 21412015

W Division of Water Resources
Facility Number - 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: Co fiance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: / County: DVftm Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: l r �l:1 c
Certified Operator:
Title:
Phone:
Phone:
Integrator:
Certification Number: �Qg I -
Back-up Operator: Certification Number:
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
Latitude: Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Dry Poultry
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes Z No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes ❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facility Number: - Date of Inspection: ue
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes /No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1�
Identifier: ll`
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):b
Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
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 No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmen71-
breat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? El Yes 90 ❑ 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 UNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes jNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12, Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes N
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes N�7No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? [:]Yes No 0 NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑ Checklists [—]Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [:]Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes V11;
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - Date of Ins ection:
24. Did 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 &No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes 26N0 ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 6/No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes V o
❑ Yes �No
❑ Yes / No
❑ Yes [�No
❑ NA ❑ NE
[DNA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes []10 ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 7❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes � No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Phone( r10 / _7 71 "
19
Reviewer/Inspector Signature:
Date: X I 1 f !'
Page 3 of 3 ' 21412015

r u r n 0 Divisioof Water Resources . +
�Faciiity Number "� 4 �� � Division of Soil and;W40,
ater�Conseiwat,on
Type of Visit: Co pliance Inspection Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: — Arrival Time: Departure Time: County: D-19L2rd Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Phone:
Physical Address:
Facility Contact: M Title: Phone:
Onsite Representative: F.Ov Integrator: ��!!
Certified Operator: Certification Number: d`{p[�
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current _ Design Current Design Current.
�Wef=Pool Ca hci �Po Cattle Ci �aci Po
a
- _ s
Swine C," cih' ,..pop try p h' P2 P ty p:
Wean to Finish La er
Wean to Feeder Non -Layer
Feeder to Finish
Farrow to Wean Design �Current''-
Farrow to Feeder Ft' .Z . l ¢Poetl Ca` aci 'Po
Farrow to Finish -4. Layers
Gilts Non -La ers
Boars Pullets
' Cow
i Calf
FDa
' Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
,-
Turkeys
a her.. _u Turke Points
` �.
Other Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes dNo ❑ 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)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ o ❑ NA ❑ NE
[:]Yes WNo ❑ NA ❑ NE
[-]Yes EIINO ❑ NA ❑ NE
Page 1 of 3 21412014 Continued

Facility Number: - Date cf inspection: '1 11
f
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes . No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: t,
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Ll -1�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑Yes YNo
❑ 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 ❑ 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 environment I threat, notify DWR
7. Do any of the structures need maintenance or improvement? [—]Yes environment
❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes YNo ❑ 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 Cf/No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ElYes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes E2r/No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13, Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
jo
o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
WNNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
C] Yes
ff/No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[2/No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
E Yes
❑ No
❑ NA
❑ NE
the appropriate b
E2rWUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Othe :
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections E2 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [] Yes �o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [�No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: - Date of Inspection:
24.`Did the facility fail to calibrate waste application equipment as required by the permit? ❑Yes Zo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ 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 N ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes V ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes La 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 E_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 No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes F31N3
❑ NA ❑ NE
34. Does the facility require afollow-up visit by the same agency? ❑ Yes No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
-r�l.� S.�v7J LJ�aS �al�f 6
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
Date: ! I3
21412015

,• q) Division of Water Quality
Faeility Number - O Division of Soil and Water Conservation
Q Other Agency
Type of Visit: Co Hance Inspection Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: DO,S' Departure Time: County: r3wapi Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: ��''++ Title:
gOnsite Representative: U 2_re j j't1
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
can to Finish
Wean to Feeder 2SIlo
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Other
Other
Latitude:
Phone:
Integrator:
Certification Number: a
Certification Number:
Design Current
Wet Poultry Capacity Pop.
La er
Non -Layer
Design Current
Pullets
Turkey Poults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Daja Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
[:]Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ o ❑ NA ❑ NE
❑ YesVNo
N❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
Page 1 of 3 21412011 Continued

FaFili Number: - Date of Inspection:
Waste Collection & Treatment
4. -ins 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 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: L
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
[—]Yes
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 environment threat,
7. Do any of the structures improvement? Yes
notify DWQ
NA NE
need maintenance or
❑
❑
❑
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
rNoo
❑ 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
En No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes M/No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
U 110
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
to❑
NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
fNo
❑ NA
❑ NE
the appropriate box.
❑WUP []Checklists ❑Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
[:]Yes
No
[DNA
❑ 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 ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ YesVNo ❑ NA [] NE
Page 2 of 3 21412011 Continued

F%cility Number: IDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes TNo
o NA NE
Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes ❑ NA D NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey Failure to develop a POA for sludge levels
El Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? Yes ❑ NA NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? Yes No ❑ NA NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
[] Yes E2 /No ❑ NA NE
Yes ;Z/No
El Yes /No
[] Yes
Yes
ED Yes
Yes
NA NE
NA NE
❑ NA ❑ NE
DNA NE
NA NE
No ❑ NA NE
(Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawinns of facilitv to better explain situations fuse additional oases as necessarv).
Reviewer/Inspector Name:
oA � f�4"C
Phone la -
Reviewer/Inspector Signature: j Date: &
Page 3 of 3 2

I
('Division of Water Quality
t Faciiity, Number .F3 - O Division of Soil and Water Conservation
O Other Agency r
Reason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: ® County: DL.,?L rilRegion:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: f ,Title:
Onsite Representative: 404plftl T w
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder iC id
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
"Other
Other
Latitude:
Phone:
Integrator:
Certification Number: d
Certification Number:
Design
Current
Wet Poultry
Capacity
Pop.
La er
Non -Layer
Design
Current
Dry Poultry
CanaCity
Pan.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Cattle
Design. Current
Capacity Pop.
Dai Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [Z No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
[3 NE
❑ Yes ❑r ❑ NA [] NE
❑ Yes ❑ NA ❑ NE
❑ Yes No [] NA ❑ NE
Page l of 3 21412011 Continued

I 1
Facilitv Number: 1 - Z Date of Insnection: c-- 2 ►L I'Z
Waste 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: LAC�r6ZYVl
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
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
reat,
notify
DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ 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
o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
<No❑
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
C25
NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[] Yes
No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yesj
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
[] Yes
VNo❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
VNo❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Z KNo ❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
�Zo ❑ 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 1240 ❑ 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 TN ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [o ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection:
' 24. Did the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes VINO ❑ NA NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ YesgyNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes Nc ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface 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 To NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any:other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
U [J l 3 �- A GAG
PhonL_�Iv
Date: 7--,a4A
21412o r

Division of Water Quality
Facility Number, ©- 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 7Routine
pliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 1ZI 14 t Arrival Time: Departure Time: County:Region:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
OnsiteRepresentative: r_rn [�`��,}[ Integrator:
Certified Operator:
Phone:
Certification Number: ZC,., 0? t
Back-up Operator: Certification Number:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder K I W
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
-'Other
Other
Latitude:
Design Current
Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current
Pullets
Turkey
Other
Poults
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: _
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current,`
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dg Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes
❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes rNo
❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
[3Yes No ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facility Number:31 - Date of Inspection: 12_
1'2_—
Waste Collection & Treatment
4. Isstorage 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 ll Structure 2 Structure 3 Structure 4
Identifier: LAG<m �
Structure 5
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3-)
5. Are there any immediate threats to the integrity of any of the structures observed?
❑YesEll
No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environments hreat, 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 Vo
❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ❑ ❑ NA ❑ NE
maintenance or improvement?
Waste Application
dNo
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground
❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes D
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 1 No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes ❑Xo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes Q o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [< No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 6XIO ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [-]Yes XNo ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Faci!!q Number: 3 - Date of Inspection: 1 Z Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑Yes VNo
[3 NA ❑ Ni
25. I's the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes �zo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [] Yes <No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes /No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No ❑ NA ❑ NE
[:]Yes No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
L!.I 'X ❑ NA ❑ NE
X❑ NA ❑ NE
No [] NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: — 3 D
Date: 1 1 I L
21412011

U Division of Water Quality
Facility Number - © 0 Division of Soil and Water Conservation
♦ 0 Other Agency
Type of Visit: Com fiance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: S x.e ) Arrival Time: Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: L-),ih _ bbo (A Integrator:
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
Latitude:
Phone:
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
5 ]Non -Layer
Non-L
Pullets
Other
Poults
Design Current
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
Kxo
1. Is any discharge observed from any part of the operation?
[:]Yes
❑ 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 DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
/XNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility Number: - Date of inspection: S 7 0
Waste Collection & Treatment l
4. ky 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 No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes E3 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 t reat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
El Yes ❑ NA
❑ Yes �Zo❑ NA
❑ NE
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes Io ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes VNIo ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes��/O ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > l 0% 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
ENo ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[ No ❑ NA
❑ NE
acres determination?
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
EKo ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Y E ��
'es
❑ NA
❑ NE
20. Does the facility f to have all components of the CAWMP readily available? If yes, check
io
❑ NA
❑ NE
the appropriate X.
WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis [] Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[-]Yes El No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes To
❑ NA
❑ NE
Page 2 of 3
21412011 Continued

Facil; Number: 3 - Date of inspection: k
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes o No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes YNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [ No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes INo ❑ NA ❑ NE
and report mortality rates that were higher than normal? /
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ❑ No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
401
❑ NA
❑ NE
D
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[] Yes
No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE

Facility Number
46 Division of Water Quality
0 Division of Soil and Water Conservation
O Other Agency
Type of Visit (37Routine
pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: L�2 E� Arrival Time: Departure Time: County: ®YIZAJ Region:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: -,� 1rTitle: Phone No:
p ,1)
Onsite Representative: IJrC� r i- ®F f Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Population
❑ Wean to Finish
Wean to Feeder
ZA zo
1 -6oaa
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Operator Certification Number:
Back-up Certification Number:
Latitude: a o = =" Longitude: [=° 0 g
Design Current
Wet Poultry Capacity Population
RLaer
Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
Discharses & 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 1'opulahou -;
❑ Dairy Cow
❑ Dairy Calf
LLDairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures
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?
':A
❑ Yes LI No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes ❑
❑ Yes
❑ NA
ElNE
❑ Yes VNo
❑ NA
❑ NE
Page I of 3
12128104 Continued

�acility Number: — y Date of Inspection
iWaste Collection & Treatment
4.' Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LA d-,,61J
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): b
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes dNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental th t, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ����No El 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 0 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes E2"No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes LJ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 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?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
IT Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
❑ NA ❑ NE
[TNo ❑ NA ❑ NE
2No ❑ NA ❑ NE
Ea'No ❑ NA ❑ NE
L3'No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments
, • s
Use drawingsof: facility, to better explain situations: (use additional pages as necessa61) • �. �
AL
Reviewer/Inspector Name' Q �( L, `�
Phone: Q 7
— 7
Reviewer/Inspector Signature:
Date:
(�
Page 2 of 3 1 12/28/04 Continued

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

rvFacll>Ity NuffiR .
Type of Visit 0 tpliance Inspection 0 Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visitoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Othelr� �❑ Denied Access
Date of Visit: 3p 6q Arrival Time: ® Departure Time: County: 0111pC�_ _ Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: G F. O P&G PE - t O's
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: o Longitude: [� ° = i
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La er
❑ Wean to Finish
Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers.
❑ Pullets
❑ Turkeys
❑ 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?
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?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes [/No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NE
❑ Yes
0No[INA
El Yes
,
;No
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
12128104 Continued

Facility Number: [ — :3 Date of Inspection 0 0
Waste Collection & Treatment
Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ff /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: iA (phi
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Zg
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ENo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmentaleat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste ADDliCation
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes dNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes EJ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 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?
❑ Yes
& o ElNA
ElNE
15. Does the receiving crop and/or land application site need improvement?
ElYesZo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
['No ❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
[I/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:necessaty).
AL
Reviewer/Inspector Name �t/lA�!1L Phone:
Reviewer/Inspector Signature: Date: 3� 6
PaQo 2 of 12128104 Continued

Facility Number: 2,1— Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Mans El Other
❑ Yes dNo ❑ NA ❑ NE
❑ Yes Q4 ❑ NA ❑ NE
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?
El Yes
[J"NNo
❑ NA
[I NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
[2 No
❑ NA
❑ NE
'o
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
WN
El NA
[I NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
UNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
o❑
NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
ElYes
ZNo
❑ 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
N
❑ 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
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
,YJ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 I2128104

J
Division of Water Qdahty
F ifity N'tiMber +� '0bivision.of, 'oh and Water Conser+Gatron"'
:�. QOther-Agencv, 4 :;
Type of Visit Jj 9"Routine
pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: L 3 o Arrival Time: Departure Time: County: f'%l'&� I Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: E;"'L- c P6Th1j
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 = f Longitude: = o =' =1 "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
Lo �tS a� ❑ Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ 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?
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?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 12No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
El NA
El NE
❑Yes
Z'o
El Yes
ElNA
ElNE
❑ Yes L/J No
❑ NA
❑ NE
Page I of 3 12128104 Continued

Facility Number: — Date of Inspection `tom
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: /J
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 1
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes o ❑ NA [-INE
(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 th�r t, notify DWQ
T Do any of the structures need maintenance or improvement? ❑ Yes 14 N ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [✓� ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes VNo
El NA El NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% 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
ONo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
U] No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
[l"No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
0"No
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
;4o
❑ NA
❑ NE
.i-d/.."��':,
Comments>(refer to queshoq;#} Explain any YES answers arCor any recommendahotts orpany
,wi`; �a other comments.
, d #�.'.y-'"'r'Kk:e,..�.��. `r .
�USedrawings; of facility to better, explatIIsttuatlons.+(use additional pages as necessary)
`
�J
Reviewer/Inspector Name L_ Phone:
Reviewer/Inspector Signature: Date: 0 a
Pake 2 of 3 I2128104 Continued

Vacility Number: 51 —�S I Date of Inspection o
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CWDesign
❑ Ma sP readily available? If yes, check
El❑the appropirate box. WUP Checklistsp El Other
❑ Ye 9 No El NA ❑ NE
Yes ❑ No ❑ NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I"
Rain Inspections❑
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
ElYes
D/o
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
U3 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
oElNA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
YN
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
13 Y s
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes
No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[3"No ❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
["No ❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
�
E 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
[I Yes
,�
EJ 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?
El,�
Yes
NNo ❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
��o❑ NA
❑ NE
Page 3 of 3 12128104

Facility Number 3
f� Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit afro Hance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: : t�UPL
•o U Arrival Time: ® Departure Time: � County Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: G Eb2G� ZLI,5
Owner Email:
Phone:
Integrator:
Phone No:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Back-up Certification Number:
Latitude: = o= 1 Longitude: 0 0=` 0
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
o p ❑ Non-Layet
F-
❑ Wean to Finish
Wean to Feeder
El Feeder to Finish
El Farrow to Wean
El Farrow to Feeder
El Farrow to Finish
El Gilts
El Boars
Other
❑ Other
Dry Poultry
ElLayers
ElNon-Layers
El Pullets
ElTurkeys
❑ TurkeyPoults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ DairyCow
El Dairy Calf
Elai DHeifei
El Dry Cow
ElNon-Dairy
❑ Beef Stocker
❑ Beef Feeder
El Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
El Yes 2rNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
�No
❑ NA
❑ NE
❑ Yes R(No ❑ NA ❑ NE
12128104 Continued

Facility Number: Date of Inspection S 30
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
El 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: LA 64L
Spillway?:
Designed Freeboard (in): / , ,—
Observed Freeboard (in): Y V
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
7No
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
❑ 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
allo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑Yes
L�'No ❑ 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
ENo ❑ NA ❑ NE
maintenance or improvement?
Waste ARPlication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ NA ❑ NE
dZNo
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
❑ 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 Drill ❑ 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
� ❑ NA
El NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes7140
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
❑ NA
❑NE
17. Does the facility lack adequate acreage for land application?
ElYes
o ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
WN o ❑ 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):
.La.) 3a DA`Js SEND vPDAr6V l.A&,0VAJ OFU6-4 62 &C-Wf— to i,1EAW 4AW6-6 ,
c.N&cIr— -POLL- Fop— SrwralL 6MA•1E01". Fossi t!C h�2�4 (L�17c1cT.Lo ,
Reviewer/Inspector Name Jdl ern/ A-_(,j Phone: I/G -756 --13
Reviewer/Inspector Signature: Date: S_ o

Facility Number: —V3 Date of Inspection J o
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the C7Design
readily available? If yes, check
the appropirate box. ❑ WLFP ❑Checklists El Maps ❑Other
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes L! 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
❑ Yes EJ No ❑ NA ❑ NE
Yes ❑ No ❑ NA ❑ NE
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
f No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ElKo'
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
ElYes
EKo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
2�,<�o
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes
[;J o .
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
2N' A
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
D No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
FNo
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ 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
❑ N
El NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
0—No
❑ NA
❑ NE
Comments and/or Drawings:
12128104

1*1
Division of Water Quality
Facility Number 3 t t / 3 Q Division of Soil and Water Conservation
-- - 0 Other Agency
Type of Visit
ompliance Inspection
O Operation Review O Structure Evaluation
O Technical Assistance
Reason for Visit
('koutine O Complaint
Q Follow up Q Referral O Emergency
0 Other ❑ Denied Access
Date of Visit: (o Z7 o b Arrival Time: ® Departure Time: County: AIPL-VI) Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: Title: Phone No:
Onsite Representative: G ECA4G P ET-rUS Integrator:
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
Operator Certification Number:
Back-up Certification Number:
Latitude: [ o [ [= Longitude: = o = i
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
WnA I -- �s�17 li ❑ Non -La er I- --
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
l
❑ Beef Feeder
❑ Beef Brood Co
I
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: =
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes b No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes 1/J No ❑ NA ❑ NE
❑ Yes L:,40 ❑ NA ❑ NE
12128104 Continued

Date of Inspection e(o
Faoility Number: - y3
f Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
PNo ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: I A §reran
Spillway?:
Designed Freeboard (in): l g, 5
Observed Freeboard (in): 3�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ZNNo ❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No ❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental hreat, notify DWQ
7. Do any of the structures need maintenance or improvement?
El Yes
dNo❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
R 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
ElO Yes
/
No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
El�Jf Yes
�
No ❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
[.2<o ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 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) 614
13.
Soil type(s) A'/T
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
d ❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
rN ❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
0,�,"/'No El NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
[2 o ❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
LEI 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):
?, u ? DA•r C_ CA 6-ouy.l ID (SY. GIB% F o 6L.. 1n16 AA1 6A PAcZT Y ,
aN) 1ck£ P f-APY cA +-�3 1r>ra� t.�w r�(L )V q '�E c,o K-p f .
Reviewer/Inspector Name _ �1✓ i-�q�Z/�f �� Phon • - ?IV 6
Reviewer/]nspector Signature: enDate: L
I I S 4 VJ J 1�//.W VT i+v1.ssrs u cu

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 CAWM readily available? If yes, check L/J Yes ❑ No [I NA ❑ NE
the appropriate box.
ElWUP ❑Checklists Design ❑Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
2 No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspections ❑
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
NNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
,j
['No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
,❑,Yes
2 Yes
El No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
! NNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
2No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
R o
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes PKo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[,__�No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
El Yes
,,__,,//
grNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
0'No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
J
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
ElYes
eNo
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
LI No
❑ NA
❑ NE
Comments and/or Drawings:
Page 3 of 3 12128104

Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit lytoutine 0 Complaint O Fallow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Arrival Time: Departure Time: 1&"q ounty:
'-� /M Owner Email:
Region: ezl! _X?e
Facility Contact: Title: Phone No:
Onsite Representative: [i"�� ��T�j Integrator•
Certified Operator: Y_i2GG 40 Operator Certification Number -
Back -up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other -
Back-up Certification Number:
Latitude: = o = I = Longitude: ❑ ° = 4 ❑
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
7 Ti4�2 10 Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Imt)acts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
El 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?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes /No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
/No
❑ NA
❑ NE
❑ Yes
9No
❑ NA
❑ NE
12128104 Continued

Facility Number: 3Z— Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Strpcture l
Identifier:
Spillway?: O
Designed Freeboard (in): a,-5-
4444
Observed Freeboard (in):
Structure 2 Structure 3 Structure 4
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes ZNo
❑ Yes ❑ No
Structure 5
El NA El NE
El NA El NE
Structure 6
❑ Yes XNo ❑ NA ❑ NE
❑ Yes /No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any oft he structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) 10
9. Does any part of the waste management system other than the waste structures require ❑ Yes IV
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes to
❑ NA El NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes /No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Eyidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
i
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
FNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',[]
Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
.. F�`�1C E , �ty�`� w�.rA`�� �. �hy�f: ..S�-� `9 �.-r�."�'�F�ih��l"'+'f^'. ,.
Comments (refer to gneshon #)Explain any YES answers and/or any recommendations or any other comments.
iJs_e drawtngs of factoabe#ter�,explatn sttuahons . (useraddtfional pages as necessary):
2 ,pA�'E r�� Z.✓ k9a'6 4 /tom 25 920 Alye, A5
/YL
Reviewer/Inspector Name 6 Phone—
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: 51 _415 pate of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ VvUp ❑ Checklists /// ❑ Design [I Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P(No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
ONo
❑ NA
❑ NE
23.
if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
(2rNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
VNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
PNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
RfNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
JfNE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
XNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
0No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
P(No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
VNo
❑ 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
JZ'No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�No
❑ NA
❑ NE
Additional C6mments`and/ojFDrawiri s
g - _Wt�e .
12128104
12128104

of Visit jo Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other [3 Denied Access
Facility Number Date of visit: D Time:
O Not Operational O $el
(Permitted © Ce ed D Conditionally Certified 0 Registered Date Last Operatedjr Above Threshold:
Farm Name: 469,M _ _.. __ . __ _ County:
Owner Name: �705 -� 1��/ Phone No:
Marling Address:
Facility Contact: . __ _. Title: .. Phone No:
Pg5Onsite Representative: ��T7L%S Integrator•. da,��
Certified Operator: Operator Certification Number:
Location of Farm:
[Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 4 " Longitude • 4 Ac
Discbarees & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes XNo
Discharge originated at: ❑ Lagoon ❑ Spray Feld ❑ 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) 0 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 ;YNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ZrNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes XNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure S Structure b
Identifier:
Freeboard (inches):
12112103 Continued

Facility Number: —
Date of Inspection If .1E
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 mainternancelimprovement?
8. Does any part of the waste management system other than waste structures require maintenancerimprovement?
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 maintenancelimprovement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN C1 Hydpuhc Overload ❑ Frozen Ground`❑ Copper
12. Crap type . j&;'I7741
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management
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?
Zinc
❑ Yes A No
❑ Yes ;ZNo
❑ Yes ONo
❑ Yes ONO
❑ Yes gNo
❑ Yes A No
❑ Yes )dNo
(CAWMP)? ❑ Yes
Odor Lssues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
❑ Yes YNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 0No
❑ Yes /jYNo
❑ Yes P(No
❑ Yes �No
❑ Yes �(No
❑ Yes O(No
Feld Copv ❑ Final Notes
/V ' �� f � GL �/�iP/3'1 �,�GG. ��}-z/� 7��i✓�U�
Reviewerlinspector Name
ReviewerAWspector Signature:
�9AIJa
rA
12/12103 Continued

Faaty Number.Nu:mber.j Date of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes %No
22_ Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, snaps, etc.) ❑ Yes ((No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ['No
❑ Waste Application [I Freeboard [I Waste Analysis [I Soil Sampling /
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
5d. o
25_ Did the facility fail to have a actively certified operator in charge?
❑ Yes
;Z(No
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 review/inspection with on -site representative?
❑ Yes
VNo
28. Does facility require a follow-up visit by same agency?
❑ Yes
P(No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
Z16 No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
Yes
❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
9No
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes
VNo
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes
VNo
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.
❑ Yes
VNo
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit fD Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit
f
Permitted 13 Ce wed E3 Conditionallv Certified E3 Registered
Farm Name: ........ ...l..:......... F�� rn................................................
Owner Name: U)F Z— ..f20 �✓
Mx.... - _.........�................
Mailing Address:
U7� Time:
O Not Operational Q Below Threshold
Date Last Oper or Above /Threshold : ............
Co.,ty-
PhoneNo: ...... . ......................................................
FacilityContact:.............................................................................. Title:.............................................................. Phone No.
Onsite Representative: . 6.genj.E..... �.................... ................................. _. Integrator- 0� �pR �................ ..........
Certified Operator:........ ............ ...... ...,........... ....,.............................................................. Operator Certification Number:
..........................................
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse
I& ' u Longitude C F• CK
DischarLyes & Stream Impacts
I _ 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)
2. Is there evidence of past discharge from any part of the operation?
3. Were there anyadverse 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
El Yes/No
10 Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Yes No
❑ Yes No
❑ Yes INO
Structure I Structure 2 Structure 3 Structure 4 Structure 5, Structure
Identifier: ... - ..... - w..... - - ...... .....--..... ................................................. ........ ............................ .......... ..........................
Freeboard (inches): ...------..�5............. .............................

Facility Number: 31 —#73 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
: , ❑ Yes
seepage, etc.)
lVfNo
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
Yes
XNo
(RE any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement?
❑ Yes
I/No '
8. Does any part of the waste management system. other than waste structures require maintenance/improvement?
❑ Yes
Z No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
INO
elevation markings?
0 Yes
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
XNo
] 1 _ Is there evidence of over application? ❑ Excessive Ponding .[]PAN ❑ Hydraulic Overload
❑ Yes
'XNo
12. Crop type qe)F
13. Do the receiving crops differ with those design in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
pilNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
No
b) Does the facility need a wettable acre determination,?
❑ Yes
XNo
c) This facility is pended for a wettable acre determination?
❑ Yes
No
15_ Does the receiving crop need improvement?
❑ Yes
XNo
16. Is there a lack of adequate waste application equipment?
❑ Yes
�No
R ,quired Records & Documents
17. Fail to have Certificate of -Coverage & General Permit or other Permit readily available?
❑ Yes
�No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc_)
❑ Yes
No
19_ Does record keeping need improvement? (iel 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 0
24_ Does facility require a follow-up visit by same agency? ❑ Yes A. No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? . E] Yes XNo
0 .No violations or deficiencies were noted during this visit. You will receive no further correspondence about.this visit.
Field Copy ❑ Final Notts
/I�LI%Cff �I�PGT.['/���nl h�rnacfn/ rs �� c zJvs r��/ 7We
)DA 44el� G( WOODa).
Are
1�5Fp T�e
1
,O,WA-roe Cvucb /�R�,� l./ � %�� /�N ��/S�S FRS► MXCI�
Reviewer/Inspector Name
.Reviewer/Inspector Signature: f vyl_ey� A, j ;SHY Date: 97k//8 Z

Q-VO3101
Facility Number.
Date of Inspection / Z
Continued
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property) _
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
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.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes No
❑ Yes �No
❑ Yes rE(No
❑ Yes No
❑ Yes ZNo
❑ Yes
No
❑ ❑
YesNo
�v � f3LL l S G r-E �5 VF2 �/ w6a, 144,ur;
�T C O6ZP5 �i✓ �� DEiP,

40 Division of Water Quality -
O Division of Soil and Water Conservation
O.Other Agency
Type of Visit iQ Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
'late of Visit: - ime. is : Printed on: 7/21/2000
)
Q Not O erational Q Below Threshold
Permitted [3 C tied El Conditionally Certified Registered Date Last Operated or Above Threshold: ..•••....
Farm Name: ........... .1! .................i' . YH^..I...................... County. ...t.q.lt .......... .........
Owner Name:........ k.� .I~?cl ..l�... .t..i... . Phone No:
Facility Contact: ..&Lo?.':� ..........`..�... ..............Title: ao.�S� fb....l![ ' . A .... Phone No: ,..................................................
MailingAddress: ................................................................................................................................................................................................
21
Onsite Representative:.°DCS............1....5............................................ Integrator:.............!....!.l.E..... ..........
Certified Operator:..................:..........I........... .... Operator Certification Number:.................
Location of Farm:
r,
r
$] Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �� �« Longitude �• ��«
Design Current
Swine Canacitv Ponulafinn
❑ Wean to Feeder
ffL Feeder to Finish
S"'240
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer FE
Dairy
❑ Non -Layer Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present 110 Lag—n Area 10 Spray Field Area
Holding Ponds / Solid Traps JEI No Liquid Waste Management System
Discharges & Stream Imuact5
1. Is any discharge observed from any part of the operation? ❑ Yes U(No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is ohserved, was the conveyance man-made? ❑ Yes ❑ No
b. if discharge is ohserved, did it reach Water of the State? (If yes, notify DWQ)
e. I1 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 I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: .............3... 111................................_._........
❑ Yes ❑ No
�N �t
❑ Yes ❑ No
❑ Yes No
❑ Yes o
❑ Yes T
No
Structure 6
Freeboard (inches):
5100
Continued on back

Facility Number: — Date of Inspection Printed can: 7/21/2000
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 5�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 0J No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes 9No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes VNo
_Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes KNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ONO
12- Crop typed
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? El Yes qNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
RNo
b) Does the facility need a wettable acre determination?
❑ Yes
VQNo
c) This facility is pended for a wettable acre determination?
❑ Yes
�No
15. Does the receiving crop need improvement?
❑ Yes
[CNo
16. Is there a lack of adequate waste application equipment?
❑ Yes
[No
Required Records &_Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
ro
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
0�'No
19. Does record keeping need improvement'? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
Wo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
KNo
21. Did the facility fail to have a actively certified operator in charge'?
❑ Yes
C No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes Q�No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'? ❑ Yes KNo
24. Does facility require a follow-up visit by same agency? a ❑ Yes 0fNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 16No
0;10 vialaiigris:vr deficiencies mere paled dix°irig this;visit: You will receive Rio further - : ;
correspondence. about: this visit_ ; ; ; ; ; ;
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
ydi-- aver `� ia_a .� PSG&i
C %0d /'CCOy� /Le�i l
►■
Reviewer/Inspector Name
Reviewer/Inspector Signatur . Date:L 5/00

Facility Number: — Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes W 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 0
2$. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ko
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 TNo
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 R'No
3 L Do the animals feed storage bins fail to have appropriate cover? ❑ Yes io
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes qNo
Additional, Comments,an or ra►vrngs: •
r� � -e�,
`

r*•
Facility Number Date of inspection
Time of Inspection � 24 hr. (hh:mm)
® Permitted ® Certified 13 Conditionally Certified p Registered 113 Not Operationa Date Last Operated:
Farm Name: Cast.F.arXn.................. ......., County: Duplin WiRO
OwnerName: ................................................... Goldsboro.Hag1-arms....................... Phone No: :I.28-3130.......................... .........................................
Facility Contact:................................................................... ....Title: ..... Phone No:
Mailing Address: E.O.Hax.1.oDQ9....................................................................................... Goldsb.ar.Q..NC ..................................................... 27532 ..............
Onsite Representative: .......................................................................................................... Integrator: Goldsborn.Hog.Farms.......................................
Certified Operator: Kyxiw.Q d M,...................... Hall.and.............. .......................... :.... Operator Certification Number: 116i53.5.............................
Location of Farm:
tht.txorxb.easx.si.d,... ri ....___. .. ..•
Latitude 0 4 ;6 Longitude a i «
Design - zlCurrent
Swine Capacttj Paptil tion
p Wean to ceder
® Feeder to ints
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
,Design Current Design Current
Poultry _. Capacity. Population: `, Cattle Capacity ;Population .
❑ ayer ❑ airy
❑ Non -Layer
p on -Dairy
❑ Other
Total Design Capacity 5,760
Tota1,SSLW 777,600
Number of Lagoons �
❑ u sur ace rams risen ❑ agoon rea ❑ pray �e rea
��
Il(olding Potids /Solid Traps ❑ o Liquid aste Management System a
Y - • _ _ • -
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 X No
b. If discharge is observed, did it reach Water of the State? (If yes„notify DWQ) []Yes H 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 ig No
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): 3,
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, [3 Yes ® No
seepage, etc.)
3/23/99 Continued on back
Printed on 11/23/99

Printed on 11/23/99
racility Number: 31-43 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 Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
p Yes
® No
12. Crop type Coastal Bermuda (Flay) Small Grain Overseed Corn, Soybeans, Wheat
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
p 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?
p Yes
® No
Required Records & .l.)ocuments
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?
(iel WUP, checklists, design, maps, etc.)
p 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
d: ;Rio:viotatious.or. deficiencies -were noted during: this -visit. , You, �will:xeceive na further :.::
..... ..........
srora°es�oridenci. about tills:visit............. .. .
A
Reviewer/Inspector Name jai aref O.'ICeefe -r 'Mrs'^ r g, John College - . -�
Reviewer/Inspector Signature: Date:

Printed on 11/23/99
Facility Number: 31_43 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 ® 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, {p Yes ® No
roads, building structure, and/or public propel ty)
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.) p 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
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Printed on 11/23/99

-1
D Division of Soil and Water "Conservation = Opei-aiion Review _
E3 Division of Soil and Water Conservation - Compliance Inspection
Division of Water Quality -"Compliance-Inspection f.e
0 Other'Agency - Operation Review
IRRoutine Q Complaint 0 Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number Date of Inspection I a 1191
Time of Inspection 36 J24 hr. (hh:mm)
Permitted © Certified [3 Conditionally Certified Q Registered JE3 Not O erational Date Last Operated:
Farm Name: (Y-S�_ ............. .............. Count kk�.......................--.............................
y:.......:.......
Owner Name:... Gil ... Phone No: ................................................................................. ..
Facility Contact: .............. Title:.................... ...---........... Phone No:
MailingAddress: .......................................................................................................................................................................... ........
Onsite Representative: ... PL.W'. .... lnte�rator ,..�.�.;-�.........................................
�r h
Certified Operator:....................................'1.......................................................... Operator Certification Number: ....
�....................................
Location of Farm:
t............................ ....... .....-...-.........-........................ -- ...............-- ............-......................................................y
Latitude 0 4 .6 Longitude • ' "
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer ❑ Dairy
54 Feeder to Finish d ❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present 110 Lagoon Area ID Spray Field Area
Holding Ponds 1 Solid Traps JE1 No Liquid Waste Management System7 .
Discharkes & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Discharge originated at, ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made''
h. If discharge is observed. did it reach: ❑ Surface Waters ❑ Waters of the State
c. If discharge is observed. what is the estimated flow in galhnin?
d. Does discharge bypass a lagoon systcm?
2. Is there evidence of past discharge from any part of the operation`?
3- Were there any 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?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
❑ Yes gNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 0 No
❑ Yes O'No
❑ Yes KNo
Structure 5 Structure 6
Freeboard (inches) ..` O
1/6/99 Continued on back

Facility Number: 3 — �j Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes bZrNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes VNo
(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 C�No
S. Does any pact of the waste management system other than waste structures require maintenance/improvement? (VIYes ❑ No
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings?
❑ Yes
MNo
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
[XNo
11, Is there evidence of over application'? ❑ Pondinc ❑ Nitrogen
El Yes
N No
}
12. Crop type ............................... .......... ................ :................................ .......................................................................................................................
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
'jNo
14. Does the facility lack wettable acreage for land application? (footprint)
❑ Yes
KNo
15. Does the receiving crop need improvement'?
❑ Yes
CR�No
16. Is there a lack of adequate waste application equipment?
❑ Yes
%No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
XNo
19. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
XNo
19. Does record keeping need improvement'? (iel irrigation, freeboard, waste analysis & soil sample reports)
El Yes
MNo
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 certified operator in responsible charge?
❑ Yes
tg(No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
Yes
ff No
(ie/ discharge, freeboard problems, over application)
❑
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
Y] No
24. Does facility require a follow-up visit by same acency?
❑ Yes
5�No
0_ No Aolations.or. deficient:ies .were noted during Ais v-isrt: You �ll.re� eive nor further . ;
eorrespoaidehee;about:this visit.......;•:•:•:•:•:•:•;•;•;-:-;•;•:•;-:-:•;•;•;•;•;•:•;•'•;•'•:•;•;•;•;•;••
Comments (refer to question #): Explain any YES answers and/or any recommendations -or any other comments:; <=-
Use drawings of facility to better explain situations. (use additional pages as necessary)
KA e,40 �kv-e_.Jz� WM ",� A-wz�_ .
Reviewer/Inspector Name
Reviewer/Inspector Signature: "3 � � - Date: �d� j� —7 1 I1/6/99

f:
E3Division of Soil and Water Conservation ❑ Other Agency
13 Division of Water Quality
IQ(Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Date of Inspection
Facility Number 1
Time of inspection ; 00 24 hr. (hh:mm)
13 Registered © Certified [3 Applied for Permit tgPermitted JE3 Not O eratiorAal Date Last Operated:.......................... . t
Farm Name: .... `t...'.............................................................................. County: ....
G�..1........................................................
Owner Name:... .�4 �� .�L'� 1.......I............ Phone No: � `� �� "� �} ................................
Facility Contact: ................................................................. ...... Title:................ .. Phone No:
tAcMailing Address: �G ,7�C �C�C�"I .... a n5 ...........I ..............
Q t E ...
Onsite Representatives.... Q` .. `: !:.......................................... ...... integrator•....... ............................................
Certified Operator...-----................................................................................................. Operator Certification Number..................... ........
L tion of Farm:
.................................. ........... ................... _................................... ... .. ......
Latitude 0• =' " Longitude =• 0` iG
Resign . x Current
: Desigit Current
Design . Current
,..
aCapacity Population Poultr
:.._ .. y Capacity Populatioer Cattle •
Capacity ..Population
❑ Wean to Feeder
.'
❑ Layer
I
I
❑ Dairy
I
I
g
Feeder to Finish
r]t;G
❑Non -Layer
❑ Non Dairy
.
❑ Farrow to Wean
'
❑ Farrow to Feeder
❑Other
❑ Farrow to Finish
Total Design Capacity
Z
❑ Gilts
=
❑ Boars
Total SSLW
�Ntiniberof Lagoons f Hoidtng Pp ds "� ❑ Subsurface Drains Present
'
❑ Lagoon Area
ID Spray Field Area
❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
KJ No
2. 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
}
j No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
PtNo
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
19 No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
P No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
DI No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
igNo
mai ntenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
Dq No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
No
7125/97

.• a, Facility Number: ' ` — 3
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (LagoonsZolding fonds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I
Identifier: A-
................................... .....
Freeboard (ft):............21......................
Structure 2 Structure 3 Structure 4
..............................................................................................
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
❑ Yes O(No
❑ Yes allo
Structure 5 Structure 6
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of W, or runoff entering waters of the State, notify DWQ)
15. Crop type Lrpt...SSA........................... .........................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
PI- deficiencies. were.noted;dtiring this:visit., You:will receive:no:furtliei-
:: corresO0bdehce about this:visit.
❑ Yes CiKNo
❑ Yes ® No
❑ Yes No
❑ Yes (g No
❑ Yes No
❑ Yes 0 No
❑ Yes Rf No
❑ Yes iZ No
❑ Yes ❑ No
❑ Yes E�No
❑ Yes M No
❑ Yes No
❑ Yes ((No
❑ Yes El No
❑ Yes W No
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: Date:

_.. _
❑ DSWC Animal Feedlot Operation Review
DWQ Animal Feedlot Operation Site Inspection
10 Routine 0 Complaint . 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection L 7
Facility lumber
Time of Inspection : S 24 hr. (hh:mm)
© Registered 0 Certified [3 Applied for Permit ;3 Permitted � Not Operational I Date Last Operated:
FarmName: C4.5e.........mr.�MM" .................. ...... rr ................................................................. County:.........�t1�alk..................................... ......................
Owner Name: ....... Go O�61 t.......... .. ita4-M............................. Phone No: ... 6.1.a.. 173-3I Q..... .........................................
Facility Contact: ...... .......lntzxl......................................... Tttle:...... `. -1aye*..................................... Phone l�o:.�`�1..4.�.7.?.$.-AMA ............
MailingAddress: ...... Pig.. ......jacaq........................................... ............. ......Nr ........................................ .......
Onsite Representative: ... &A ...... lsau{��r`.......... ......l..-...... .... ....... ....................................... Integrator:-....6005, .bara....... .....- M4:� .......................
Certified Operator:.....-. .M{......]......----LarIv.r.. .................................................... Operator Certification Number-, ........ ff4.,5�
Location of Farm:
...I� . .......... ..... ... o ..:.... w� ...... �u.tllA............... .. cvtWA....belu....... s ..... g�.... ! i I ,�a x
far .......' ..'Dd,.m_\Us.......r..ly ......z.�.. z. &.t3�.�O. n --Diu. -...xti ttx , ec,,�f....�.i b �..-1 �..��Kls......... .......................... T
Latitude Longitude �• �L OS
Design Current Design Current Design Current x:
Swine Capacity Population Poultry Capacity Population Cattle Capacity.. Population
❑ Wean to Feeder I0 Layer ❑ Dairy
Feeder to Finish SQ ❑ Non -Layer rEDNon-Dairy
❑ Farrow to Wean
❑ Farrow to Feeder JEI Other
❑ Farrow to Finish Total Design Capacity .
El Gilts `7
El Boars Total SSLW �ry
Number. of Lagoons/ Holding Ponds 10 Subsurface Drains Present ❑ Lagoon Area Io Spray Field Area
❑ No Liquid waste Management System
General
1. Are there any buffers that need zilaintenancelimprovement? ❑ Yes No
2. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon El 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
maintenance/improvement?
5. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
❑ Yes
No
❑ Yes
allo
❑ Yes No
❑ Yes No
❑ Yes 0 No
❑ Yes No
❑ Yes No
Continued on back
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97 '

Facility Number:
S. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons,11oldine Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes $ No
❑ Yes EgNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
...................................................................................................................................................................................................................
Freeboard(ft): - .......................................................................................................................................................................................
10. Is seepage observed from any of the structures? ❑ Yes XNo
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes ® No
12. Do any of the structures need maintenance/improvement!
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14, Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop �xt5�
type �......1�4..i'.mva...........................................................................- .. ..................
16, Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment.,
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes ® No
❑ Yes (5FNo
❑ Yes & No
.................. ......... I ........
❑ Yes
I...............
jd No
❑ Yes
No
❑ Yes
No
❑ Yes
M'No
❑ Yes
0 No
❑ Yes
CRNo
® Yes
❑ No
Nwviolitions ar deficiencies were -noted -during thisvisit.• Xou,will re'ceive-ho ftirther
corresp6nden6e'a4out this -visit: :
❑ Yes M No
❑ Yes No
❑ Yes No
�o,
t,3,L`a c a.�'3 Soil ctrtalyses 56A
K&
ov1 sot,
N mac of Alk, vr(,p. cM
�tet�s
fiS¢)r5 Sinou�t) be, in44Ctr�i e� �ay►. N
c4tj
oi- �
iPpo ems sf ,i�J be on -4G
7/25/97
�w
Reviewer/Inspector Name .��in.._WAA
Reviewer/Inspector Signature: ��� �„ 1���, ...�— Date: 9 f//,/4-7

JUL-14—'_95e
� 11:22 FROM DEM WATER QUALITY —-_TION TO WIRQ F.02/02
Site Requires Immediatc Attention: _
Facility No.
DIVISION OF EN7IRONMENTAL MANAGEMENT
ANMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 51/ , 1995
Time: 1 `t o s_
GebQe
Farm Name/Owner M Z
Mailing Address: P o 4 �' 661� 'ro (VC `� o? 7 S 1 .—
County: (4-P
Integrator: 1� s �cr 4--ky�(-�f
On Site Representative: �i,d mn E
Physical Addressg ocadon: C l I m4L
Phone:
Phone:
Type of Operation: Swine f Poultry Cattle
Design Capacity: (,y01 Ax4 &-&'y Number of Animals on Site: '(oU
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: `�� ° 0 Longitude: 71 _' 1 Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hoar storm event
(approximately 1 Foot + 7 inches) Por No Actual Freeboard: _4_3t. Q Inches
Was any seepage observed from the la oon(s)? Yes or &Was any erosion observed? Yes ord�>
Is adequate land available for spray? or No Is the cover crop adequate?(fpor No
Crop(s) being utilized: G a fl f/ 1 �7cc /e,<
Does the facility meet SCS ruinimud setback criteria? 200 Feet from Dwellings? a or No
100 Feet from Wells? Vee or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a liSGS Map Blue Line? Yes or No
Is animal waste discharged into waters o the state by man-made ditch, flushing system,, or other
similar man-made devices? Yes or ti If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure. land appliechY�
spray irrigated on specific acreage with cover crop)? Yes or No �,W
Additional Comments: gAgm czi2(/",_e
inspector Name
Simature
cc; Facility Assessment Unit Use Attachments if Needed.