310058_INSPECTIONS_20171231

NORTH GAHULINA
Department of Environmental Qual

C7 Division of Water Resources
Facility Number �3� s�j 0 Division of Soil ands Ater Conservation
Other Agency �i; z:.@cb Rs., :; `X L �
Type of Visit: Co)x6liance Inspection 0 Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up O Referral O Emergency 0 Other 0 Denied Access
Date of Visit:Arrival Time: I Departure Time: r County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: ( / Title: Phone:
Onsite Representative: %� �l l 1 r` Integrator:
Certified Operator: Certification Number: Q !J !
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
-
Design
Current
Design :Currenf..:
' :; Design Current
Swine''° 'Capacity
Evp.
Wet Poultry Capacity
Pop.
Cattle Capacity Pop
__..
:e
x :_
lsiiv::
We=
La er
Non -Layer er
Dairy
to Finish
an
eerier to Finish 5'T10 on
Farrow to Wean
Farrow to Finish
Gilts
to Feeder
Farrow to Feeder
Boars
Non -Layers
Turkeys
Turke Poults
Pullets
Non -Layers
Turkeys
Turke Poults
Pullets
Calf
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of.the State? (If yes, notify DWR) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
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?
'Page 1 of 3
❑ Yes � ❑ NA ❑ NE
❑ Yes � ❑ NA ❑ NE
[:]Yes [:]No ❑ NA ❑ NE
214,12015 Continued

Facilit Number: - Date of inspection:
+Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
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 t eat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ .Yes N ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes Dr
No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require [:]Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 10 ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Vo ❑ 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
�No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
CoF❑
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
EZNo
❑ NA
❑ NE
Re wired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes dNo ❑ 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 D NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes gNo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number:31 - Date of Inspection:
•24. Dio 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 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
34. Did the facility fail to notify the Regional Office of emergency situations as required by the
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 ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes M No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? E�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
NA ❑ NE
TNZ�NA ❑ NE
No ❑ NA ❑ NE
Reviewer/Inspector Signature: -" `/" Date: ' . fir&
Page 3 of 3 21412015

rt °_ 1Ylsion of Water Resources
FacilityxNumber O#DEvision�of,Sotl,and Water Consefvatian
�►gency'�,
Fype of Visit: D�eompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Ezeason for Visit: fa'Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
II`IYYYYY�YYYYY�II III
Date of Visit: Arrival Time: ; Departure Time: County:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Pullets
Other
Title:
Latitude:
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?
Phone:
Integrator: m z` j
Certification Number:
Certification Number:
Longitude:
Dairy Cow _
Dairy Calf
Dairy Heifer
Dry Cow _ _
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Region:
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes [?fNo ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes [:6 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 E] No
❑ Yes Ef No
❑ Yes VNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA' ❑ NE
Page 1 of 3 21412015 Continued

F*acili umber: 31 jDate of Inspection:
Waste CoUgetion & Treatment
4. Is`storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier: /{
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
4 No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
[;dNo
❑ 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
PL No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
M No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
[A 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 [] No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[] No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste 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
❑ No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Page 2 of 3 21412015 Continued

)Eacili ,Number: - Date of Inspection: 11 a
24. Did the. facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
qNo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
[] Yes
VNo
❑ 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
qNo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[:YNo
❑ 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?
Use' dra*".inQs
t/)j- 1" �g
YQ 1� 3 7
t014 �/' y8 -
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
, r—arty" rr Ce. Cof CAS
❑ Yes �D No ❑ NA ❑ NE
❑ Yes [�] No ❑ NA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes (7 No ❑ NA ❑ NE
❑ Yes
[XNo
❑ NA
❑ NE
❑ Yes
[A o
❑ NA
❑ NE
❑ Yes
TNo
❑ NA
❑ NE
Phone: Az;fi'!�_73
Date: 111144
2/4/2015

Division of Water Resources
Facility Number -� 0 Division of Soil and Water Conservation /
. _. _71� 0 Other Agency v
Type of visit: eO Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Qruoutine 0 Complaint 0 Fallow -up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of visit: Ja Arrival Time: Departure Time: County: j Region:
Farm Name: iY��� �����t�il- Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: 1�3
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Phone:
Integrator: K Ia
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish �1
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Layer
Non -Layer
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes C2rNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes 4-'j 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 VjNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes ?I No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes ZNo
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facility Number: - Date of Inspection: 1 1 G
IjK :I —
Waste Collection & Treatment
'4. I oss t rage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes P No
a. If yes, is waste level into the structural freeboard? ❑ Yes 911,10
❑ NA ❑ NE
❑ NA ❑ NE
Struc e l 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 P]rNo ❑ 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 ff No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes r] No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ��" No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes R
No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [7No ❑ 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 0No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes �a No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ;2 No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
❑ Yes
gNo
❑ NA
❑ NE
❑ Yes
PrNo
❑ NA
❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
0 Yes
;"No
[DNA ❑ NE
the appropriate box.
T
❑WUP ❑Checklists ❑Design ❑ Maps [:]Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
[2fNo
❑ 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
0 No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes VfNo ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Vumber: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 12'No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 0No ❑ 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 J2"No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes J�T'No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes -ffNo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
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 Jf'No ❑ NA ❑ NE
❑ Yes En -No ❑ NA ❑ NE
❑ Yes ,ENo ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? []Yes ;2 No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments {refer to queshon�#) Explain any -YES answersand/or any addrhonal'recomm�endatipns�vr�>any�atbergcommentR t�
iJse drawEngs:of facility°to;lletter:explain."sityahons:(use additional pagesas.necessary,)
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: L C) [G
21412014

M Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number. 310058 Facility Status: Actin
Permit: AWS310W8
❑ Denied Access
Inppection Type: Compliance Inspection
Inactive Or Closed Date:
Reason for Visit: Routine County.
Duplin Region:
Wilmington
Date of Visit: 12/16/2015 Entry Time: 08:00 am Exit Time: 9:00
am Incident 9
Farm Name: King Farms - Hailsville Farms
Owner Email:
Owner: Craig King
Phone:
910-285-2692
Mailing Address: 126 Garland King Rd
Teachey NC 284649736
Physical Address: 466 Durwood Evans Rd
Beulaville NC 28518
Facility Status: ❑ Compliant ❑ Not Compliant Integrator.
Murphy -Brown LLC
Location of Farm: Latitude:
34° 52' 60" Longitude:
77` 49' 10"
Southwest of Beulaville. On West side of SR 1964 South of SR 1800.
Ouestlon Areas:
Dischrge & Stream Impacts Waste Col, Stor, & Treat
Waste Application
Records and Documents Other issues
Certified Operator.
Operator Certification Number:
Secondary OIC(s):
On -Site Representative(a): Name Title Phone
On -site representative Buddy King
Phone:
Primary Inspector. Kevin Rowland
Phone:
Inspector Signature:
Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

).Permit: AWS310058 Owner - Facility : Craig Icing Facility Number: 310058
Inspection Date: 12/16/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity Current promotions
Swine
SvAne - Feeder to Finish 5,720 4,400
Total Design Capacity: 5,720
Total SSLW: 772,200
Waste structures observes
Disignated
Type Identifier Closed Date start Date Freeboard Freeboard
Lagoon 1 W.00
page: 2

. Permit: AWS310058 Owner - Facility : Craig IGng Facility Number.
310068
Inspection Date: 12/16/15 Inppection Type: Compliance Inspection Reason for Visit:
Routine
Discharnes & Stream Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
0 ❑
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
0 ❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
0 ❑
❑
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWO)
❑
❑
❑
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 Waters of the
❑
❑
❑
State other than from a discharge?
Waste Collection, Storage & Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
ED
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large
❑
M ❑
❑
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not property addressed and/or managed through a
❑
MCI
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0 ❑
❑
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
❑
❑
maintenance or improvement?
Waste Application
Yos No Na No
10. Are there any required buffers, setbacks, or compliance altematives that need
❑ 0 ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ M ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zr, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total Phosphorus?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
page: 3

►. Permit: AWS310058 Owner - Facility : Craig King Facility Number. 310058
Inspection Date: 12/16/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No Nam
Crop Type 1
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste
❑
0 ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
0 ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre
❑
0 ❑
❑
determination?
17. Does the facility lack adequate acreage for land application?
1101111
18. Is there a lack of properly operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes No Na He
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
1101111
20. Does the facility fail to have all components of the CAWMP readily available?
❑
❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ ■ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

.Permit: AWS310058 Owner - Facility: Craig King Facility Number. 310058
Inspection Date: 12/16/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Records and Documents
Yes No Na No
Crop yields?
❑
120 Minute inspections?
❑
Monthly and 1" Rainfall Inspections
❑
Sludge Survey
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
01111
(NPDFS only)?
24. Did.the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check the
❑
0 ❑
❑
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?
❑
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
0 ❑
❑
Other Issues
Yes
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
1101111
and report mortality rates that exceed normal rates?
29. At the time of the inspection did the facility pose an odor or air quality concern? If yes,
❑
0 ❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
M ❑
❑
(i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility?
❑
M, ❑
❑
If yes, check the appropriate box below.
Application Field
❑
Lagoon / Storage Pond
❑
Other
❑
If Other, please specify
32. Were any additional problems noted which cause non-compliance of the Permit or
❑
0 ❑
❑
CAWMP?
33. Did the Reviewerlinspector fail to discuss reviewlnspection with on -site representative?
❑
❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
❑
❑
page: 5

D1vlSid af'Water, Resource&" dzw�o
ber Dlvlsion {�
'ype of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
teason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I ja/ I Arrival Time: : �3 i Departure Time: County:
Farm Name: ,z,� s iCr�.-i — _ �p/�s �/Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: h 1
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Region:
Des n. Current _ Desi n Current DesrgnCurrent ... j ig _ A g
w w Wet PoUI Ca aCl Pa a Cattle �° Swine Cfl ACl Pa Cfl aCl PO..' t:.g
�� P tY P 3' p - tY p w� P, rY p=
Wean to Finish - ti �� Layer ��
Wean to Feeder Non La er
Feeder to Finish°= '
Farrow to Wean �» X wDeslgn Gurrenf?
Farrow to Feeder D , �.P.oul'' Ca acl t oDry
Farrow to Finish Layers
Zy
Gilts Non -Layers
Boars W Pullets ;s
z q Turkeys
TurkeyPoults�
Other Other
Discharaes and Stream Imuacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
ige 1 of 3
Dairy Cow
Dai Calf
Dai Heifer
Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes �no ❑ NA ❑ NE
❑ Yes
[:]Yes
ZNa
❑ NA
❑ NE
❑ Yes
fZfNo
❑ NA
❑ NE
52-No ❑ NA ❑ NE
❑ Yes JZiNo ❑ NA ❑ NE
❑ Yes [%f No ❑ NA ❑ NE
-- '2%4/2014 Continued

Facili ,Number: - Date of Inspection:
- t
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑Yes
P No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
[—]Yes
2 f4o
❑ 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
�No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes PNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes �oo ❑ 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 J'No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes j�No ❑ NA ❑ NE
maintenance or improvement? r
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ,fNo ❑ 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 [EI-No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes EfNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes ,E!J'No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes FZrNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes ZI—No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes,,0 No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWW readily available? if yes, check
❑ Yes No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EJ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes J�fNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: -1 jDate of Inspection: 9 c /
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 RfNo ❑ 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 P No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes VNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes FrNo ❑ 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-No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately. T
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes ONO ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes ,fNo ❑ 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 O No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes E
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).
Corr.
F� rrr _ �_ f e C_ 6 (O?
Reviewer/Inspector Name: _�� / 1 Phone:
Reviewer/Inspector Signature: ��G�� Date: A
Page 3 of 3 1214120441

- lvision of Water Quality
},,
f ci1i �- lumber - � O Division of Soil and Water Conservation
O Other Agency
Type of visitmpliance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: QXeutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region: /' I/�
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Integrator: 1fit
Certification Number:
Certification Number:
Design Current
Wet Poultry Capacity Pop.
' Layer
Non -La er
Design' Current
Pullets
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
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
[:]Yes �To ❑ NA ❑ NE
❑ Yes EfIgo
❑ Yes No
❑ Yes 4 No
❑ Yes 6VNo
[]Yes
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Candnued

Facility Number: Date of Ins ection:
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
PNo
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
1/
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Z 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
� o
❑ NA
❑ NE
waste management or closure plan?
T
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
�No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
�No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes P(No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [—]Yes �No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops duffer from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Re4uired Records _& Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes [ZNo ❑ NA ❑ NE
❑ Yes RNo ❑ NA ❑ NE
❑ Yes
9Io
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
[:]Yes
&No
❑ NA
❑ NE
❑ Yes P No ❑ NA ❑ NE
[:]Yes ff No ❑ NA ❑ NE
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes ❑ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: 3 4 jDate of Inspection:
24. Dsd the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes p"No ❑ NA
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes o ❑ NA
the appropriate box(es) below. T
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
❑ NE
❑ NE
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
ONo
❑ 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 concem?
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? ❑ Yes �alNo ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes EZNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes E� 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).
❑ Yes (No ❑ NA ❑ NE
❑ Yes 2(No ❑ NA ❑ NE
❑ Yes VNo ❑ NA ❑ NE
❑ Yes VfNo ❑ NA ❑ NE
Z3/l 3 •3 ��C4 al w [ JAY\_
P
1a d 1c.
f
Reviewer/Inspector Name: Phone:1 711
Reviewer/Inspector Signature: / Date:
Page 3 of 3 114120111

IQ Division of Water Quality
.Facility Number - ® 0 Division of Soil and Water Conservation /
0 Other Agency V
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
[teason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral LEmergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: County: (./ Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
Onsite Representative: V_->tap0%1 + C-"7(S V-)NG Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Latitude:
Phone:
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer I +--j
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
Discharees and Stream Imnacts
Design Current
Dry Poultry Capacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Daia Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
1. Is any discharge observed from any part of the operation? ' Q Yes ❑ No ❑ NA ❑ NE
Discharge originated at: ❑ Structure 'Q5 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)? 7�
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes A No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facilrty` umber s - Date of Ins ection: J41 M3 110
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes )A 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? 1A
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No [3NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes I
No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require Yes ❑ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ 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 ❑ No ❑ NA A NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [—]No ❑ NA AR NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [—]No ❑ NA NE
acres determination? �4
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA fo NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA ANE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
❑ NA NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ No
❑ NA NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA NE
❑ Waste Application ❑ Weekly Freeboard [:]Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weat6eCode
❑ Rainfall ❑ Stocking [] Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
[:]Yes
[:]No
❑ NA 0NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA ANE
Page 2 of 3
21412011 Condnued

Facili Number: - Date of Inspection:
24--Did the facility fail to calibrate waste application equipment as required by the permit? [:]Yes ❑ No ❑ NA NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA 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 f 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 No
❑ Yes No
f
❑ Yes 1j No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
'%NE
❑ Yes
❑ NA
❑ NE
No
❑ YesINo
❑ NA
❑ NE
t Yes ❑ No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or, any other commentsr' "
Use drawings of facility to better explain situations (use additional "pages as necessary).
r ja�IlV FFli�fi/Ec[_�ir AistA ocO &qI v6S4S5G0-u6b AI IN g cIraA NUS 5� �lau4
r 5c) w� Q(tace6(t�6t--> -T)4E FA¢N� TO P)Alb SoA40ON0- *M19l« StvtC-G
f v j? "C —6—Nt o �� LF W i4 QU�anl T ti �� p Ig J Id' WAz�
n �L ClflN% S;)tc_Ft6w�Nc�j , i�irGOA1T19GTED �A6ir iZ L�55TN� S3exi-
r1 �J w�,l�D ?H)S BAR ivy . i rt� NG�GN8a6L�w5 c+gc1G� D �cAD� 1�)M6 .
�pCll`6� Ou.l wrr6 0 � � ��� N�1G1��3aR-+aaT s]��'TtiAGTdC��TC�7��� S`1 P714G
l�lN� � t"5AS a,,v T _� w W AS�t E3� dFF, C,RAitS 1CirV�S /�S tU�D w
� [ G iti r cl G►+ ` 71� (� � t F (-� • � G R-uN 0 � a.,�' • N&A Doi K ►)v 6 ,� a?A
L T11�
�>%rNG �a s F w wsas xe . k\f �c��iclN
, n1Tu� ; o cgjtjL� AN��N
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�A,�
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w►u,
f36 f3RC.lt.. ON 10l9S 7o
o&st(w a c LGAN LA?
Reviewer/Inspector Name:
Reviewer/Inspector Signature
Page 3 of 3
Phone: 916
Date:
21412011

1�1
Rkility Number
-401Division of Water Quality g .
O Division of Soil and Water Conservation
0 Other Agency
Type of Visit _,G'tompiiance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit pifolutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 1 /0 Arrival Time
Farm Name: 7/hC ful/o,"/
Departure Time: County:
Owner Email:
Owner Name: Phone:
,Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Region: a
Phone No:
Integrator: m / /_ _
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 c = 6 Longitude: = ° = ` = `t
Design' : Current " = Design', Current r Desrgn Cnrreut
Stv�ne . Capacity Population Wet Poultry Capacity Population Cattle Capacity _�Populstion�
❑ Wean to Finish
❑ Wean to Feeder
�] Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
``Other
❑ Layer
❑ Non -Layer
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?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number' W. tr, ctures
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 �TNO ❑ NA ❑ NE
❑ Yes O—N o
❑ NA
❑ NE
❑ Yes Wo
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes ,ET -No
❑ Yesx No
❑ NA
❑ NE
❑ Yes �io
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility Number: Date of Inspection: ZD U
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes JZNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes/J�J'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
FjNo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[2]"No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
'p]-No
f 2 F4o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
T
9. Does any part of the waste management system other than the waste structures require
❑ Yes ,EI—No
❑ NA
❑ NE
maintenance or improvement?
Waste Apolication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes FONo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes eNo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 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 ,EfrNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes EfNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes [3' Vo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes_,B'Fio
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes' jD-&o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes ED No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes E f Mo
❑ 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. FYes .flffNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard Waste Analysis ❑ Soil Analysis D 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 fj'No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 12140 ❑ NA ❑ NE
Page 2 of 3 21412011 Continued.

Facility Number: - Date of Yns ection: 6
24jDid the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ZNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ZjNo ❑ 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,,ErNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 12'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? ❑ Yes j2r�l o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes N o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes d 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).
❑ Yes �a&o
❑ NA
❑ NE
❑ Yes Callo
❑ NA
❑ NE
❑ Yes rj" No
❑ NA
❑ NE
❑ Yes [:I -No
❑ NA
❑ NE
�&z
S
6 7l / Z
10/', /'
'L a G 0 /L 00 CJ 4
71,� J /I f / - 2-,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: %6
l/4 011 .

Facil#y.Number.
Division of Water Quality
0 Division of Soil and Water Conservation,.-•
0 Other Agency
Type of Visit 9leompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 00utine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Z Arrival Time: Departure Time: County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: !�
Certified Operator:
Back-up Operator:
Location of Farm:
Owner Email:
Phone:
Phone No:
Integrator: e2
Operator Certification Number:
Back-up Certification Number:
Latitude: = c ❑ 6 ❑61 Longitude: ❑ ° = I = 11
Design Current Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle Capacity Population
F❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Laver
❑ Non -Layer
pry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Imoacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood 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 P No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes YfNo ❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 3 12128104 Continued

Facility Number: — Date of Inspection 2
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ,❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ff No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes Z No El NA El NE
through a waste management or closure plan? /
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes/11No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes [To
❑ 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 PlNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes �No
El NA
El NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [1No [I NA ❑ NE
El Excessive Ponding El Hydraulic Overload El Frozen Ground El Heavy Metals (Cu, Zn, etc.) /
[--]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes _P'No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
o
El NA
El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
JLI No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[No
❑ NA
❑ NE
Comments (refer to.quesflon;#) .. Explain any YES- answers andfor any recommendations or any ottier
Use drawings of facility to better.ex lain situations., (use additional pages as necessary):
Reviewer/Inspector Name �1� ( �. r�� '� Phone: 2d "`
r
Reviewer/Inspector Signature: Date: %1 l
Page 2 of 3 12128 04 Continued

Facility Number: — Date of Inspection 2
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes XNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes P No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
ZIE, Yes
❑ No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis gSoil 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
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
'XNo
ZjNo
❑ NA
❑ NE
4.
24.0
0
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
VNo
❑ NA
El NE
2 .
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
PfNo
❑ NA
❑ NE
Did the facility fail to have an actively certified operator in charge?
❑ Yes
,'No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
Pio
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes /2No El NA El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes � No ❑ NA ❑ NE
and report the mortality rates that Were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes (0—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 [,_511Qo ❑ 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 /Ko ❑ NA ❑ NE
Page 3 of 3 12128104

Facility Number: / s Date of Inspections D
Waste Collection & Treatment lJ
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 allo
❑ 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 PNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes CfNo
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes ;3 No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
Cl Yes /0 No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes No
❑ NA ❑ NE
maintenance or improvement?
.0
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes EJ'No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes [?No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[--]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
P1 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
PNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
�allo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
0 No
ElNA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E No
❑ NA
❑ NE
Comments (refer to question ft 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):
1e aclu6�-1 ec., l�J co s-L
ReviewerA n spector Name Phone:
Reviewer/Inspector Signature: Date: dy
- •--� 77/7R/nd I/'ns�tia'rioil
A4r--__-__ ____ _._ '

Facility Number: — Date of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes jo No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes P-fl4o ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
❑ Waste Application '10 Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
r
/0 6 1 1C,_S_ " YC 0 t 7/' 4, f c ,- �6 5? �_ 5
12128104

Type of Visit �Q'Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit:
Arrival Time:
Departure Time: County:
Region:
Farm Name:
S ' Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:.
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Phone:
Phone No:
Integrator: MA'
Operator Certification N er:
Back-up Certification Number:
Latitude: = o = Longitude: ❑ 0 0 1
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer -
❑ Non -La et
❑ Wean to Finish
❑ can to Feeder
Lateeder to Finish
-%
❑ Farrow to Wean
j
❑ Farrow to Feeder
❑ Farrow to Finish
i
❑ Gilts
El Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Imp
acts
It 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
❑ Pry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures: Lill
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ErNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
P No
❑ Yes
,D—No
❑ NA
❑ NE
❑ Yes
�Ko
❑ NA
❑ NE
12128104 Continued

Facility Number: 3 — Date of Inspection 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 9.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): f ' f�
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes PNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ❑ No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 3 No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ff 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 []NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ,D"No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No
No El NA El NE
❑ Excessive Ponding El Hydraulic Overload ❑ Frozen Ground El Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evi ence of Wind Drift El Application Outside of Area
12. Crop type(s)�&rAVZZ 62
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes )7::FNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes f:fNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[] Yes fl No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes dNo ❑ NA ❑ NE
18. Is there a tack of properly operating waste application equipment? ❑ Yes ETNo ❑ NA ❑ NE
Reviewer/Inspector Name � Wa = ;� * Phone:
Reviewer/Inspector Signature: G1 Date: rr
1212 04 Continued

Facility Number: 73 Date of Inspection
Req`u.ired Records & Documents �,�
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ElfJ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes IffNo ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard J11*aste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑'No
❑ NA
[:1 NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
E]-No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
;]-No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
P-No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
P'No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑No
❑ NA
❑ NE
Other Issues
i
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
❑ Yes allo
❑ 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 J No
❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes ;EINo
❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes JZ No
❑ NA ❑ NE
Addihopal Conimen0andYorDrawutgs V.
r1,�1,1 dC �' &)a5 ah� -flyrr�c«'r
Gl e� /sue r�
6-0C�
fin S,
Gqca•-c�S��
12128104

Type of Visit OCom➢liance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit z
Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: % P Time:
Facility Number
O Not Operational O Below Threshold
1] Permitted O Ce '' ed ❑ Conditionally Certified
© Registered Date -Last Op eroedLor Above Threshold:
Farm Name: /!I! �..rr�. f%sL County: � »» ...�.... . .
Owner Name:
Nfailing Address:
Facility Contact:
Oasite Representative: _ .
Certified Operator: .
Location of Farm:
Phone No; _ ..
Phone No: W
Integrator:
Operator Certification Num
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' " Longitude '
Discharges & Stream Lnaacts
1. Is any discharge observed from any part of the operation?
❑ Yes,2-No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c_ If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes'E30so
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes -ARWo
Waste Collection & Treatment
4_ Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: /
Freeboard (inches):M
❑ Yes '2 No
Structure 5 Structure 6
12112103
Continued

Facility Number: 3— tZ-7 Date of inspection
5�
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 maintenancelimprovement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelumprovement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload Q
r 77
12. Crop type
13. Do the receiving crops differ with those designated in the Certi
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?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attar 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
❑ Yes [RWo
❑ Yes -2'No
❑ Yes j;Wo
❑ Yes ZO No
❑ Yes �O-No
❑ Yes �IM
❑ Yes .j!f_No
❑ Yes ZNo
❑ Yes J214o
❑ Yes _21fio
❑ Yes .Ergo
❑ Yes '21qo
❑ Yes ,O No
❑ Yes 13,&o
❑ Yes E;�No
❑ Feld Copy ❑ Final Notes
1 ell, SOo �r -
��o'�s-t ��2�5r�i�i-� �v l� �✓ i�r 5�� �1��-c �l�'ce s'
Iva
Reviewer/Inspector Name tF.
Reviewer/Rmpector Signature:
Date:
72/I2ro3

Facility Number: — Date of Inspection
Wauired.Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes.E�o
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ W13P, checklists, design, maps, etc.) ❑ Yes ,EINo
23. Does record keeping need improvement? If yes, check the appropriate box below. ,',8' files
,P"W'aste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes —E &o
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes AR'No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, Freeboard problems, over application) ❑ Yes ,❑iqo
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes 'E3"No
28. Does facility require a follow-up visit by same agency? ❑ Yes Ejl o
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes A0ft
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, slip questions 31-35) ,Otes ❑ No
3I. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes O'go
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes EMO
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes .ErNo
34. Did the facility fail to calibrate waste application equipment? ❑ Yes j2vKo
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes EtNo
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
0 No violations or deficiencies were noted during this visit. You wM receive no further correspondence about this visit.
I-1p 3)
12112103

Type of Visit I& Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit i9;Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Faciliri' Number
Date of Visit: Ti Time:
Not O erational Beloti<• Threshold
®.Permitted ® Certified © Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: _ m9 — �i L)'Ipt CM15 _ _ ._ County: Al"OtK
Owner Name: 4�ad _.. Phone No -
Mailing Address:
Facility Contact: Title: //Phone No:
Onsite Representative: &.i P _ _ _ Integrator: _1/90roe _
Certified Operator: Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 6 " Longitude ' 4
;-Design " Cilrre©t. Design - Current. :,'. - DesEgtt Cni rent
5wlne ti Ca aci Pu "alahnn - 'Poultry =-Ca aeity .Popelation _Cattle' ^• _.Ca apty "Po` ulatioA
..: ❑
*, El Wean to Feeder ❑Laver Dairy
^� Feeder to Finish I A7Z Non -Laver ❑ Non -Dairy
❑ Farrow to Wean x
ElFarrow to Feeder❑ Other
Farrow to Fitrish r 4 Tatai�Desi Ca aC '
Gilts
- ❑ Boars = ,tY< 3 :'Total SSLW: MC
Number.ofLagoons s' `� ❑Subsurface Drains Present La oon Area Spray Field Area �xti
M . .T,.�.. r�rl "" �'4r..} "�S�'4+� :'r � tiV t {a _. .. � "fir S- { i� P•*i'�
of ;;0IIdS"/ SoltdTra s�-i j Pf - � ❑ No Li rid Waste Mana ement System
Dkeharges & Stream Impacts - _ I. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gallmin? E
d. Does discharge bypass a lagoon system? (If yes, notiR, DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spiliwav ❑ Yes No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: i
Freeboard (inches): -
05/03/01 Continued

Facility Number: Date of Inspection
5_ Are there anv immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure Milan?
(if any of questions 4-6 was answered yes, and the situation poses an
❑ Yes
ON,
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
g Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9yes
❑ 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
allo
11, Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12. Crap type u!f p �
13, Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
59 No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
59No
b) Does the facility need a wettable acre determination?
ERYes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
[54 No
15. Does the receiving crop need improvement?
JR Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
W No
Reuuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
[A No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20, Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
P No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
J54 No
22.- Fail to notify regional DWQ of emergency situations as required by General Permit?
-' (ie/ discharge, freeboard
❑Yes
No
problems, over application)
- 23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
R No
24. Does facility require a follow-up visit by same agency?
❑ Yes
5,No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
®,NO
�] No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Field Copy U Final Notes
4d-t,*1cn5 are Aetded for 1�J2 # , �-6-
'�4ie S an L4gvoh 'AW1 n v e ICJ -o -fie. week/�d o.a,
ll%i Q Clot Wef�[r,n,J_ n bi 4r°k 11 # iS OJP/7'iOv;I'll` -7�_ 19onh'70
B �tlt�f�e 4CYG. G(✓/�ti�Ai)!n �a [Al5 A17ra5h•
1 Ppry I-fAt'L 4`5 A�eeld d,
.Reviewer/Ins ector Name ' r_ .�+.t "{ •`-
fi : Reviewer/Inspector Signature:. Date: zAZ 7L
05103101 Con nued

Facility Number: l — Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor 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 [! Na
❑ Yes �gNo
❑ Yes & No
❑ Yes �INo
❑ Yes ELNo
❑ Yes 15!�No
❑ Yes MNo
05103101

Division of Water. Quality
isi Q;Divon of Soil and Water Conservation f
- Q
Other Agency.
Type of Visit Compliance Inspection O Operation Review Q Lagoon Evaluation I
Reason for Visit A Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number �G Date of Visit: Time: I 1330Printed on: 7/21/2000
Q Not Operational Q Below Threshold
Permitted ❑ Certified © Conditionally Certified [] Registered Date Last Operated or Above Threshold:
l j , I
Farm Name: .... t1.�,�\SvlA1......................................................................................... County:......j.�.........................................................
1
OwnerName................................................................................................ Phone No:....................................................................... 1-1.............
Facility Contact:.............................................................................. Title:.........-....... Phone No:
Mailing Address:. .................... ...........
Onsite Representative: !" p .. { L-1i,..........................
...........
I.........................
Integrator :.......Kk-f y ...................................................
Certified Operator:................................................................................................................ Operator Certification Number:.............. ...........
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 9 fit Longitude • & 66
Dedkn Current Design Current Design `: Current
capacity Po ulatiion Poultry Capacity Population Cattle Ca as Population
Wean to Feeder ❑ Layer::::]I ❑Dairy
eeder to Finish .IG ❑ Non -Layer ❑Non -Dairy
Farrow to Wean _
Farrow to Feeder ❑Other
j K Farrow to Finish Total DeSign'CaPacity
Gilts
' Boars Total ssm
Nifiib6 of.Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Hobdug Ponds / Shcid Traps ` ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a- If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes gNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 91 No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes XNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...............................................-................-...-.............................................................................. .............................. .... ...............................
.
Freeboard (inches):
5100 Continued on back

Facility Number: — Date of Inspection L�
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes [�No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes kNo
(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 maintenancermpmvement? ❑ Yes ((No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes NNo
Waste Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes 04No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes D�No
12, Crop type bVN r \o 0 ► VG --
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Regagred Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
O: iq viola iutis;etr dgfeWhcies •vg*re h0* d0dog �hjs;vWjt;. Y:o0 will-t &give 4o Curthtr -,
t`orresPozideRce about this visit .....:::......:..........:::....... .
❑ Yes C<No -
❑ Yes qNo
,fYes ❑ No
❑ Yes ❑ No.
❑ Yes U No
❑ Yes Ef No
❑ Yes RNo
❑ Yes 9No
❑ Yes "No
❑ Yes O(No
❑ Yes 9No
❑ Yes q No
❑ Yes CKNo
❑ Yes 9No
❑ Yes. Vf No
C�'-\ 1SSi�e IC�scx� �cti� 1� ve"y
�lG�'��=tom ►,...�.�e�=��� �./�+t-��G�� �e �-��.�-�. e:��:zQ�� ��- •�.- -
QiA
1 Y'
Reviewer/Inspector Name Q _ x �7
Reviewer/Inspector Signature: Date: `a �� U 5/00

Facility Number: Date of Inspection �G Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge 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, ❑ Yes k�No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? 'Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes j No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes Wo
Additional -Comments an or rawtngs: - - - _-
J
5100

Facility Number 3i' S Data- of Visit-
Permitted j] Certified��--E3 Conditi�oJnallly Certified J3 Registered
Farm Name: it 1"a� r y� x — �c r .. F� �l. ....T�t.?r.' `?!R ........ ......................................................
Owner Name: C rA +„
10'1-iine: �� Printed on: 10/26/2000
Not Operational O Below Threshold
Date Last Operated or Above Threshold: ......................... '.
t
County:........!.n....................................
Phone No: ....1..�.!....�..2-.8..—j`....R...2. 61..�.................
FacilityContact: .............................................................................. Title:.............................................................. Phone No:...................................................
Mailing Address: 12r,, G�i r I a ✓,4 k;,, �('d G � Iv fv Z Qu "1 t�'7
................................................................................................... r.................................................................................... ..........................
r
Onsite Representative: � t�G'� K. n Integrator: yr ...... _ `QI!! "! +5.............................
y...............�.......... .......... ................................... h.
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location of Farm:
,Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • C 4; Longitude • L «
Swine
Design Current Design Current
Capacity Population Poultry Capacity Population
❑ Layer
Srj�.D ❑ Non -Layer
❑ Wean to Feeder
9Feeder to Finish
El Farrow to Wean
El Farrow to Feeder
[I Farrow to Finish
[I Gilts
❑ Boars
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy
❑ Non -Dairy
Total Design Capacity
Total SSLW
Number of Lagoons I Fr]SubsurfaceDrains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Im�t
1. Is any discharge observed from any part of the operation? ❑ Yes )ZNo
Discharge originated at: ❑ Lagoon El Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? El Yes JR No
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ) ❑ Yes 2fNo
c, tf discharge is observed, what is the estimated flow in gal/min/ `? r. t r',
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ONo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ;KNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes JgNo
Waste Collection & 'Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 0No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier ...............................................................................................................................................
........................................................................
Freeboard {inches): 40
5100 Continued on back

Facility Number.-3 [ — Date of Inspection Z D Printed on: 10/26/2000
Ar"here any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes XNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes 9NO
(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 P No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? 8 Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes JgNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes 0No
11. Is there evidence of over application? ❑ Excessive Ponding OPAN ❑ Hydraulic Overload $j Yes El No
I2. Crop type f3e Ol�VO/A C.14 e r led Gr" se , ?fie�Lf �f - j;'t6 l 6eer ilk,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes J4 No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? XYes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes fffNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes 0 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.) XYes ❑ 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 ONo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application) ❑ Yes O No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes O No
24. Does facility require a follow-up visit by same agency? ❑ Yes 9No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes SNo
. . . ... . . . . def cie;r�... vt=ere notes during this:visit: Yoh will xeearipe Rio further ;
correspondence: abouk this visit:.... • .. :
Comments (refer:to question #):. Explain any YES answers.and/or any-recominendations:or_any other comments.,-
Use drawings of facility to better explain situations. (use additional pages as necessary)
g. Meed 46 r'era:,r kek.s ah 4'1tA 4ar►ks rnd •Flush fAnk Pipes, Also .
rera;r cra.ek is, ho3 h.nu.se IjA,'A is Jeakih,� w�4et, AISc 4kere t`.r
.saf^c W454e- oh 44c jr�ound be-4ween k09 koLAse avid rq�oo�.�Itve
pipe- be4tjeen La y cos) b house Aar- l ea kx .
11. vverotrr l � oet4; o�, &.,P plahf qvn b[e ni'l re9ah lets oeUU rr-ed eft. -AC
1 ell -1q — Za 0 0 St^-z p► (/ elot, o tw C r
13. Gr-owe a �.as d ,'_VCJ beer-, u ,,t,� ih F-'e rA o pre
JVeed 4v ensvre 4LA4 e-scye cqobeiLj4 ►ss oLdde.A 4o Ian
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 5/00

Facility Number: 3 Date of inspection Printed on: 10/26/2000
�F O�crrlssues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below OYes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) [:]Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes Z No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? 15Yes ❑ No
Additional Comments: an orDrawings:
iS, LJork �-o i,.,,,lp,rrrve wef aree, i%l Flo Id 9
need s p 6e P [an 4ed it-, reed z N yA ra
18, njecd 44 Lt.&ve la�ne1-, V4Iv:yle G�eGk
1`]eed to 11av+e F-gs4 avtA VrG�a ed -�'r �,AGird r�c�rds crvgf Iti���
01 oree-41 o h . N e ed 4.0 4 Ave j09 s4 so s ) 4e.s4s I pe, .s 4 w�►s
Gh�t�ySi S eweal l Able -far in.r pet,41'o-n - !Need h txs�e a tx"J,_
a hat/y s. r Lr I � �O� d��_r or' Arp 11 n4j eh on 4' e TO-Z'J
�CLardI so,� �cs�} recew►ri,enda-�'o�s.
A H -r;c,ld s k)e,,4'%4 ie4.4 -1 4oi, %a cre -
�a-�e � ��-.E ��.s-�e �Zccn .?�WS �t Se�-�e�"�beX''1vaJ��b�►^
��� � i C 4'i' ��o � 1n✓ i n� D i.v 10 h SrwG11 � �j "'GL' H j j V} 1% �"� + � c� e � /I � "'`�
[$ `^'� b r� -( �E�(tT �j � e bt 1G�i! 1 �{ -� t �r� �v i ,rl.L� a w � r t �Ln r t'i-�'b �! � kt Yl • L
Gld[S t4!5 oore skcwrj ;h 1N*s4'_ 'f 1q' pis 16. S �Gres bVT
(tre Stx,,Q,) OLl 'If AS 19%5 Aid Z0..5 ,,,Cfj
jlc rtorje rt�lr� 6e Cie--rtr►�;
t7r� C�Y�S. t 'Od Z t T S�i4'Njt GCS G. sAG✓GS i"l � ttt�'l 6v4 if
7 acfes Opt 7t,irl; de4er►'"', nc cor'reG4 ne naae nod use t►%
F14h,nta.p1ar,A reto,-AS. r;e1dt kJJ .rh,jt1d &e coe-t-b;qcd
W ►A -f-e 1d z t,-)A1Af'1 .
Z 1. C3 r c Aj o _t, r' ; S i s .S 1-,Puv rN A S `11 e G j e A* G-1 had w o r k-
hereare. lub O G-Fier'n Whig
Lv A rey re 3Q Y '44 1 VCr
A) o4 e � Se n � VI-t c / r j � � � � 1,,, .� s -�� �l t1 �l i yes td� 1�1 � �i �
-rree-b0or'd�-re&0,-d& 4-,oy_x C)gY1.�` I -i �+tt►`V pre---o-fif
by 12-1 11 f no.
.
J
5100

[ Division of Soil and Wier -Conservation - Operation Review 3 a
D Division of Soil and -Water Conservation;- Compliance I>rtspectit►it , 4
Division of Water Quality . Compliance Inspectrpai
13 Other Agency. Operabton,Rev�ew�.m r
-
10 Routine O Complaint O Follow-uu of DWO inspection O Follow-uv of DSWC review O Other I
I Facility Number f
Date of Inspection /-4)
Time of Inspection 3D 24 hr. (hh:mm)
Permitted 10 rtiifiied © Conditionally Certified [] Registered C
Farm Name: ..... 11 -1. - !.....-.. ....�%�i ......-.... - �% S-......
I6�
OwnerName:.... I�}.................................. \l....................................................
Facility Contact: ..(.. ,f�Gt ! ..-..�.1.1!14... �. . y... ..
... I Title:.
Mailing Address: ..I2.4i....4a'LI' d ........h.../..r"itq..I ..........
Onsite Representative: h^'
Certified Operator:... ................................................
Location of Farm:
Not Operational I Date Last Operated:
County
Phone No:..1:(..lp�. � r/r. `............................
Phone
��No: ...�11.0). �(r
............. WT I {........4.16........................ -Alf
Integrator:......................................................................................
Operator Certification Number: ..... 1?,2,110,•,_„
r-
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
� .
Latitude • �° Longitude • C�4 °`
;Design Current `Design Current Design Current
Swine PoltPopulationCCapacity Population . attle . Capacity Po ulahon '
❑ ❑Dairy❑ Wean to Feeder Layer A
Feeder to Finish ❑ Non -Layer JE1 Non -Dairy
Farrow to Wean
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity
❑ GiIts - -
❑ Boars Total-SSLW
Number of Lagoons ago
❑ Subsurface Drains Present ❑Lon Area ❑Spray Field Area
Holdiingl'oiids / Solid'Traps ❑ No Liquid Waste Management System
_..
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 0 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? ❑ Yes 1No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes (No
c. If discharge is observed, what is the estimated flow in gal/min? /,'/t
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Ye ® 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 Q No
Waste Collection & Treatment \\
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure h
Identifier: �%
Freeboard(inches): ....&0..............................................................................................................................................................................................
S. Are there any immediate threats. to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes *o
seepage, etc.)
3/23/99 Continued on back

Facility.Nurwber: 3 — 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 UfNo
(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 XNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes 14 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes jA No
Waste Ap llcatiOn
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
� No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
j No
12.
Crop type S�—ba J314
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
No
b) Does the facility need a wettable acre determination?
❑ Yes
[KNo
c) This facility is pended for a wettable acre determination?
❑ Yes
[IrNo
15.
Does the receiving crop need improvement?
❑ Yes
A No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
DdNo
Reauired Records & Documents
IT
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
DkNo
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
,KNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20 Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
[A No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
XNo
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
O No
0: io•yiolattoris'or• deficiencies •were note#- OtWing this. s. t. You will•reeeiye Rio foi-ther
correspon�eizce about this viset. .. . .. .. ... . .
Cotnments=(refer to question #}; Explain any YES answers and/or any recommendations or_ -any other coniimments.. $
Use drawings of facility to°:Hefter explain situations (use additional"pages as.necessary)
�. _. „.
1q) 041k �94495.
i.5 Ix� Orer�re�°
Reviewer/Inspector Name = '
Reviewer/Inspector Sign Date:
3/23/99

FacilityNutrnber: — Date of Inspection f/
Odor Issues
�Yliquid
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below '� Yesr" fN9
level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 56 No
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?
�Y- Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes 0 No
❑ Yes E, No
❑ Yes [0 No
❑ Yes U1 No
tr v ,o
[Additional omments an or ravvtngs:
i
3/23/99

[j Division of Soil and Water Conservation [] Other Agency
�r
Division of Water Quality
T
Ry—
Routine 0 Complaint O Follow-up of DWQ inspection 0 Follow-up (if DSWC review 0 Other
Date of Inspection
• Facility iV'urnber
Time of Inspection 'd.34 24 hr. (hh:mm)
0 Registered © Certified [3 Applied for Permit S Permitted 0 Not Operational Date Last Operated: ..........................
Farm Name• ........ ... `. � ... ......County:
`..............................................................................
Owner Name:......`! S1 ram. �'Yy. ..... Phone No :................. ..
....................................................................................................................................................
Facility Contact: ................................. ........ Title: ---.------.-----.- ... Phone No:
MailingAddress: ..................................................................
Onsite Representative:.- --.---..-_ .: . .................. ..
Certified Operator:................................................................
......... ...... ................................................................... ...... .... ................
Integrator:......... t1...£...................................
Operator Certification Number, .........................................
�ocat' n of F rm
x...............ti.i....�,.......c................-••----.............................................
1..{........-...s....s-�...�............................................................................................--.................._
Latitude Longitude �• 0' �" ,
Design= Current ' Design Current
--- _
Swtuue�_.. e Capacity `Population Pouttiy " 'Capacity Population Cattle
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Other
Total Design t
Tota
'apacli L
y Population
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
9No
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
No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
P(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
*o
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
5No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
M No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
0 No
7/25/97

i
Facility Number: —
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures fLagoons.Holding Ponds. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
❑ Yes % No
❑ Yes VNo
Structure 5 - Structure 6
Freeboard(ft): ................................................................................................................................... ...........................---
10. Is seepage observed from any of the structures? ❑ Yes No
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 maintenancelimprovement? Yes ❑ No
(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?
WasteApplication
lication
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type Il.... .......................
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 0nl
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?
0-No.violations.or' deficiencies.were_noted,during this:visit.; You.vdfi-ivC6ve_i�o f6rtiier
. • correspQndepce atiout this: visit.- ' ; � . ; - : - ; ' '. - . - : - ; :: : � . '.. ' ; . ; : •. � '. � . ; :: - : � : � . �.
❑ Yes N(No
❑ Yes bq No
❑ Yes WNo
❑ Yes M No
OYes ❑ No
❑ Yes O(No
❑ Yes P9 No
❑ Yes [YNo
XYes ❑ No
❑ Yes .0 No
❑ Yes No
❑ Yes No
R JL y A7,�, cc- 3�
AG box►— CAI �
j �a5St1Ae.
sue` 5l� C;1yf tr,
7/25/97
Reviewer/Inspector Name
IReviewer/Inspector Signature:
Date:

❑ DSWC Animal Feedlot Operation Review
U.
® DWQ Animal Feedlot Operation Site Inspection tk
rQ Routine O Complaint O Follow -tip of DWQ inspection O Follow-up of DSNVC revieiv O Other 1
Facility Number
Farm Status: ❑ Registered ❑ Applied for Permit
gj Certified ❑ Permitted
Date of lnspection
Time of Inspection I I5= CD 124 hr. (hh:mm)
Total Time fin fraction of hours
(ex:L25 for f lir la rain}) Spent on Review
or Inspection (includes travel and processing)
0 Not Operational , Date Last Operated:
FarmName........... ...... ..# r tit!.!i!_........................................................................
Owner Name:
..... q.........Si!L'Its'W................................................. .............
County: ....... Lwi r.....................
Phone No: .....016 IR-3,3.3
Facility Contact: ........�,Q,�,jt51......�M%s ....... ..... Title:........4.in Phone \o-�iID��
r'� .`.....-.............. ....... v.K-3SZ......
il4ailiug.�dciress:......raG..Sr--- f'}'l��lT)11. ............................. .Tc2...... ......, ...........................................................I................ .r...................
- A
L f
Onsite Representative:.... .m S1�11.11t�....................................................... Integrator: .......'.`l(1..
......................................... ................
�.
Certified Operator: .................................................. ................................ . Operator Certification Number:....... 7_ �... .......
Location of Farm:
Latitude �'C�`�4° Longitude • 6 64
Type of Operation Design Current Design Current; ID
estgn Current.r
Swine Capacity, Population : Poultry Capacity Population Cattle Capacity Population,
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Other
Number of LaEoons /:Holding Poncls l . 1 1='' ❑Subsurface Drains Present I0 Lagoon Area ❑ Spray Field Area
General
1. Are there any buffers that need main tenance/improvement? ❑ Yes WNo
2. is any discharge observed from any part of the operation? ❑ Yes RLNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes -P No
b. Tf discharge is observed, did it reach Surface `'Water:' (1f yes, notify DWQ) ❑ Yes V9 No
c. If discharge is observed, what is the estiniated flow in gal/min?
d. Does discharge bypass a lagoon system? (1f ves, notify DWQ) El Yes [,jNo
3. Is there evidence of past discharge from any part of the operation? ❑ Yes JR No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes IEI�a No
5. Does any part of the waste management system (other than lagoons/holding ponds) require a ❑Yes No
maintenance/improvement?
4/30197
Continued on back

Facility Number:
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
S. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons and/or Holding Ponds)
9. is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure 1 Structure 2 Stmcture 3 Structure 4
Z-T
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)
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)
❑ Yes J!9,No
❑ Yes ISNo
❑ Yes ONo
❑ Yes
JI&No
Structure 5
Structure 6
.............................................................
❑ Yes
sd�No
❑ Yes
; d No
RYes
❑ No
❑ Yes
IgNo
❑ Yes
V No
15. Crop type
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?
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
r z.- C 51or` a-rcas a r, i Amw wa l l
% 5kould 6 res"ed.
)(-.Toff(_o 5rou.)trL5 in 4e[6 * h
7-4, S" wofk s6Id be y
Reviewer/Inspector Name
52 Yes ❑ No
❑ Yes CR No
❑ Yes
Ca No
❑ Yes
Pq No
❑ Yes
CWNo
❑ Yes
JB No
❑ Yes NJ No
❑ Yes Mo
R Yes ❑ No
s6uld be (41U) w{ 4 dcy c,,d Yt,%edrd • &we-
. M; l bt zhoA �e � J.
by by Jr lt-i S1r rLVAW a*xj Aeld nuwt6r.
r
Reviewer/Inspector Signature:
Date:
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30197

.� ram^ :• ,: ..
4
DSWC Animal FeedIotOpera tlon Review
r - � �DWQ Animal.Feedlo>� Operation Site Inspection _
'_ .•O Routine O Complaint O Follow-up of Dw0 inspection O Follow-up of DSWC review O Other
Date of Inspection J -i
Facility dumber $ Time of Inspection Use 24 hr. time
Farm Status: --. C e- r 1: t _ _ ._ _. —
Total Time (in hours) Spent onRetzew �I
or Inspection (includes travel and processing)
�a ..� t f
� sL.r 1 �x _ RR.. � f _S- .._ t`: � L.3ca.. ... .......... ....._ _—._L� Farm Natne: Coun
Owner Name: iL[ AQ - _ Phone No: '1 10 15.._._Z__LJ,7
h3ailing Address: .._�r� quo. L t� _ 1 e V s.�L.Ee
Onsite Representative: fl. - Integrator:._
Certified Operator _C­6 i.g.Operator Certification
Location of Farm:
rs �' �.� !_
•- _ �) ,� - < s .� t� ins _r f e Q ..�er_.
v e� ��[.�.� _
Latitude ©• S� [ !�` Longitude ©• F �`u` 41
❑ Not Otieradonal Date Last Operated:
Type of Operation and Design Capacity M
Swine r ".._:Number y Cattle
- x
.: w ..r_
r: ...Poultry :Number ..
;:
umber
❑ Wean to Feeder
j
❑ Laver I
[] 7a�
I
® Feeder to Finish
I fl
❑Non -Lave: I
❑ ��
Farrow to Were
I
Farrow Feeder
to
Farrow to Finish
, <❑ Other Type of Livestock
R
,
lYumber of La6oansrcf HoldtngPottds; © Subsurface Drains Present
❑ LagrQon Aie3 y'=10 Spray Field Area
General
1. Are there any burie-s that need mainteaancedinprovemeat?
2. Is any discharge observed from any part of the operation?
a_ If discharge is observed, was the conveyance man-made?
b. If -discharge is observed, did it reach Surface N ater? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gaVrnin?
.d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
Is there evidence of past discharge from anv pan of the operation?
4. Was there any adve -se impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management syste n (other than lapoons/hold:n_ ponds) require
rr�iatenanc�'imoro�.e.-_^ t'
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
RNo
r} A
❑ Yes
INO
❑ Yes
® No
❑ Yes
® No
SYCS
❑to

6. Is facility not in compliance with any applicable setback criteria?
7. Did.the facility fail to have a certified operator in responsible charge (if inspection after 1/1/97)?
❑ yes ®No
❑ Yes ® No
8. Are there Iagoons or storage ponds on site which need to be properly closed? ❑ Yes [KNo.
Structures {Lagoons and/or Holdinn Ponds/
9. Is structural freeboard less than adequate? ❑ Yes 0-No
Freeboard (ft): Lazoon I La_oon 2 Lagoon 3 Lagoon 4
10. Is seepage observed from any of the structures? ❑ Yes ZNO
11. Is erosion, or any other threats to the integrity of any of the structures observed? KYes ❑ No
12. Do any of the structures need maintenancelimprovement? [K Yes ❑ No
(If any of questions 9-I2 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
11 Do any of the structures lack adquate markers to identify start and stop pumping levels? ❑ Yes ®,No
Waste Aunlication
14. Is there physical evidence of over application? ❑ Yes Ej No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type - w La a � - - a.L! ..V-r%`^
16. Do the active crops differ with those designated in the Animal Waste Management Plan? ❑ Yes E-No
17. Does the facility have a lack of adequate acreage for land application? " ❑ Yes KNo
18_ Does the cover crop need improvement? RYes [! No
19. Is there a lack of available irrigation equipment? ❑ Yes n No
For Certified Facilities Only R ~
20. Does the facility fail to have a copy of the Animal Waste Management Plan readi.iy avail_ble? ❑ Yes O N=o
2L Does the facility fail to comply with the Animal. Waste Management Plan in any way? ❑ Yes B No
2-1. Does record keeping need improvement? EL Yes ❑ No
23. Does facility require a follow-up visit by same agency? ® Yes ❑ No
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in cha*Q:? ❑ Yes E,No
Comriients' (refer to question,:) £tglatri any�YES aiisR es and/or any recommendanons or aa� athe� comments . .
LJse drawtngs.of faciity tobetteaxplsiu srtutons use additional pages as necessa-5) '• w . =
lr-- CLra v�a�� �CCt "'� SFrC �,��� Si-fl-ld �7t' Ccr.rzCTQet. �'r4StCh rj-4s 1h
J 51�-0`✓ici l also �1 D, �eLt r� ...; t� rev, k o k i E'
�. u r Q. t Fe.-'e�. � t �r
5 S
e1 Sko 1d bz 11 QL-d a c'aKV C-,-F� t J-0 c� 4 aSi +jwE w gR rz
co. r 2.4 S ; �-, 5 P r f + e l a S c rya t� st 1, y c u f E e) ,n L. a r Z �! �j Q �7�. 1) c
n� 5
tr C v-C S S a w z f t e S L' cL - e-a. S u-V '1 , f ro a +�-� 1 a v�F [ e r r e c
cLr �(
Q `� P b
it im z 10- e c .. � a L j +^ � Q-d ixr i, a �, E [ e.,d a ,.-cl_ � e v e.. � t--4 f-Qei,
O�1,er loe ra 4rZ�LS c.- 1agp��+ WC,11 �nflQd {E1 b� vri—L e�2 �-4 ivv,w• t
{o r eN �ivt ti v t ttie�r e-r o �i � ^ .
Z Z. % 4'-2 5" r 4- t t , 4fl Ci r. ... b e.+rs i, . y c v r a ✓w ti. i G p
�Lav, vtlr✓e�S�G.� {C �tia vtVw. cl,. IEG�vr ►r-,r��,Q}c��C+4 rtC-0�xs
Grate c� 0Y2,rrt�ed'�� im bZ a co rQc rV.; - t 4-0 ca ^ 1► � t,}�S �' r
Reviewer/Inspector Name C" _r-
Reviwer/InspectorSignature: ��,� �"` " ', �,,,�����,�,� Aate: S
cc: Division of Warer Quality, Rarer Qiralitjr Sec Dlt, Facility Assessment Unit 11/14!96

State of North Carolina
Department of Environment, Health, and Natural Resources
Wilmington Regional Office
James B. Hunt, Jr. Division of Environmental Management Jonathan B. Howes
Governor Water Quality Section Secretary
Certified Mail # Z 405 591243
Return Receipt Rffluested
Mr. Craig King
126 Garland King Road
Teachey, North Carolina 28464
• Dear Mr. King:
•
'Y
August 11, 1995
Subject: Hallsville Farm
Duplin County -- 3 /" 6-p
On July 20, 1995 staff from the Wilmington Regional Office of the Division of Environmental
Management inspected your animal operation and the lagoon serving this operation. It was observed that
a drainage ditch between your hog houses and lagoon showed signs of recent wastewater -flow.
It is assumed that the wastewater came from an overflow of the house flush tanks. Remedial action
should be taken to prevent overflows form occuring.
To remain a deemed permitted facility, all corrective actions must be made within seven (7) days.
Failure to do so may result in the facility losing it's deemed permitted status, requiring a certified waste
management plan and certification form for the facility to be submitted prior to the December 31, 1997
deadline, and being required to obtain an individual non discharge permit for the facility.
Please be aware it is a violation of North Carolina General Statutes to discharge wastewater to the
surface waters of the State without a permit. The Division of Environmental Management has the authority
to levy a civil penalty of not more than $10,000 per day per violation.
127 Cardinal Drive Extension, Wilmington, N.C. 28405-3845 a Telephone [phone] • Fax [phone]
An Equal Opportunity Affirmative Action Employer

Craig King
August 11, 1996
Page 2
•
When the required corrective actions are complete, please notify this office in writing at the address
below. I you have any questions concerning this matter, please call Steve West or Dave Adkins at
[phone].
Sincerely,
B. Steven West
Environmental Chemist
cc: Dave Adldns - Regional Water Quality Supervisor
Duplin County Soil and Water Conservation District •
Duplin County Health Department
Tom Jones - NC Division of Soil and Water Conservation
Operations Branch
is
I .Y

Site Requires Immediate Attention:
Facility No. 31- S Fr
DIVISION OF ENVIRONMENTAL MANAGE?YIENi
ANU AL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE:,- 3 b , 1996
-Time: / 0
Farm Name/Owner: j-1A4 Z
Mailing Address:
County: _ i � O p ! %►�
Integrator: F Phone:
On Site Representative: Z v,_dy ' ;, (n Phone: Z - Zt
Physical Address/Location:
Type of Operation: Swine X Poultry 'Cattle
Design Capacity: Number of Animals on Site:
DEM Certification Number. ACE DE]k Certification Number: ACNEW
Latitude: 3�' sue' 5 Longitude. _ �' Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot - 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) or No Actual Freeboard: _ F _� Inches
Was any seepage observed from the laaoon(s)? Yes of Vo Was any erosionbbse.ved? es yr No
Is adequate land available for spray?' e�r No -Is the cover crop adequate? (yj�br No
Crop(s) being utilized: -
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? es r No.
100 Feet from Weals? �fp or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line S trea m? Yes orb
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or(ff!>
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man -trade devices? Yes or(T�) If Yes, Please Explain_
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? IKEPbr No
Additional Comments: L�T-� L hEcfla�l. Y►�Q_ Lam, a1G i s �~rH�
ef'b c5 w3 i C%t 1 aA-)
A N l7 H E09 les AM) vt DJ�nJ� a-C d 1K
h1r%s Tt_ aN Ekis4in/6 Nam! F;L7ate_
� L vA.) 6E4 -p <3t E.y as dtt AjL a 5 odi -TA!5 se L,.,!a.J 1 et
7ti �k c,AZ s��sc=.�C L2 A_ J4SJ=/jEjS 3,Uddy TO Co"u--c-"T,'
do/.51 16/z el 4 Sp 4
-` Inspector Name Sianatu�e
cc: Facility Assessment Unit Use Attachments if Needed.

1 Site Requires Immediate Attention:
Facility No. 3 t — 5 '�r
- DIVISION OF ENVIRONMENTAL MANAGEMENT _
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
01
DATE. `Z Z- ' 1996 n
Time: , r
Farm Name/Owner: a f �S v L E recce _ C ed4 I
Mailing Address:
County: JA.7`
Inte--ator: �L Sn 17.2 n �'�JD ' , Phone:
On Site Representative: _ :1 C E_4" - Phone:
Physical Address/Location: _Q L� �R2 -6" :� "Ti-it,
��`Tlr��i rt� S� l 4Ec{a
Type of Operation: Swine ,, ;Poultry µ' ' Cattle
Desic-In Capacity: _� Z 'Number of Animals on Site:
DEM Certification Number. ACE DEM Certification Number: ACNEW
Latitude: Longitude: Elevation: Fee,,
-Circle Yes or No'
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches or No E _ Acival Freeboard: ,'' Ft. -6-.-aches
Was any seepage observed from the lagoon(s)? Yes or4o Was anv erosion observed? es r No
Is adequate land available for spray? e r No Is the cover crop adequate? "or No
Crop(s) being utilized: e
Does the facility meet SCS mu' di ,um setback criteria? 200 Feet from Dwellings? or No'
100 Feet from Wells? Zpor No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Scream? Yes orC
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes orb
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes orQT) If Yes, Please Explain_
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or�
Additional Comments: 0sinj 0 /1 on �Dr bil,0/1S A E�—S 7"0_
l
nspector Name
�i_ature
cc: Facility Assessment Unit Use Auacliments if Needed.

Site Requires Immediate Attention:
Facility No. 3 L — 5 Y
DIVISION OF ENVIRONMENTAL MANAGE?YlENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE. "Z Z 1996
Time: �t
Farm Naze/Owner. Cerg l &r k_16':�6
Mailing Address: Z (o
County: _
Inte g ator: _ v17 p r= d Phone:
On Site Representative: , _3 C �2 H _ Phone:
Physical Address/Location: 5 Q i a Lo at 7LALT,_r4S CFC T7!)_7 r?__ Sit l li(v(
Type of Operation: Swine Poultry Cattle
Design Capacity: ?- tJ Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number ACNEW
Latitude: 0 rtLongitude: " Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot _ 25 year 24 hour storm evert
(approximately 1 Foot + 7 inches) (P or No Actual Freeboard: __FL 19-7nches
Was any seepage observed from the lagoon(s)? Yes or4gWas any erosion observed? jjjr-No
Is adequate land available for spray? e r No Is the cover crop adequate? 0 or No
Crop(s) being utilized -
Does the facility meet S CS minimum setback criteria? 200 Feet from Dwelin?s? or No '
+ 100 Feet from Wells? es or No
Is the animal waste stockpiled within 100 Fee: of USGS Blue Line Sa-eam? Yes or(o',
Is animal waste land applied or spray irigated within 25 Fe4r of a USGS iNLu Blue Line? Yes or(�e
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or� If Yes, Please Explain_
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes orC;
Additional Comments: o /1 o- A/� -- 5 �
�f!� �f� � r2.�1� . � l.7 f�[�/r iYI / G f%.t•'/.� /S /��� fCr .�� �'. �C,�lit�'�
_ nspecror Natne
1gT.laEure
cc: Facility Ass;:ssrnem Unit Us.- Attachments if Needed.

N
JUL-14-1595 1-:22 FROM DEN WATER QUALITY SECTIot`t TO
I,WIFO P.02/02
Site Requires Immediate Attend
Facility No. -_T/Z�Z
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 7 + ZC7 1995
Time: 36
Farm Name/Owner: C iZ" t G- HAc_ t� S v
Mailing Address: r--"- cr 2o r-SC 20 4,.
County: o PLt +�
Integrator: A r+ 2 I'P Phone:
On Site Representative: _,. C t- -' tc-- 1G r Vl cam- Phone:" t °� 'ZK ` � 6 9 �
Physical Address/Location: N CS R i-� c 4 � ' S +v+ �_ S C- hl /{ tt,S V t L,CC
Type of Operation: Swine +� Poultry Cattle (P) rt r S k IW-
Design Capacity: 57-6O O Number of Animals on Site: _ 4 J 0 O
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: v 4 * _<_e�' �" Longitude: ` �� ' _ 0y ' Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) es r No Actual Freeboard: _11—Ft. — Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or No
Is adequate land available for spray? es r N Is the cover crop adequate e r YNo
Crop(s) being utilized: 0�9 �-^o ,
Does the facility meet SCS minimum setb ck criteria? 200 Feet from DweIIings es or�No
WO Feet from Wells(Y or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? es ol�9
Is ariinial waste land applied or spray irrigated within 25 ,Feet of a USGS Map. Blue Line? Yes or No
Is animal waste discharged into of the state by maxi -made ditch, flushing system, or other
similar roan -made devices? es r No If Yes, Please Explain.
�i
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? e r No
Additional Comments: � a I ru4ew-
• cam —
Inspector Name
lz_)S
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

OPERATIONS BRANCH - WQ Fax:[phone] Rug 1 '95 10:24 P.08/08
Site RegtYires Iianiedi' A * ' tion
Facility -Number.,
SITE' VISITATION RECORD
DA'1TE:', 1x.�1 -2-,: ' .1995
Owner: G ,.� ' Faria Name:
County: o.
Agent Visiting Site: ri A Phone: _
Operator: Phone:
On Site Representative:' phone:
Physical Address: SA Z 946: ' -P �' �` j6:J'
Mailing Address:
Type of Operation: Swine )!L Poultry Cattle
Design Capacity: . 7 Number of Animals on Site:
Latitude: -0 -- _ Longitude: o '
Type of Inspection: Ground Aerial
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) Yes o No'Actual Freeboard Feet inches
For facilities with more than one lagoon, please address the other lagoons' freeboard under the
comments section.
Was any seepage observed from the lagoon(s)7 Yes 00Was there erosion of the darn?: Yes or No
Is adequate land available for land application? Yes or No Is the cover crop adequate? Yes or No
Additional Co=cnts:
to [phone]
Signature of Agent