310087_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

» DivisionOf'w$ter:"RC5onlCeS
Facility Number, Division of Soil and Water Conservation
Type of Visit: Compli spection Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency Q Other Q Denied Access
Date of Visit: �3 1 Z,71P Arrival Time: Departure Time: = 5a County: Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: LA 16'5( u 0'Lz -- _ Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number: 2 7j
Certification Number:
Longitude:
Design_,...Current E Design Current - Design �yCurrent
Swine Capacity Pop. Wet �Pbultr� ' Capacrty`Pop. Cattle �� Capacity`. __ Pop.,
Wean to Finish
We4n to Feeder
Feeder to Finish
p
0
ow to Wean
-')w4
2
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Turkeys
Other Turkey Poults
Other Other
esign Current-.,h �-
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
2, Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
4
❑Yes 0-N 1]NA ❑NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes 6No ❑ NA ❑ NE
❑ Yes Q�lIo ❑ NA ❑ NE
Page I of 3 21412015 Continued

Facility Number: - Date of Inspection: t
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Ej No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 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 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 ffNo ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4fi were answered yes, and the situation poses an immediate public health or environmental at, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No DNA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes FlNO ❑ 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 ONo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 7"' ❑ 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 0 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ZrNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable 0 Yes ErNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
[:]Yes Pto ❑ NA ❑ NE
❑ Yes T To ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑WUP ❑Checklists [:]Design ❑ Maps [:]Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 6 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 o ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: jDate 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 o [] NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No qNA
NA NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes No [DNA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility9 If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ]iNNo NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes o ❑ NA ❑ NE
Comments (refer to question #) "Ezplaith 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). .:
63• Lr f( I!� S1`� I r rL Cash �jrc'ctkC —
AN
2S try Q C'C_�•'3
Reviewer/Inspector Name:
Phone: �(o 7? G 7-)94
Reviewer/Inspector Signature: " l Date: 3 f 2 Zi 7
Page 3 of 3 21412015

°' m 1Vi$1Qn�of„Water Resonrces� r r � c �.�'+� FaciitOtrs:ri'o�Ac.g,ofrn�SC..,oDWNumber
��w -•��"`�i 5
811-0
y Y.
� .
Type of Visit: C=outine
e Inspection Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: O Complaint O Follow-up O Referral O Emergency Q Other O Denied Access
Date of Visit: 7 Arrival Time: (p D Departure Time: / County: Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: L 4 A' Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Latitude:
Phone:
Certification Number: P 2 P 7.0
Certification Number:
Longitude:
Design Current Design . Current'.. J Resign ~Current.^Y.
Capacity Pop. Wet Popltry,Capacity Pop Ciiitil { �z 56�Capacity , ,Pop
Wean to Finish
can to Feeder
3 *'
.fee
-der to Finish
PO
Xarrow to Wean
Y AD
`f Dag
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Non -La er
t.
Design Current"_
_Dry Pou1 - Ca _aci --Po <�
.::
La ers
Non -Layers
Pullets
Turke s
Other Turkey Poults
Other Other
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non-Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 6 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?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
❑ YesgNo ❑ NA ❑ NE
Page I of 3 21412015 Continued

Facih Number: - Date of Inspection: /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑-N —❑ 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 Zg_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
❑.Nv—`❑ 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
Now ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[214o ❑ 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
Q'No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ff 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
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[3 No ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[.-I-No ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[;P4-6 ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑'Ko_ ❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
�--��
1__I' o ❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
ENo ❑ 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 [3'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 To ❑ 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

Facili Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑-?4rr- NA ❑ NE
y
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes o ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes [2-Ko ❑ 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 ld &o ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes Ej No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes ❑/ oo ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes �o ❑ 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 ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes E3-V V ❑ NA ❑ NE
Comments (refer to question. #): Explain. any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use -additional pages as.necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: l 7Q� 7-YP t�
Date: f/71,/ 16
21412015

F . UDivision of Water Quality
Facility Number L_.Ti 1 - ® O Division of Soil and Water Conservation
O Other Agency
Type of Visit: Com fiance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit:( Arrival Time: Departure Time: OO County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: I C'- 5 n k 4'.� r N
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Latitude:
Phone:
Integrator:
Certification Number: Q
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
jJ Non -Layer
can to Finish
Wean to Feeder
Fader to Finish
9D
-7oo
arrow to Wean
ar4 00
9
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Pullets
Other
Poults
Design Current
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Imoacts
1. Is any discharge observed from any part of the operation?
❑ Yes
io
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
Q- o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[�io
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility Number: 31 - Date of Inspection: S
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
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
` QQ
Zcf ff
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes E311< ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes E N ❑ 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 ETNo ❑ 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?
011—s there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes ❑ No
❑ NA
❑ NE
Excessive Pondin Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN PAN > 10% or 10 lbs. Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop mow ❑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?
❑ Yes [!�N-o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
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 eNo
❑ 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 []"�o
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes F5No
❑ NA
❑ NE
Page 2 of 3
21412015 Continued

Faefli Number: jDate of Inspection- Q4o
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 to provide documentation of an actively certified operator in charge? Ef Yes ❑ No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [] No I__l 1vH ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [:]Yes 1__I l�o ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes Ej No ❑ NA ❑ NE
]f yes, contact a regional Air Quality representative immediately.
6 30. id the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes ❑ No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes k o ❑ 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 LJ o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes] No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES: answers and/or any additional recommendations or any other comments'
Use drawings of facility to better explain situations, (use .additional pages as necessary). -
IVg�C_6_ra?r- _50.`/"^rtIy50
Zu ' �R ` n Co,., �lR �� � f (Q � 1 y 9Z [ c � 4
n p /� LI
4 < <� O �/` Ct F ! o /L s �J U- y R a 2 \ /2_�C; r' 17-1Vr&kr
t Q 5/� f _I o
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3-0. Fe e
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
au 4— ` q 11 L
g (9 716 73c-? f
n I 1 0 V ,�_ 51-
Phone: [phone]py
Date: Ll /
V412014

A
.1.
Division of Water Resources
Division of Soil and Water Conservation
Other Agency
Facility Number.
310087 Facility Status:
Active Permit: AWS310087
E] Denied Access
Inpsectlon Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine
County: Duplin Region:
Wilmington
Date of Visit:
06/01/2015 Ertry Time: 09:05 am
Exit Time: 10:00 am Incident p
Farm Name:
B.W. Barwick Farms LLC
Owner Email:
[e-mail]
Owner.
Bennie W Barwick
Phone:
252-669-1846
Malting Address:
1498 Mark Herring Rd
Seven Springs NC 28578
Physical Address:
1431 Bowden Rd
Warsaw NC 28398
Facility Status:
❑ Compliant ❑ Not Compliant
Integrator Murphy -Brown LLC
Location of Farm: Latitude: 35" 01'
East of Warsaw. On West side of SR 1301 approx. 0.5 mile North of SR 1300.
Longitude: 78" 00' 58"
Question Areas:
Dischrge & Stream impacts Waste Col, Star, & Treat Waste Application
Records and Documents Other Issues
Certified Operator: Operator Certification Number:
Secondary OIC(s):
On -Site Rep. ntative(s): Name Title Phone
On -site representative Barber Latisha Phone:
Primary Inspector. David Powell Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
No year of Soil Analysis
26. Taking course in Dec. Has 2014 OIC card
11. Possible overapplication on SGO. Using 219/256 PAN rate.
Have Frank Call David Powell @ 910 796 7304 within 30 days
30. Freeboard is at 19 Call DWR if below 19" freeboard. 910 796 7304
page: 1

.1 Permit: AW5310087 Owner- Facility: Bennie W Barwick Facility Number: 310087
Inspection Date: 06/01/15 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current promotions
Swine
Swine - Farrow to Wean
3,400
3,200
Swine - Feeder to Finish
900
700
Swine - Wean to Feeder
350
0
Total Design Capacity: 4,650
Total SSLW: 1,604,200
Waste Structures
Disignated Observed
Type Identifier Closed Date Start Date freeboard Freeboard
Lagoon 1 19.50 24.00
page: 2

-1 Permit: AWS310087 Owner - Facility: Bennie W Barwick Facility Number.
Inspection Date: 06/01/15 Inpsection Type: Compliance Inspection Reason for Visit:
310087
Routine
Discharges & 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?
❑
❑ ❑
❑
b. Did 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?
❑
0 ❑
❑
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection. Storane & Treatment
Yes _00 Na_ No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
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 properly addressed and/or managed through a
❑
M ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
01313
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0110
to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑
0110
maintenance or improvement?
Waste Application
Yes No Na Ng
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ ❑ ❑
maintenance or improvement?
11. Is there evidence of incorrect application?
❑ ❑ ❑ ❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, 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: AWS310087 Owner - Facility : Bennie W Barwiclk Facility Number: 310087
Inspection Date: 06/01/15 Inppection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No No No
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 ❑
El
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?
❑
❑
❑
18. Is there a lack of property operating waste application equipment?
❑
0 ❑
❑
Records and Documents
Yes No No —No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 []
[]
20. Does the facility fail to have all components of the CAWMP readily available?
❑
01111
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
1101111
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
❑
Soil analysis?
❑
Waste Transfers?
❑
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

" Permit: AWS310087 Owner - Fadlity : Bennie W Barwick Facility Number: 310087
Inspection Date: 06/01/15 Inppection 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
❑
0 ❑
❑
(NPDES only)?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
0 ❑
❑
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?
011011
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑ M
❑
Other Issues
Yes No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
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,
❑
❑
❑
contact a regional Air Quality representative immediately.
30. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑ ❑
❑
(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 I 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 Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0 ❑
❑
34. Does the facility require a follow-up visit by same agency?
❑
0 ❑
❑
page: 5

fwatec R w►sion,o esources
Facillity Number, , 4 © O I)rvision of Soil and Water Conservation.
0, Other Agency � `W
Type of Visit: �-eompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: e' Departure Time: County:
Farm Name: ( /L }Qr/rv(r- �' Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: ] t Title:
Onsite Representative: L 2 `r C t eL G. r �a� r
Certified Operator: l a 'T
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Region:
Integrator:
Certification Number:
a-1 -7
Certification Number:
Longitude:
'
Design' .'Curren ,
Desigu ,Current Design "Current'
Swine
Capacity : Pop.
Wet Poultry Capacity ', '
Pop Cattle Capacity .'" Pqp
:...:
..
a
Wean to Finish
Layer
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
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 .
Da' Cow
❑ Yes �lo ❑ NA ❑ NE
❑ Yes PNo [] NA ❑ NE
❑ Yes [;no❑ NA ❑ NE
❑ Yes No
❑ Yes No
❑ Yes HNO
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
1/4/20I4 Continued

1p
Facili Numher: - Date of Inspection:
Waste CoUction & Treatment el
44 19 storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes PNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes �o
❑ 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 j_��o
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
T
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes ONo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes �+No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:)Yes E2 No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
T
9. Does any part of the waste management system other than the waste structures require
❑ Yes 5Vo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes E�!rNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes 9No
❑ 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?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
PNo
❑ NA
❑ NE
❑ Yes
FZ�o
❑ NA
❑ NE
❑ Yes
],No
❑ NA
❑ NE
❑ Yes
R No
❑ NA
❑ NE
[] Yes
ID -No
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes %�No ❑ NA ❑ NE
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. []Yes PT&o
❑ 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
ff-
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 21412014 Continued

Facility Number: ,3 - Date of Inspection: O 1
24. Did 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 ZNo ❑ 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 .0 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �i No ❑ NA ❑ NE
Other Issues J"
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes � o ❑ NA ❑ NE
and report mortality rates that were higher than normal? T
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ZNo ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes ;;�No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes PrNo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWW?
❑ Yes ,2'No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes Wo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes <
❑ 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).
/. Y
Reviewerfinspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ?ld 77173� 3
Date: . 7&V
240014

,r
Division of Water Resources
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number
310087 Facility Status: Active
Permit: AWS310087
❑ Denied Access
Inpsection Type:
Compliance Inspection
Inactive Or Closed Date:
Reason for Visit:
Routine County:
Duplin Region:
Wilmington
Date of Visit.
10/27/2014 Entry Time: 09:15 am Exit Time: 10:16 am Incident 0
Farm Name:
B.W. Barwick Farms LLC
Owner Email:
[e-mail]
Owner.
Bennie W Barwick
Phone:
252-569-1846
Mailing Address:
1498 Mark Herring Rd
Seven Springs NC 28578
Physical Address:
1431 Bowden Rd
Warsaw NC 28398
Facility Status:
❑ Compliant ❑ Nat Compliant integrator
Murphy -Brown LLC
Location of Farm:
Latitude:
35" 01' Longitude:
78' 00' 58"
East of Warsaw. On West side of SR 1301 approx. 0.5 mile North of SR 1300.
Question Areas:
Dischrge & Stream Impacts Waste Col, Star, & Treat
Waste Application
Records and Documents Other Issues
Certified Operator: Bennie W Barwick
Operator Certification Number: 17666
Secondary OIC(s):
On -Site Representative(s): Name
Title Phone
24 hour contact name Leticia Herring
Phone :
On -site representative Leticia Herring
Phone:
Primary Inspector. Kevin Rowland
Phone:
Inspector Signature:
Date:
Secondary Inspector(s):
Inspection Summary:
page: 1

Permit: AWS310087 Owner - Facility : Bennie W Barwick Facility Number: 310087
Inspection Date: 10/27/14 Inpsection Type: CompHance'Inspection Reason for Visit: Routine
Waste $ ructures
DIsignated Observed
Type Identifter Closed Date Start Date Freeboard Freeboard
Lagoon 1 19.50 26.00
page: 2

Hermit: AWS310087 Owner - Facility : Bennie W Barwick Facility Number: 310087
Inspection Date. 10/27/14 Inppection Type: Compliance Inspection Reason for Visit: Routine
01schaEges S Stmam Impacts
Yes No Na No
1. Is any discharge observed from any part of the operation?
❑
❑
[]
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
EDO
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?
❑
0 ❑
[]
3. Were there any observable adverse impacts or potential adverse impacts to Waters of the
❑
0 ❑
❑
State other than from a discharge?
Waste Collection, Storage S Treatment
Yes
No Na No
4. Is storage capacity less than adequate?
❑
0 ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large
❑
moo
trees, severe erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a
❑
0 ❑
❑
waste management or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
M ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable
❑
0110
to roofed pits, dry stacks and/or wet stacks),
9. Does any part of the waste management system other than the waste structures require
❑
m ❑
❑
maintenance or improvement?
Waste Application
Yes No No No
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ M ❑ ❑
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, Zn, 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: AWS310087 O ner - Facility : Bennie W Barwick Facility Number: 310087
Inspection Date: 10/27/14 Inpsection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No Na He
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
❑
■ ❑
❑
Management Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
❑
M ❑
❑
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?
❑
0 ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
ED
❑
Records and Documents
Yea
No Na No
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
00
❑
20. Does the facility fail to have all components of the CAWMP readily available?
1101111
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Lease Agreements?
❑
Other?
❑
If Other, please specify
21. Does record keeping need improvement?
❑ M ❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
Weekly Freeboard?
❑
Waste Analysis?
[]
Soil analysis?
❑
Waste Transfers?
[]
Weather code?
❑
Rainfall?
❑
Stocking?
❑
page: 4

Permit: AWS310087 Owner - Facility : Bennie W Barwick Facility Number. 310087
Inspection Date: 10/27/14 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?
❑
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment
❑
0110
(NPDES 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
❑
E ❑
❑
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?
❑
N ❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
E ❑
❑
Other Issues
Yea
No Na No
28. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑
0 ❑
❑
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 fall to notify regional DWQ of emergency situations as required by Permit?
❑
0 ❑
❑
(.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility?
❑
E ❑
❑
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 ❑ ❑ ❑
CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewfinspection with on -site representative? ❑ ❑ []
34. Does the facility require a follow-up visit by same agency? ❑ ❑ ❑
page: 5

_0 Division of Water Quality % -r
Facility Number 3� - ® 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: om Hance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: �eparture Time: County: Region:��
Farm Name: Owner Email:
tk
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: �Integrator:
Certified Operator: Certification Number: / �r✓ p2 ce
Back-up Operator: Certification Number:z9TC�
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
I L�_] I I Layer
Non -La er
Discharges and Stream Impacts
Pullets
Other
Poults
Design Current
Longitude:
Design Current.
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
1. Is any discharge observed from any part of the operation? ❑ Yes ..0 No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes oNo ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ,[!fNo ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)? _
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes o
❑ Yes �90
❑ Yes�'No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: 113ate of Inspection:
Waste Collection & Treatment
4,.Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes ,0 No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ZNo
❑ 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
(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 L f 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 9.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 ,fNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes 2�No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes ZNo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs. ❑ 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 Ej 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 L�'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 [�r_No ❑ NA ❑ NE
❑ Yes J:?No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes C2 &o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes E5"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
❑ 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 ,[ErNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes L2rNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - Date of Inspection:
OF
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
2t . 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 Ievels 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 0No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes HNo ❑ 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 file 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
❑ NA
❑ NE
❑ Yes
ffNo
❑ NA
❑ NE
❑ Yes J[ErNo ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
❑ Yes P� No ❑ NA ❑ NE
❑ Yes Vo
❑ NA ❑ NE
[—]Yes ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawings of facility to better explain situations (use additional pages as necessary).
'; r-ZllX' f re6a'2-1,6 160&JI24rl,
Reviewer/Inspector Name: /C 114
ReviewerlInspector Signature: /` �'�
Page 3 of 3
Phone: 7r v /--x ` '
Date: G X3
21412011

; �' vision of Water Quality
F; edQ Number 0 Division of Soil and Water Conservation
0 Other Ageney U
Type of Visit ,compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit _Q'Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 13 T., Arrival Time: Departure Time: County:
Farm Name: 3 Z_/ / e Lr. _r7 r dG Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title: Phone No:
jj
Onsite Representative: I�e"'Lie G Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
F_
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Region k~l
o /!
Operator Certification Number:
Back-up Certification Number: 7
Latitude: = o = f Longitude: = ° ='
=
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La er
Other
❑ Other I
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design ,Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ 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 0No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
[2Po
❑ NA
❑ NE
❑ Yes <o ❑ NA ❑ NE
■
Page I of 3 12128104 Continued

Facility Numher: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structu;e 1 Structure 2 Structure 3 Structure 4
Identifier: 7
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
S. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
[--]Yes ;dNo
❑ Yes [;rNo
Structure 5
❑ NA ❑ NE
El NA ONE
Structure 6
❑ Yes VNo ❑ NA ❑ NE
❑ Yes jZNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [2No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes PKNo
❑ 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 OlNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
❑ NA ❑ NE
_;Ao
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 7(No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or l0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes /ZNo
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of property operating waste application equipment?
❑ Yes
Pl�o ❑ NA ❑ NE
PKNo ❑ NA ❑ NE
o ❑ NA ❑ NE
No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or arty othercoomments'.
Use drawings of facility to better explain situations. (use additional pages as necessary):'
T
ReviewerlInspector Name Phone:
Reviewer/Inspector Signature: Date: -2-
Page 2 of 3 12/18/04 Continued

Facility Number: Date of Inspection 13
Rgqnired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ETNo ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists El Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
E3 No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1"
Rain Inspections ❑
Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
KNo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
KNo
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
7fNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes VfNo ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ONo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes VrNo ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ONo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
7Io
❑ 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
PNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
Vf
El
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
o
El NA
NE
33. Does facility require a follow-up visit by same agency?
El Yes
7No
❑ NA
❑ NE
Additional Comments and/or Drawings:
tv
• liL 5 !v� l ,� /�f o / .3
raw o� r C
Page 3 of 3 12a8/04

D
Division of Water Quality :
Faci1iWT lumber. Q Division of Soil and Water Cohservation. r ,
Q Other Agency
Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit outine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: n Region: Lzzd<10
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: %r Zl�-'?C' 42fj,'--4rt_.'5 Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: o [--] ' = Longitude:
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La er
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharzes & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ,EfNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
;2'&o
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
Page 1 of 3 12128104 Continued

Facility Number: 3 — Date of Inspection p
ante Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 9No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes 0 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 P�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 P 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 Jj'No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes )2No ❑ 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 PNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application �/
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes IQ No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ZNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes O No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes pNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes PrNo ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes YJ No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes dNo ❑ NA ❑ NE
Comments (refer to, question #): Explain any YES answers and/or any, recommendations or any other comments '
Use drawings of facility to better explain situations. (use additional pages as. -'necessary):
Reviewer/Inspector Name Phone: �%
Reviewer/Inspector Signature: Date: 2op i
Page 2 of 3 I2/2ff/04 ' Continued

Facility Number: - Date of Inspection I
Z / d
Wored Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes J'No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes '- o ❑ NA ❑ NE
the appropriate box. ❑ wup ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? if yes, check the appropriate box below_ JVYes ffl?No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard VWastc 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 Jam' No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes Lallo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes �Io
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes ;�J'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 �' o
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes JD -No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ yes )2rNo
❑ 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 )�T-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 WNo
❑ 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 Q No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes / o
❑ NA
❑ NE
Additional Comments and/or Drawings:
�—
���°7�°� o q8'
U5 c a2 �l p�t� w� 4� � 1y s r s t�i� a��/a 31111.
6
�Jc u J{ q�
o � _T 'S ,� 3 ", / � s
S
rr—
Page 3 of 3 12128104

-loHivision of. Water Quality
Facility Number i �2 O Division of Soil and Water Conservation
O Other Agency .�
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ( Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: : C3 CJ Departure Time: County: rt Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: //��.. __ Title: Phone No:
Onsite Representative: �C / ! G fY-Ci'Y/s-L� Integrator: ,J";lIF
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = , „ Longitude: = ° = 1 Q "
Design Current Design Current' _ Design Current
Swine Capacity Population Wet Poultry „Capacity Population„ Cattle. Capacity Populattona
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ La er
❑ Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
Other
u
Turke
PEO]Other
❑ 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 Coui
--'Number of Structures ; l If
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2, is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ,'No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
O fo
❑ Yes
Z"No
❑ NA
❑ NE
❑ Yes CJ No ❑ NA ❑ NE
12128104 Continued

Facility Number.— Date of Inspection F4�Gr
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 P"o
❑ 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 ON.
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes ZNo
❑ 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 ,,ffNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes EfNo ❑ 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 FNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ZNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes gNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes ZNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes JZNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes Z No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes EfNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes Q4o
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or.,any other comiments
Use drawings of facility to better explain situations. (use additional pages as necessary):
AL
• Gc�r/ems lj� ���,��.� G d
� r �
Reviewer/Inspector Name >r�1 - � v Phone: �l�i -J' 1
Reviewer/Inspector Signature: ,00 �] �� i Date:
IM8/04 Continued

FaciliV Number: — Date of Inspection
Required Records & Documents
l9. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists ❑Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes l No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 1;2Mo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [ o ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
2rNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ZrNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
Mo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
VNo
❑ 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
�3No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
O No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
J'No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ZfNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
01<0
❑ NA
❑ NE
"Additional Comments and/or Drawings:
A.
vJA �
&Pa 9
1V28104

w
U Division of water Quality
Facility Number Q Division of Soil and Water Conservation
- - — - C) Other Agency L�
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: i J / VA/4 Arrival Time: v Departure Time: �� County: Region:
Farm Name: �^� G7r6.11C r- Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: // Title:
Onsite Representative: 011`
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Gilts
Other
❑ Other
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: 1=1 o =1' 0 « Longitude: = e =' = «
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
f�, ❑ 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?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ D*g Calf
❑ Dairy Heifer
QDry Cow
❑ Non -Dairy
❑ Beef Stockei
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: ED
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes effNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
allo
❑ Yes
`❑ No
❑ NA
❑ NE
❑ Yes
0-No
❑ NA
❑ NE
12128104 Continued

Facility Number: 3 — Date of Inspection S- G
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
Mo ❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
O—No ❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ No ❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
rl-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 Z No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes n 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 PNo ❑ NA ❑ NE
maintenance or improvement?
Waste Avolication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes PNo ❑ 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
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] yes
PNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
PNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�Ao
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
9A'J'jd-7 /1y v No 51adly- , cl-ve�)
to/ 11/0 6.73 oreC0V-dSLY Cjt0_ 3So--)o0v
ll
r/1Z ZIP
Reviewer/Inspector Name Phone: j'%—Yc1W
Reviewer/Inspector Signature: Date:
12128104 Continued

I
vision of Water Quality
Faeil„fy Number `7 O Division of Soil and Water Conservation
c. - - -
Other Agency
Type of Visit114 compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit,,&Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: G Arrival Time: i byr Departure Time: County: Region: �f
Farm Name: �15 fi✓ �17R_l t.► h/ Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: _
Onsite Representative:
Certified Operator:
Back-up Operator: _
Location of Farm:
Swine
Phone:
Title: Phone No:
Integrator:
Operator Certification umber:
Back-up Certification Number:
Latitude: ❑
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
� ❑ La er
3�Q ❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
El Feeder to Finish
d
O
El Farrow to Wean
-f
El Farrow to Feeder
El Farrow to Finish
El Gifts
El Boars
Other
❑ Other
Dry Poultry
❑ La ers
ElNon-Layers
El Pullets
ElTurkeys
ElTurke Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field El Other
a. Was the conveyance man-made?
Longitude: [�0 ❑
Design Current
Cattle Capacity Population
El Dairy Cow
ElDai Calf
ElDai Heifer
El Dry Cow
[INon-Dairy
El Beef Stocker
El Beef Feeder
El Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes ❑>0 ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
o
[-INA
❑ NE
ElYes
rjqq10
❑ NA
❑ NE
12128104 Continued

Date of Inspection -�
Facility Number: 3—
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
ONo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Strut 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
X 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
eNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental
threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
,ONo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ yes
J'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
E ❑ NA El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
Cl Yes
,(
LI No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
JZ'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) Ali/rn"a (f
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
P
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
ElYes
No
ElNA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
KNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
V1 No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name I A vim- G'1 Phone: 7/25�— 7�'�
Reviewer/Inspector Signature: Date:
1-uge L VJ I [L/L6/VY F-Unrin"eu

Facility Number: — Date of Inspection 0
1!teguired Records &Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists El Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" 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:
1V / AL
lr
�-
or�i
Page 3 of 3 12/2&04

ity Number
Type of Visit (2)Compliance Inspection
Reason for Visivd Routine O Complaint
Date of Visit: I /,2/u7 D Arrival Time: I(Y/ i
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: _
Back-up Operator: _
Location of Farm:
Swine
-A)Di,v2sion of Water Quality I
0 Division of Soil and Water Conservation
0 Other Agency
0 Operation Review 0 Structure Evaluation 0 Technical Assistance
0 Follow up 0 Referral 0 Emergency 0 Other El Denied Access
:1.
Departure Time: County: l Region: 7w7/0
Title:
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Nn er:
Back-up Certification Number:
Latitude: = e = 4 0 « Longitude: = ° = 6
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
GO
❑ Farrow to Wean
b
36000
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Cilts
❑ Boars
Other
❑ Other -
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharp_es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood CoyA
Number of Structures: E�
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 Im No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
KNo
❑ NA
❑ NE
❑ Yes
eNo
❑ NA
❑ NE
12128104 Continued
i
0

Facility Nunsber: — S Date of Inspection o� B
"•
Waste Collection & Treatment
�j
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
El Yes R No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
El ❑ 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 ZNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes VNo
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate. public health or
environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes No
❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes �'No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes 2No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes_j2"No
❑ NA ❑ NE
rhaintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes ,ENo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 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) >I
13. Soil type(s) C/ de' ��
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes O'No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes Q No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[] Yes )2 No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes V�No
❑ NA ❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes 2 No
❑ NA ❑ NE
Comments (refer to question ,ft Explain any YES answers and/orany recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name Phone:
Reviewerftnspector Signature: Date: /oA /•3 �2oG�f�
12128104 Continued

Facility Number: 3 Date of Inspection U
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes eTNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes WfNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. Oyes JA No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 ° Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27, Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes FjNo ❑ NA ❑ NE
❑ Yes I] No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
&No
❑ NA
❑ NE
❑ Yes
FZNo
❑ NA
❑ NE
❑ Yes
F4o
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
�zNo
to No
❑ NA
❑ NE
❑ Yes Q] No ❑ NA ❑ NE
❑ Yes ["No ❑ NA ❑ NE
Additional Comments and/or Drawings: /
460
QfZCI� s/i
1416
C'U/- t n>�y � �� �u COL
/ryZ S
C�7rec�rL
12128104

Type of Visit 0 Corgpliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility N ber .:t
Date of Visit: Tune: 1 tin o� r
O Not Operational 0 Below Threshold
Permitted Certified © Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ... .
Farm Name: W Alr.w �Ja� Lw5 t.t ,C County: 0")+->
Owner Name:
Marling Address:
— . Phone No:
Facility Contact: .. c. .. _ Title: . , _ ....... Phone No: _
Onsite Representative: J 'Lt . ��_E R - �� Integrator. MUg=Ef4y--,__
Certified Operator:
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ horse Latitude • 4 44 Longitude • 4 46
Discharges & Stream Impa ,
1. Is any discharge observed from any part of the operation? ❑ Yes [3 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If "discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?"
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
[a No
❑ Yes
[3/No
❑ Yes
[/NNo
5aTture 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure b
Identifier: ... _. _ ..__..,
Freeboard (inches): M
12112103 Continued

Facility Number: j — Date of Inspection 7 2 u
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 0 No
• seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWO)
7. Do any of the structures need maintenanceJimprovement? ❑ Yes /No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancerimprovement? ❑ Yes Wo
11. Is there evidence of over application? If yes, check the appropriate box below. ❑Yes
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type o ck r- J-DA 60 S 6 t7
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes
14. a) Does the facility lack adequate acreage for land application? ❑ Yes rNcq
b) Does the facility need a wettable acre determination? ❑ Yes
c) This facility is pended for a wettable acre determination? ❑ Yes No
15. Does the receiving crop need improvement? ('Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes No
Odor issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atior below ❑ Yes 340
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes OINQ
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes C3 0
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ZNo
Air Quality representative immediately.
�� a�.�ES�aasv�ers-atuilora�y ��dt;i� �ama�s.� � � �:
,.gC��(r+tffer.�a�gan �rrxas
BUst drgwmgs ciff faaTety to better racism (use p as'k Feld C Final Notes"
Oct-t� Z� RFfkL? u-z� ANC tag ;'67-0L
Loo5 � Ef(3oAfc.G r�cor'>" ti-' i- -5f:�; ��+X �cPJ �� :.�-►�Ft�(�f�i�.
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to
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35.) jCtFr �
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,
t.1EE O T•:, iN�T�I,
Kc- F P L�iL t `l' �fti�2 �:tc. Cc�iviitJ �i
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CuQ ct,EN-t �'R-o:�PAM f1E E In ,APP€.
Ct GDf 'hE:Lb)
La �DA•iS focC,<-E \No A,-i-C-tL SArnl?(-�
Reviewer/Inspectar Name r i"J`aa �4L
Reviewer/Inspector Signature: Date: -71 7 c+ otl
r �ed
I2/Izro3 _ (ci i b� ��,",� 3 5 o i�6at� Cox#

Facility Number. 3-1 = Date of Inspection
R uired'Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUP, checklists, design, maps, etc.)
23. Does record keeping need . provement? If yes, check the appropriate box below.
❑ Waste Application [reeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/mspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
TWDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need ' ement? If yes, check the appropriate box below
dStocking Form [:I Crop YieIdTorm ❑ RainfaU Inspection After 1" Rain
�/120 Minute Inspections [Annual Certification Form
❑ Yes ['No
❑ Y s O/NNo
Yes ❑ No
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
ZYes
❑ Yes
❑ Yes
FYes
t N
LTN0
�0
[jfNo
❑ No
❑ No
❑ No
12112103

f I k
Type of Visit V Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit QRoutine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facilih• Number
Date of visit: /D Q Time:
f
Not Operational Below Threshold
®-Permitted M Certified 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: _ �/'-" A "�f/C- CL d County:
Owner Name:
Mailing Address:
Phone No:
Facility Contact: Title: Phone No:
Onsite Representative, too-- Integrator:—
Certified Operator:
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry [:]Cattle ❑ Horse Latitude ' 0. 0" Longitude 0'
_.
Design Gurrettt = Design Current _Design :. Current
Swine :� m.Ca acitv:. P6� elation - `Ponitrt Ca acity�-Po ulskian Icapacjtv'Pa �ulation
❑ Wean to Feeder ❑ La aye ❑ Dairy
Feeder to Finish Non -Laver, ❑ Non -Dairy
❑ Farrow to Wean - - y
El Farrow to Feeder
❑ Other
❑ Farrow to Finish w Total Design Capacity .
❑ Gilts
❑ Boars Total SSLW _
plumber of Lagoons �_� ❑ Subsurface Drains Present ❑ Lagoon Area JE3 S rav Field Area
Holding Paads J_Soiid Traps s. ❑ No Liquid Waste Management System
Dischartres & Stream impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 15No
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 ves, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes SNo
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes B-No
Structure I Structure ? Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Freeboard (inches): 5110,
05103101 Continued

.+ b
Facility Number: 31 —
Date of Inspection �D
5. Are there any immediate threats to the integrity of any of the structures observed?.(ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any pan 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 Anrslication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type 5 oiol t ES✓Sf; �.r Ud "�{�C
❑ Yes [9 No
❑ Yes 9LNo
❑ Yes RNo
❑ Yes &No
❑ Yes [B No
❑ Yes No
❑ Yes No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ®No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes E&No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ®No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
'El No
Required Records &_Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
allo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
CR No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
[.No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
VS -No
(ie/ discharge, freeboard problems, over application)
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
C$No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ETNo
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer-to`guest€on #) Explain any YIES'ansvters anchor any reciimmeadativas or, any other'cmment = -
Use drawings of fac7ity to better explam situation ,'(ase addttconat'pages'ss ctecessary) ❑ Field Conv �❑ Final Notes -
/ld�G,' — /'�l 1g- /lt.eW G,,c dctvo4%tS -d 3����Z �o.�� �.Fi�+�'� resuli's.
�7'_
Reviewer/InspectorNgme elm r
Reviewer/Inspector Signature: �� Date:
05103101 V-11, Continued

r �
Facility Number: % — Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge 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?
05103101
❑ Yes t-No
❑ Yes �5 No
❑ Yes t�],No
❑ Yes �1 No
❑ Yes IE�-No
❑ Yes tR No
❑ Yes & No

Facility Number 3 i Date of Visit.
,.E"ermitted © Certified [I Conditionally Certified `❑ Registered
Farm Name: Kw �?, q'''w t C * �G MS L
OwnerName:.............................................a.. t L L�................ ....................................................
Facility Contact: .............................................................................. Title:
flailing Address:
Onsite Representative: -SG ear` �
........................)...................................................
Certified Operator:
Location "of Farm:
Q:1Time: q3S Printed on: 7/21/2000
Not Operational O Below Threshold
Date Last Operated or Above Threshold: .........................
County: ..,'/.....`........................................................
PhoneNo:.......................................................................................
Phone No:
................................................................................... ..........................
Integrator:
.................................................
Operator Certification Number:,,,,,,,,,,,
A -Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 6 « Longitude • 4 «
Desigp .'Current Design Current _ .Design . Current'
swine .:.
.._ .Ca aci Po elation Poultry Ca aci Po ulat<on Cattle C aci Population
Wean to Feeder ❑Layer ❑Dairy
Feeder to Finish ❑Non -Layer ❑Non -Dairy
Farrow to Wean
Farrow to Feeder ❑ Other
Farrow to Finish Total Desi Ca aci-
� P . ty
Gilts _
yr:
ds..
Boars Total SSLW
._
Number ol[Lagoons II
1E] Subsurface Drains Present J10
Lag -an Area
❑ Spray Field Area
❑ No Liquid Waste Management System
HoMing Ponds I Solid Traps
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3.. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ....................................................................................................... .......................
�7
Freeboard (inches): 3 Gr
5100
❑ Yes �No
❑ Yes f 9No
❑ Yes 0No
h //
❑ Yes )21�10
❑ Yes Fe NO
❑ Yes f/ No
❑ Yes _,&No
Structure 6
Continued on back

Facility Number: j — Date of Inspection Printed on: 1/9/2001
b. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes 1;91No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes )2(No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes [ INo
{Waste Application
10. Are there any buffers that need maintenancelimprovement?
❑ Yes
11. Is there evidence of over application? ❑ Excessive Ponding [I PAN ❑ Hydraulic Overload
/FlNo
❑ Yes �No
12. Crop type _gG r' v� V Gl `i ce s5 " 11
13. Do the receiving crops differ with those de 6gnated in the Certified Animal Waste Management Plan ((!AWMP)?
❑ Yes /jZfNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes ❑ No
b) Does the facility need a wettable acre determination?
❑ Yes ❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes ❑ No
15. Does the receiving crop need improvement?
❑ Yes ONO
16. Is there a lack of adequate waste application equipment?
❑ Yes VfNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes /F2(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 ONO
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes /] No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes 33RO
24. Does facility require a follow-up visit by same agency?
❑ Yes gNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes P No
Q ViQ�a00I)�S,OC [��fl@IeliCiE'S VF�eCC llQte(1 �IH'illg 1thiS.V�SIt. i01! Wli� �'eLClye i�UIII't#l�C .
C' rispOIIdenCe.a�itlllt.th' Vlsitr'. .'.".".". .'.'.'.'. .'.'. .'.". .'.. . . .. . . .
Conaiments {refer to question #):-:Explain any YES answers and/or any recomImendatioas ©r stir at]
eretpasitnaddnlUse:drawm- of facltytwbettn ,_ tpages as necessary,
Fotc,;1 � yeC,4-4SM,,-e Ve'-4 Wl )r ^V—op f
� I
C Dorf gyre 4'01 EXCgt � C1044;un .
I&
Reviewer/Inspector
p
Reviewer/Inspector Signature: Date: Q S/np

Facility Number:. 37 — Date of Inspection Printed on: 1 0/26/2000
.Odo r -'Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below F(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 IV(No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 'P�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 'INO
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
Ja 31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
JAdditional Comments an orDrawings:
J
5100

WRoutine Q Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other j
Facility Number Date of Inspection
Time of Inspection I JL100 24 hr. (hh:mm)
'Permitted 0 Certified © Conditionally Certified © Registered 113 Not Operational Date Last Operated:
Farm Name:..........................................................
[` !�
.1 ....,r.�...............................................................I....... County• i..f
OwnerName:........................................................................................................................... Phone No:......................................................................................
FacilityContact: ...........Title: ................................................................ Phone No:...................................................
Mailing Address: ................ .. .
ddress:.............................................................................................. ..........................
r
.................... .............. ...
Onsite Representative:...)+~. a......i�-��...................................................... Integrator:.....�p........................................................
+t
Certified Operator:.................................................:...............................I.............................. Operator Certification Number:..........................................
Location of Farm:
Latitude Longitude
Design" Curr'ent' Design Current-: - �Desrgn Current
Svnne m .. -
Ca" aci -Po elation Poultry Ca aci
r Po elation C ttie Ca aci _- Po` `ulabon
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
q4 60
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Layer ❑ Dairy
❑ Non -Layer ' ❑Non -Dairy
❑ Other 1 1
Total Design :Capacity
7.77
;Totat'SSLW
.� .. _..
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? []Yes j14No
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)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier -
Freeboard
Freeboard (inches): ,'I,3,
❑ Yes
❑ No
❑ Yes
iV No
❑ Yes
*0
❑ Yes
No
Structure 5
5. Are there any immediate'threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes KNo
Continued on back

Facility Number: — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
El Yes
>0No
(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?
❑ Yes
gNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
RNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
XNo
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
VNo
11. Is there evidence o over. application? ❑ Excessive Ponding ❑ PAN
❑ Yes
KNo
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
XNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
KNo
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
XNo
16. Is there a lack of adequate waste application equipment?
❑ Yes
jg�No
Renuired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
gNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
�[
(iel WUP, checklists, design, maps, etc.)
❑ Yes
,KNo
[
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
ElYes
WNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
XNo
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 gNo
24. Does facility require a follow-up visit by same agency? ❑ Yes KNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 0No
violaii[.. . i .. Ie. ....were noted durinsib-is'visa: You will receive iio: further :::I
�orrespoxidenke: ab6 tt. this visit: f
Com nentsY(refer to question #) `Explairrany YE5 answers andlor any=reeotninenda tions or:any other,comments '
Usedrawings of facility to better explani situations (use.additibnal pages as necessary)
--�
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:

6 �
Facility Number: — Date of Inspection
ddoir Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below KYes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes X No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 4No
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 KNo
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 kNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes XNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes X No
Addibonal-jUomments and/orDrawings:
i

10 Routine 40 Complaint 0 Follow-up of DWQ inspection 0 Follow-ufi,of DSWC review 0 Other
Facility Number 31 87 !)ate of Inspection 3/3/2000
Time of Inspection 11:40 24 hr. (hh:mm)
Permitted M Certified E3 Conditionally Certified [3 Registered Not O erational Date Last Operated: ..........................
Farm Name: DAY!d.l..I!hiUipfi.,So.w..Earma-Tac .......................................................... . County: Dmpliri ......... ...................................... WMRO .........
Owner Name: DAYMMMAU ..................... ritillipm ........................................................ Phone No: ...........
FacilityContact: .............................................................................. Title: ................................................................ Phone No:...................................................
Mailing Address: PUXAL.720 ............................................................................................ KeuanmyJlle,.NC .................................................. 253.49..............
Onsite Representative: ............................................................................................................ ]Integrator: Muj;phy.F.axn*..F."M .....................................
Certified OperatonDayid.S ................................. Herring............................................ Operator Certification Number: .112.17 .............................
I M.ti.n of 1p.rm-
IAtitude F-35---1 & F-01--' F 1-3 - Longitude F-78--I* F —51--1, F-5-8-1-
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feede
Farrow to Finish
..........
IDG Subsurface Drains Present 11LJ Lagoon Area JD9 Spray Field Area
H* FEI No Uq;i:5 Waste Management System
-------
--
Discharees Ar Stream Impacts
1. Is any discharge observed from any part of the operation?
E] Yes
E] No
Discharge originated at: El Lagoon [] Spray Field [] Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
E] No
b. If discharge is observed, did it reach Water of the §6th? (dyes, notify DWQ)
❑ Yes
❑ No
c- If discharge is observed, what is the estimated flow; n gaUniin?
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
E] No
3. Were there any adverse impacts or potential adverse impacts to the Waters-ofthe State other than from a discharge?
❑ Yes
❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? EI.Soillway
❑ Yes
❑ No
Structure I Structure 2 Structure 3 o Structure 4 Structure 5
Structure 6
Identifier: ................................... ................................... .................................... ................................... ......................................................................
Freeboard(inches): ............... 26 ............... .................................... ................................... .................................... .................................... ....................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
El Yes
[]No
seepage, etc.)
3/23/99
Continued on back

Facility Nun_ier: 31-87 Date of Inspection 3/3/2000
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenancelumprovernent? ❑ Yes []No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
19. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
o io1atioxis ar:dief"rciericies vvere:rioted:during i its ' iiii. , V-6u w' :receive nQ NrNie'r
r�treciiripili�xir.i+ .. .. .. .
Q received a compliant that spray mist was hitting highway. I investigated the complaint and no evidence of runoff or discharge
found. Mr. David Phillips (owner) and Dan Lehr (OIC) both met with me on:site. Farm is an ABSOLUTE MODEL FARM!
)rd keeping is SUPERB! Mr. Phillips has very healthy cedar trees that buffer the highway at end of sprayfield.
did advise Mr. Phillips to be careful spraying on mild windy days.
i
Re vtew erllns actor Name
:...........
Reviewer/Inspector Signature: Date:

�• - •� Division of Soil and Water:Conservation . "Operation Review F Y
El Division of Soil and Water Consetw`ation=,Comp�ance LZspecttoief 1
Div11sion of Water Quality ',Compliance Inspection
Other Agency. Operation Review,
Routine O Complaint Q Follow-up of DWQ inspection Q Follow -tip of DSWC review Q Other
Facility Number Date of Inspection
Time of Inspection E=24 hr. (hh:mm)
(Permitted [3Certified Q CConditionallCertified Q Registered Not O erati]nal Date Last Operated:
&)ttrS­-
1-�?..................................... County:..... .... ... ..Farm Name:11...... ........[�-Nv'. •- -• -•
Owner Name:. ................................................... Phone No:
FacilityContact:.............................................................................. Title:................................................................ Phone No:...................................................
MailingAddress:.......... ...................................................... .I.....'..................
Onsite Representative:` ... �C;a.........� .............................. Integrator.... .a^...
CertifiedOperator:................................................................................................................ Operator Certification Number:..........................................
.0 atiox of F m:
4d5
............................................................................................... .............................................................---.............................
119
..................................................... ......................................... .....................................................................................................................................
Latitude �' �� � Longitude
_ Design Current " Design Current _ `- Design Current
- -
Swine Capacity Population ; - Poultry Capacity._ Popaalatiori Cattle Capacity Population
can to Feeder
(}
eeder to Finish
q0o
Farrow to Wean
(yp
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
- Number of Lagoons 10 Subsurface Drains Present ❑ Lagoon Area JE1 Spray Field Area
S m'
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 'ANo
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 JXNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): .........��....................................................................... .......... I................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes 1 No
Continued on back
3123/99

Facility Numbers — Date of Inspection
�- 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenarice/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
I I - Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(le/ 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?
"'"�y� vielatioris ;or ref eiencies mere noted dpring this;visit: • Y;oit will -receive iio furttf ...
correspondence ahvuti this -visit: ::......:::::::: ::::::::: :..:.. .
❑ Yes [�(No
❑ Yes XNo
❑ Yes No
❑ Yes 9No
❑ Yes �(No
❑ Yes a No
❑ Yes XNo
❑ Yes P�No
❑ Yes r'O No
❑ Yes No
❑ Yes KNo
❑ Yes K No
❑ Yes A No
❑ Yes KNo
❑ Yes 4No
❑ Yes VNo
❑ Yes kNo
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
Comments_ (refer=to question #)E .ptain any YES answers andlor auy recommend at tons arany outer comments., ,
Use drawings of facility to better eipwn"situations (ttse additional j5ages as -necessary)
A.
11 IN
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
3/23/99

Facility Number: 7 — Date of Inspection
Odor I'- Sties
2.6. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below KYes ❑'No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes gNo
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 aniettals feed storage bins fail to have appropriate cover? ❑ Yes WNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ayes ❑ No
3/23/99

Facility Number Date of Inspection �� q
Time of Inspection O.' 24 hr. (hh:mm)
© Registered 10 Certified [3 Applied for Permit 0 Permitted [3 Not Operational Date Last Operated:
Farm Name: ... %w`
c ... ................................. County: ...... Drat.p\....................................... .......................
S �
Owner name:...... �1.}........��x....................�1a��;.................-----.-•------.---.............. Phone No:..�� lf��Z A `� ��
Facility Contact: .......:kqi ....ALV-.x Title: .....}kq"O, ..er......................... Phone No:
MailingAddress:..... to .... aa%..... 3 . ..............................................................................�ctaanSVS.�.�..�.1.1L....................................... 23.3% ...........
Onsite Representative:...........
Certified Operator;
Location of Farm:
Integrator: ........ L"1.1L+........................................................
...... Operator Certification Number, .........................................
xr�xrr�...ts...va..... e z .e...,a 41. .r!mt ..... 4x................ 5.&A?M..................................................-----....
........ .... .. ........... ........................ ..............
Latitude Longitude �• ��
General
1. Are there any buffers that need maintenancelimprovement? ❑ Yes [h No
2. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑Yes 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? N
ti •
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes RI No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes EP No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes] No
maintenancelimprovement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes 1� No
7/25/97 Continued on back

Fsicility Number: '31 —
S. Are there lagoons or storage ponds on site which need to be properly closed'? ❑ Yes M No
Structures rLa2oonsjlolding Ponds Flush Pits CU.
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes Q] No
Structure I Structure ? Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(ft): 3-4................. .................................... ................................... .................................... .................................... ....................................
10. Is Seepage observed from any of the structures? ❑ Yes M 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 maintenance/improvement`?
] Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
d
an immediate public health or environmental threat, notify DWQ) '
r
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
[ No
Waste Annlic:ation
14.
Is there physical evidence of over application'?
❑ Yes
® No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type .........1bttr_rhV A C......I......... 11..In............................................................................
.I.-.........
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AW VIP)?
❑ Yes
No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
j$j No
IS.
Does the receiving crop need improvement?
❑ Yes
No
19.
Is there a lack of available waste application equipment?
❑ Yes
® No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
s
❑ Yes
] No
22.
Does record keeping need improvement?.
Yes
❑ No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
[B No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Permit'?
❑ Yes
No
0 No.violations or deficiencies were noted during this visit. .You4ill receive no further
. coires'pondence. ii oiet this:visit
Comments (refeir:to, question'#)::Explain any YES answers and/or`any recommendations or any other commenis�4
Use drawings of facility to better explain situations (use additional pages as.necessary)
iz _ spa k o>~ t a5oo►� t tc, sha,( b� res ee feiv� sh�IJ be, rt t�.o�tJ �v>•- (der. d Es�ostr}
2,z, aVOctokior- Aa+tices St,00lt3 iaQ 0- l�s/aG• lJa a�sis 51wl) bQ
7/25/97
F
Reviewer/Inspector Name `
Reviewer/Inspector Signature:
%, _ Date:

e
of Soil and N.j'att
of Soil and Watt
of,Witer Qualit'
ency:- Operatio
}p Routine p Complaint p -" Ij inspection p hollow -up of review p Other
Facility Number r
-I imi. =i1' 1iisTu•clion 24 hr. (hh:mm)
p Registered ■ Certified p Applied for Permit E Permitted 113 Noit Operational Date Last Operated:
Farm Name: DaYId..T_.Pltiliips.Sps�..F txA]t..Iat�......................................................... County: Duplin WiRO
Owner Name: DavitVP.au.l............. ........... — PhLillips....... ................................. I...
Facility Contact:...............................................................................Title:
Availing Address: P..O.Ro-02A....................
Phone No: 91fl-23-43Ofl.�k�._Q.10-2Qfrfl293--(H}...........
PhoneNo: .............................................
KeaansYille.NC.......................................•........... 2.8.49..----........
Onsite Representative: .......................................................................................................... Integrator:MLLrphy..Famiiy.Falrms......................................
Certified Operator:Dayld.S.•................................ Berr-iAg............................................ Operator Certification Num ber: 1.72.17 ............................
Location of Farm:
Latitude ©• ® © Lnngitudc ®. �®
r. esign [.ui•rcn Desigh Currentesign urren
..Swine Capacity Population Poultry-: Capacity Population Cattle - Capactty Population
® can to ee er
1)
® Feeder to FirnsF
®---0VU—
P arrow to Wean
p Farrow to Feeder
p Farrow to Finis
p Gilts
p Boars
i:] Layer
p on- ayer
a 0'
�-
Other
Total Design^- " 'Capacit. __y_" ,'
-'- .: E:
Total-SSLW - 1,604,
Number of Lagoons / Holding Ponds ® u sur ace rains resent ® goon rea p pray ie rea
p No Liquid Waste Management ystem
a
General
1. Are there any buffers that need maintenance/improvement? p Yes p No
2. Is any discharge observed from any part of the operation? p Yes p No
Dischar-e originaied -ii: Lagoon p Spray Field ❑ Other
a, if dischai-Le i� nh�� r; cct. \+as the conveyance man-made" p Yes pNo
b. If discharuc is cdl did ii reach Surface Water? (If yes. notify DWQ) p Yes p No
c. If diseharuc is OhScrv,'; n-hal is the estimated flow in c=al/min?
d. Does discharge il\ p,.e�, ,i lagoon system? (If ves_ notif", MAID) [3 Yes p No
3. Is there evidence of past discharge from any part of the operation? p Yes p No
4. Were there any adverse impacts to the waters of the State other than from a discharge? p Yes p No
5. Does any part of the waste managenient system (other than lagoons/holding ponds) require p Yes p No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? p Yes p No
7. Did the facility fail to have a certified operator in responsible charge? 13 Yes p No
7/25/97

aft tty 1tutt er: 31-87
8. Are there lagoons or storage ponds on site which need to be properly closed?
Struelures (Lagoons.Holding I'omk-
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I ::rri11,hWe -, Structure
Identifier:
Freeboard (ft):
10. Is seepage observed from any of the structures?
Structure 4
1 1. Is erosion, or any other threats to the irate<grity 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)
p Yes p No
Yes p No
Structure 5 Structure 6
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?
22. Does record keeping need improvement?
For Certified or Permitted Ftw lifie.
23. Does the facility fail to have a coPe 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?
Q .. o vltr ttons.or a arrenrtes:trei-e.note uring. this -vdsit:. ou wi .receive na' further.
Yes p No
p Yes p No
p Yes p No
p Yes p No
Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes 13 No
[)Yes p No
p Yes p No
p Yes p No
oee retergstton.rt�Ar xptam pray a nersor anyrmmenaanousior anotnercommenrsWiF
llse:drawtngs o%facili ` to better ea lam cttitattons:! usciaddtttonal a es as neeessaty): k •. w
Visit was made to assess if facility is a likely candidate for State groundwater study. Observations of spray field borders were made
from public roads.
Some ponded water was observed in spray field #2 near road. A drain the was also seen emptying water into the state road ditch
from this field. Spray field #3 looks dry.
One manufactured home is located at southeast corner of spray field 42. A possible well locatioti was identified on this site.
7/25/97
T
Reviewer/Inspector Name Attdirew G.:HeImin' e___
Reviewer/Inspector Signature: I
Date:

vank" sit} 1, 1'
Wan...
Ir,

10 Routine O Complaint Q Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Date of Inspection o
Facility Number
Time of Inspection ; }$ 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: ❑ Registered ❑ Applied for Permit (ex:1.25 for I hr 15 min)) Spent on Review
® Certified ❑ Permitted or Inspection includes travel andprocessing)
❑ Not Operational Date Last Operated:...... .... .......... ........ »_.... »............. ........ .......... ........ _..... .......... ........ ....... .»...... ......... ..........
Farm Name:. �?ta. T ._..£ , �..�. ypV� .. .A .v +St_ l.s ... Caunty:..V.'..L .... ......... ......... __....
Land Owner Name: .._....... Phone No: _.-1144...zg.b ..� .0 7 `i .3
Facility Conctaet:...,. Title: .. ...... Phone No:
iE--.
Mailing Address: » . ! �.... ?.� ! .� ....... , .�...
Onsite Representative: .. Integrator: .M� r
_........ _................_.
f I
Certified Operator:....%�.��......»�... .... _... Operator Certification Number: _....�......_.... ..
Location of Farm:
;1.. Jut g.6,.j__.5 t .. W. r. a .Q x 0 ]4�.i !^ u� ..._ ... . = ....s!.^.i» e S.._ 1l!...I-T.: ...» .. 4
Latitude I Longitude•
Type of Operation and Design Capacity
a
Swi �€ Design Current DesignCurrent Design Cunt
. _. Ca ace Po elation Poultry Y ft'a acitrr Po elation r, Cattle = Ca aci Po uliiteon
®Wean to Feeder ❑ La er ❑ Dairy
® Feeder to Finish ❑Non -La er ❑ Non -Dairy
Farrow to Wean �� z _'��
Farrow to FeederTatai Design�Capaciy 5 0
Farrow to Finish:#
-....-�,....--.,,......--:.:_u . ...... _ . ._.. .. ..... Z € ��
i
❑ Other t ,� Number of Lagoans�/ Halding Panels � ($Subsurface Drams Present
v
.e. �.u.�� v r:. `�. �•x � ,'�.� r 4�.0 `��_ � Lagoon Are Lag . � a �, ❑Spray Field Area
Genera
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
. Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/97 maintenance/improvement?
❑ Yes ® No
❑ Yes J9 No
❑ Yes ® No
❑ Yes R) No
❑ Yes
19 No
❑ Yes
9[ No
❑ Yes
® No
❑ Yes
9No
Continued on back

Facility Number:..��.,,,,—._.._.. .
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes PTNo
7. Did the facility fail to have a certified operator in responsible charge?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures a,avoons and/Qr Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure I Structure 2 Structure 3
�.:. Z.... .. ....... .._...._..........
10. Is seepage observed from any of the structures?
Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes 0 No
❑ Yes IgNo
❑ Yes Iff No
Structure 5 Structure 6
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-I2 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop types x r ri pr...._ ..I ► .....
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 O
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes 0 No
❑ Yes ® No
® Yes ❑ No
❑ Yes EK No
❑ Yes RNo
❑ Yes 59 No
❑ Yes ®.No
❑ Yes ® No
❑ Yes 1.�A No
❑ Yes ®. No
❑ Yes 10 No
❑ Yes ® No
❑ Yes No
❑ Yes No
Comiiients (refer tq giieshon Explain any YES answers`and/or;any recommendations'or anyy othercorrunents
Use'drawings of facility Eo better explainsituations •(use additional pages as necessary)Z.
/ •,'3'',; _ 'ism �eS' .ri rk K `7 -
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0 1n e.vwv`IJ$ �' o C.- i i l o o o V f o .� l o 0 vs
Jul
Reviewer/Inspector Name r w, : 3 yv `.F <i , ,.s.,` r �7
Reviewer/Inspector Signature: Date: t p
cc. Division of Water Oualitv. Water Oualitv Section. Facility Assessment Unit 4/30/97

Site Requires Immediate Attention:
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: _- -7--Z 1995
Time: J ¢gyp
Farm Name/Owner: t 2AA
Mailing Address: H7 60X 1759 1205e i ( Z 7¢ 5
County: '
Integrator: Phone: Z-eq — 2 11
On Site Representative: S H �7� !'r! Phone: 793— 4 300
Physical Address/Location: 1 ¢ 31 kc( Q -24-50(&) Z 9 39 9
5R , l 30V & 50e- 130 Iems, m; - on lep+
Type of Operation: Swine ✓ Poultry Cattle Sow 5 �2rm
Design Capacity: 'M00 !EQ0-)5 / Number of Animals on Site:
DEM Certification Number: ACE ✓ DEM Certification Number: ACNEW
Latitude: -55 " 01 ' f 1 5& Longitude: rl'JS ' 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) es r No . Actual Freeboard: 3 Ft. 6 Inches
Was any seepage observed from the agoon(s)? Yes o No Was any erosion observed? Yes o No
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes r No
Crop(s) being utilized: (3y-Mode
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Yes or No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o No
Is animal waste land applied or spray irrigated within 25-Feet of a USGS Map Blue Line? Yes 00
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? .Yes o>o If Yes, Please Explain.
Does the facility maintain adequate -waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes r No COGG �r— 'V --a
Additional Comments: 7151 orb SCC r7 b,,7
Roqu
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.