310092_INSPECTIONS_20171231

NOHTH CAHULINA
Department of Environmental Quai

40 Division:'of'Weter: Resources * ='=
Facility Number, - .. u.
Division �of-Sort and Water Conservahon -
O Other Agency
Type of Visit: ® Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Keason for Visit: 0 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: 11 Arrival Ti e: D Z %tr7 Departure Time: 2 ; Q yy County: �!t G l Region:-*1
Farm Name: 't /04"1 Ali'7;:Ivj fiq4m Owner Email:
Owner Name: & _hknA/j (::9,27 Phone:
Mailing Address:
Physical Address: [II A
Facility Contact: 10L q- -5 4"'L Title: Phone:
iv
Onsite Representative:
Certified Operator: o(-6�0"x D I i L7"X'j
Back-up Operator:
Location of Farm:
Design ° Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish o
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Integrator: &±2� 9-e
Certification Number: ��-7 3-
Certification Number:
Latitude:
Design Current
Wet Poultry - Capacity Pop.' .
Layer
Non -La er
0
Design oCurrent
Non-L;
Pallets
Other
Poults
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
Longitude:
Design -Current
Cattle.: Capacity., Pop.-,
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes allo ❑ NA ❑ NE
❑ Yes []No �PNA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
[PNA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No
NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
ONo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
Wo
❑ NA
[3NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

acili Number: - Ds ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
No
NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Cf
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
fpNo
❑ 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
�yNo
❑ 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
In 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
PNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
-
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes PNo ❑ 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 rift Application Outside of Approved Area
12. Crop Type(s):G�S_W 1PIC/4
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?
❑ Yes
P No
❑ NA
❑ Yes
[P No
❑ NA
[:]Yes
R] No
❑ NA
❑ Yes
❑ Yes
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes
the appropriate box.
❑ NE
❑ NE
❑ NE
No ❑ NA ❑ NE
No ❑ NA ❑ NE
❑ WUP ❑Checklists ❑ Design []Maps ❑ Lease Agreements ❑Other.
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tra sfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and i" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412015 Continued

f
Facility umber: ( Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
QQNo
❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
rNo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes 0 No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes ®No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes [j 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 R9 No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes [�No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or anylother comments.
Use drawings of facility to better explain situations (use additional.pages as necessary). ;
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 3
Date:
4 015

U'Division of Water Resources /
Facility Number - I� 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: Compli a Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: ( Arrival Time: v Departure Time: f County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
D � � Ir2 �.✓ C
Title:
Latitude:
Phone:
Integrator:
Certification Number: ! r-0sS
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -Layer
Discharges and Stream Impacts
Lary rounry
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Nan-Dai
Beef Stocker
Beef Feeder
Beef Brood Cow
1. is any discharge observed from any part of the operation?
❑ Yes
�' F] NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[]Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
�o
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facility Number: - Date of Inspection: [( Z
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
©-No ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 7
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
Q-?To— ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
❑' o `❑ NA
❑ NE
waste management or closure plan?
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
❑ 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
Uqqlo�❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[:]Yes
No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 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
E3 No ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ YesKNA
❑
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
F rNo ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
E!f"N(o ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ YesFl"No
❑ NA
❑ NE
Required Records & Documents
19. Did facility fail have Certificate Coverage & Permit
Yes
N NA
NE
the to the of readily available?
❑
Ef ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
No ❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists [:]Design [:]Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 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 l" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [j No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes FfNo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

FacilDate of Inspection:
S
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[?-N<o ❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
E3 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 ❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No C]-l'qA—
❑ 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
E� No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[r�o
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ErN o
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
El No
[] NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessarv).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ? r D 7 9(? ,�o V
Date: f l L /
21412015

Division of Water Resources
Facility Number - ® 0 Division of Soil and Water Conservation V
0 Other Agency
Type of Visit: ACompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time:1 Departure Time: County: Region:
Farm Name: —
j A;2.- i A P- M Owner Email:
Owner Name: V Ur j Lj �� Phone:
Mailing Address: 1 [J �'� /y NL //`963 )C�C—/Vfj/VSy;LC , /% [_ COR 3Cl I �I'Q
Physical Address: �l
Facility Contact: 0 L_ ITitle: Phone:
Onsite Representative: V. (C . i�Lt F�,� Integrator:
Certified Operator: y ph/ Certification Number: ) IR Tao
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish y 1D
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Wet Poultry Capacity Pop.
Layer
Non -La er
N
Other
Poults
Design Current
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify 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?
Design Current.
Cattle Capacity Pop.
Dai Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 1� No ❑ NA ❑ NE
❑ Yes 'MNo ❑ NA ❑ NE
❑ Yes Yam' No ❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
Lpj No
❑ NA
❑ NE
❑ Yes
Xo
❑ NA
❑ NE
Page I of 3 2/4/2014 Continued

Facili Number: 1 - Date of Inspection: J J t
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ]` g No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes ;A
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
TT••No
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes W No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 0 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): r j17 Sr/1 L74".-)J N
13. Soil Type(s): LUQAA
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes N No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes K 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?
Lfq
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes No ❑ NA ❑ NE
❑ Yes `� No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? Yes [A No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check Yes 0 No ❑ NA ❑ NE
the appropriate box.
PWUP ❑Checklists 50 Design U Maps ❑ Lease Agreements ❑Other.
21. Does record keeping need improvement? If yes, check the appropriate box below. Mi Yes No
[] Waste Application Krl Weekly Freeboard 0 Waste Analysis ❑ Soil Analysis [:]Waste Transfers
C@ Rainfall ❑ Stocking ❑ Crop Yield (4 120 Minute Inspections [1 Monthly and I" Rainfall Inspections
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?
❑ NA ❑ NE
❑ Weather Code
bfl Sludge Survey
❑ Yes JA No ❑ NA ❑ NE
❑ Yes tX No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

,. .
Facili Number: - Date of inspection-
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
. 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?
❑ Yes
( No
�®
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes No
❑ NA
❑ NE
❑ Yes j No
❑ NA
❑ NE
❑ Yes No
❑ NA
❑ NE
❑ Yes No
❑ NA
❑ NE
❑ Yes MI No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facilitv to better explain situations (use additional oap-es as necessary).
6t)LA Ll
)b
-3151iu
`I-4
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ����} �9� -T j Sk_)
Date: Li
21412014

Division of Water Quality
Facility Number - ® 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 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 0 Denied Access
Date of Visit:Arrival Time: Departure Time: County:
Farm Name: 0__Vw� Finn Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title: Phone:
Onsite Representative: Integrator:
Certified Operator: ��'�(" Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -Layer
Pullets
Other
Poults
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Longitude:
Region:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Da'y Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes �No ❑ NA ❑ NE
[]Yes
❑ No
❑ NA
❑ NE
❑ Yes
[]No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE_
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes �TNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ZfNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility Number: - of Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ;�r"No D 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: 0 —
Spillway?:
Designed Freeboard (in):
Observed Freeboard
(in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ;a No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes X No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes o
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes,,o No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ZI No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes XfNo ❑ 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 �o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes P!rNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes JZNo ❑ 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 I " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ONO
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
�' ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili wNumber: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ONo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes,6No ❑ 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 ;2-No ❑ NA 0 NE
2T Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes OKNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes No ❑ NA ❑ NE
[] Yes No ❑ NA ❑ NE
❑ Yes �No
[:]Yes YfNo
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes VrNo
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? [:]Yes ONo
34. Does the facility require a follow-up visit by the same agency? ❑ Yes V&0
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
0 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 pates as necessary).
Reviewer/Inspector Name:UI+S#�r+ V p`�� Phone:
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412011

ivision of Water Quality
Facility Mumber © - ® Division of Soil and Water Conservation
O Other Agency �^
type of Visit: Compliance Inspection Operation Review Q Structure Evaluation p Technical Assistance
Reason for Visit: Routine O Complaint Q Follow-up Q Referral O Emergency O Other p Denied Access
Date of Visit: Arrival Time: © Departure Time: County Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title: Phone:
Onsite Representative: 3nme& Integrator:
Certified Operator: 0 Q cv /��U 2,2 PIN Aq— Ceri'Fication Number: ILI�
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
Other
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current
Dry Pouitry Capacity POD.
La ers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Da' Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
-J
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
[:]Yes
�'No
❑ NA
❑ NE
Discharge originated at: [3Structure [3Application 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
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
XNo
❑ NA
❑ NE
of the State other than from a discharge?�
Page 1 of 3 21412011 Continued

Eacili Number: -cl, jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1
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.) kNo
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require [] Yes �No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? 0
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes kNo ❑ 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): 5 C. ' &jz•cT—�
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.
Q WUP ❑ Checklists [•] Design Q Maps [:]Lease Agreements
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes eNo
[]Yes jNo
❑ Yes No
❑ Yes 4
No
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
0 Waste Application Q Weekly Freeboard Q Waste Analysis Q Soil Analysis ❑ Waste Tr ns ers
Q Rainfall ❑ Stocking ❑/op Yield Q 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? [] Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Weather Code
0 Sludge Survey
❑NA ONE
❑ NA ❑ NE
Page 2 of 3
21412011 Continued

Facility Number: - Date of Inspection: /
4 ­
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA [3NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check El No ❑ NA ❑ NE
the appropriate box(cs) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes No �(NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
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) TT
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes j No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other: 7[
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? [:]'Yes XNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes TO No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes D.-No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
U �Cj
511620
gp-+/m
jighl
Reviewer/Inspector Name: Phone:
Reviewer/Inspector Signature: _ Date:
Page 3 of 3 21412011

Division of Water Quality
Facility Number , F 3_J__] - ® 9NDivision of Soil and Water Conservation
Q Other Agency
Type of Visit: V Compliance Inspection 0 Operation Review p Structure Evaluation Q Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time:® Departure Time: County: LI/V
Farm Name: � p2M Owner Email:
Owner Name: j�Cr) ��� Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: "(�-IO/V I<- , L i -Z Z_ pQ D —] Z. Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Phone:
(LION 1Z, &,:a?,gq Certification Number:
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er I ]EEJ
Non -La er
Ury roultry
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Region:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Ron -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes KNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Faci ' Number: - Date of Inspection: j
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes -No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA [] NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1460c N
Spillway?: n
Designed Freeboard (in):
Observed Freeboard (in): {-
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?�T�[(
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes I Xl 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): __5G Z e ( 2�
13. Soil Type(s): FpL`C '&7aw U 1 L G
14. Do the receiving crops differ from those designated in the AWMP?
❑ Yes i No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes No
❑ NA
❑ WE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[] Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes ANo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes No
❑ NA
❑ NE
the appropriate box.
[]WUP [3 Checklists Q Design 0 Maps [—]Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
Q Waste Application Q Weekly Freeboard [E Waste Analysis [] Soil Analysis ❑ W/te Transfers ❑ Weather Code
0 Rainfall ❑ Stocking ❑ Crop Yield 0120 Minute Inspections 0 Monthly and 1" Rainfall Inspections [] Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facilitv Number: 'Z I - G Date of Inspection: S ! 11
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 �kNo ❑ 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 XNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ;A No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
0
❑ 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
0
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
0 No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
C r7 L t91
A
1311
Reviewer/Inspector Name:
Reviewer/inspector Signature:
Page 3 of 3
Phone: 16CD30� +
Date:
2/4/2011

Division of Water Quality.
[Facility Number � � � 0 Division of Sod and Water Conservation'
V
O
Other Agency
Type of Visit
Compliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
Routine O Complaint
O Fallow up O Referral O Emergency
0 Other ❑ Denied Access
Date of Visit:J Arrival Time: Departure Time: County: C 1 Al Region:
Farm Name: /� 2 i .FARM Owner Email: r? a� 9
Owner Name: V �• �L l� 2�Phone: f q1d- a 7LO-
Mailing Address: qL) IVXC, 11 - !Q 0'_� K C/VAIVSUILCC- 1, NC 0,? S - I - ]-- d y
Physical Address:
Facility Contact: Title:
Onsite Representative:{�. V h • 13(_az a�
Certified Operator: 3;b cvj V_ • ELIZ?-
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = 4 = Longitude: = o 0 , = li
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -La er
LA Ij 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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current'
Cattle 'CapacityPopulation
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
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
N No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
12128104 Continued

Facility dumber: j — g Date of Inspection 11d
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LA 6w^l
Spillway?:
Designed Freeboard (in): 19.5
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes IX1.No El NA El NE
(ie/ large trees, severe erosion, seepage, etc.) ' C
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan? 9
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes` No ElNA ❑ 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 i No ❑ NA ❑ NE
maintenance or improvement?
Waste Aanlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload El Frozen Ground [I 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) Sla
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
A No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
X No
❑ NA
❑ NE
t7. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes$L
❑ 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):
A,
�
Reviewer/Inspector Name I N �} �i r Phone: `'W(0_D!1
v�j
Reviewer/Inspector Signature: ri. Date: -9 j 3p1)p
Page 2 of 3 12128104 Continued

`Facility Number: 1 — qog Date of Inspection f Id
Reuuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes XNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ko ❑ NA ❑ NE
the appropriate box. El WUP ❑ Checklists 0 Design 0 Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes )No ❑ NA El NE
0 Waste Application ❑ Weekly Freeboard 0 Waste Analysis 0 Soil Analysis ❑ 1vaste Transfers'' El#ual Certification
0 Rainfall ❑ Stocking ❑ Crop Yield 0 120 Minute Inspections El Monthly and /V Rain Inspections E]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
Wo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
o❑
NA
ElNE
26.
Did the facility fail to have an actively certified operator in charge?
ElYes§Zo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
A No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
$6No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[:]Yes
RNo
❑ 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
Fj 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
KNo
❑ 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
[I NA
El NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�4No
❑ NA
❑ NE
{A�}ddiitional Comments and/or Drawings:
VL F L _t qAA i )0A1 bkArr cad 1 � y
Ca
W- /4
5IIy116 3- 3
Page 3 of 3 12128104

Division of Water Quality
Facility Number � � 9 Division of Soil and Water Conservation
-- Other Agency
Type of Visit AA Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit xRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: P6� Arrival Time. Departure Time: o County: 1/ Region:
Farm Name: 1 4Z (V\ - Owner Email:
Owner Name: 0 • +c- •! 4 A]IC-1�� A Phone: n
Mailing Address: �Y"] /Y { "qV� K /il�%V V!�E N C,
Physical Address:
Facility Contact: P [� Title:
/Jy
Onsite Representative:y • T' •
Certified Operator: _yVAON �Z " E-1 ��Qn . R
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number: 1 g-436
Back-up Certification Number:
Location of Farm: Latitude: = 0 0 I 0 it Longitude: = ° = , = "
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
I'F �❑ Non -La er —. -- - - — -- '
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: 0
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 x No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page I of 3 12128104 Continued

acilit* Number: —
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: C'4GQ0A1
Spillway?: Q
Designed Freeboard (in): [. 5
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes X No ❑ NA ❑ NE
❑ Yes ANo ❑ 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 klNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ,[� No El NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) -
9. Does any part of the waste management system other than the waste structures require ❑ Yes kNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ 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 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) J L• 'l�Er�P�
__ _.
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
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
)kNo
❑ 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):
W. A- -
SAP&
Reviewer/Inspector Name F f - --— Phone:
Reviewer/Inspector Signature: Date:
Page 2 oj"3 1212RI04 Continued

Facility Number: -3 ! — Date of Inspection OWE
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box. ❑ WUp 0 Checklists ❑ Design 0 Maps El Other
21. Does record keeping need improvement? 1f yes, check the appropriate box below.
❑ Yes
XNo
❑ NA
ElNE
ElWaste Application ElWeekly Freeboard ❑ Waste Analysis 0 Soil Analysis ❑ Waste Transfers
❑ 44nual Certification
Q Rainfall ❑ Stocking ❑ rlop Yield El120 Minute Inspections 0 Monthly and 1 °
Rain Inspections 0
Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
0No
❑ 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
N No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
LXNo
❑ 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
ElNA
ElNE
If yes, contact a regional Air Quality representative immediately
II ``
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
V_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
M—No
❑ NA
❑ NE
Page 3 of 3 12128104

e -
-T 1' xv Division of Water Quality
Facility Number 3 �'E O Division of Soil and Water Conservation V
-- -- 0 Other Agency
Type of Visit 6 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit )ORoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: ® Departure Time: County:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: 2 Title:
Onsite Representative: (2).Z.
Certified Operator: dq-icw �L 1A�� •��
Back-up Operator:
Location of Farm:
Swine
Phone No:
Integrator:
Region:
Operator Certification Number: 1 25Y-SQ-�1
Back-up Certification Number:
Latitude: = n 0 S = Longitude: = ° = F = 1{
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
i
❑ Layer
❑ Non -La er — -- — - - - -
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars - - - --
- -
- - - -UI
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ TurkeyPoults
❑ 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 Cowl
Number of Structures: 0
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 R No '❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ]]No El NA El NE
❑ Yes `WNo ❑ NA ❑ NE
12128104 Continued

F4cility-Number: �' Q
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:-LALOL)LI
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes 0No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes Dg�No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
(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
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes No
❑ Yes No
El NA El NE
[I NA El NE
❑ Yes KNo ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes KNo ❑ 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
.l No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
Z No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
J.No
❑ NA
❑ NE
Comments (refer to question #f): 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):
C_Q©S1Ck0N1 CAN J>1)CG 1j3E_fwEEAJ L4COON$ f
p45 Gar, eN rqj�jxC) ?o cE i C tAS4 To C Gtstw . �Jl � +�� R� �► 1K � , BEST
Siti C F I< 5? 1 vN ! Z�Z.l AIC SA-tuT> W� 5�C 5?R' C PLA-7 5'0 $A E PaL� bo W)v .
I-,.- c-o m F A-c i F ARM �(Z
-4=0- y!G .-rG 33
Reviewer/lnspector Name -r� Phone: p+
Reviewer/Inspector Signature: Date: o�` 36
Page 2 of 3 12128104 Continued

r.
Facility Number: 3 ! —70(
Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No []NA ❑ NE
the appropriate box.
❑ W[TP El Checklists El Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes fat ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
XNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Di�No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
JWNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
D&{No
❑ NA
El NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
El Yes
0: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
CgNo
El 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
A 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
IkNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/]nspector fail to discuss review/inspection with an on -site representative?
❑ Yes
XNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
XNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Facility Number z
Division of Water Quality
O Division of Soil and Water Conservation
O Other Agency
Type of Visit gCompliance 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:q4t�-Arrival Time: ; c� Departure Time: ; County: P« Region: ///P;1Q
57
Farm Name: Q i Owner Email:
Owner Name: �/Z � Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
hone No:
Onsite Representative: _
/� /j
i �� ,
&Z Z2 � �,�n
Integrator: AXL
—
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Operator Certification Number:
Back-up Certification Number:
Latitude: = 0 = �" Longitude: = ° = , "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
1 [:]Layer
1� ❑ Non -La er
Other
❑ Other - - - - - - - - -J
Dry Poultry
❑ La ers
❑ 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
❑ Dair Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes /No ❑ NA Cl NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes X No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
12128104 Continued

Facility Number:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 130 � 38
❑ Yes No
❑ Yes ❑ No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes A No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not property addressed and/or managed
❑ Yes
❑ NA
❑ NE
through a waste management or closure plan?
/'INo
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?
❑ YesxNo
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
No
❑ Yes X
ElNA
ElNE
(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
ElNA
❑ NE
maintenance or improvement?
/
Waste Application
10.
Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
[-INA ❑ 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)/Y1MOti
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?
No
❑ Yes7r—xNo
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',[]
Yeill
❑ NA ❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yeo
❑ NA ❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yeo
❑ NA ❑ NE
me
n'
ts,(refer to question #): Explain. any YES answers and/or any recommendations or any�other, comments��
� Y �
Use drawings of facility to better explain situations. (use additions! pages as.necessarv) .
A'bW5- 10 ,J
15') � 4 P �c��f� �✓ !� o �/ /�,Z ,�. - �i✓ mac_ s
Reviewer/Inspector Name I �� j Phone: (,?/o) 79i�, — 7.�7Z
Reviewer/Inspector Signature: Date: 5 !S cJ
12128104 Continued /
I

1 �
Facility Number: — Date of Inspection / d
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ YesNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ YesNo ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No El NA El NE
1p�
El Waste Application ❑ Weekly Freeboard El Waste Analysis El 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?
No
❑ Yes gzo
ElNA
ElNE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
ElYes No
El
ElNE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ No
Urlor,
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
Yes ZZ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes ❑1 No
[INA
ElNE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
ElYes 1No
❑ NA
El NE
Other Issues
/[J
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes d No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
I
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
El Yes �LJ No
El NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
/
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes VNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
No
2 19m;
/Vo C'op-1
A'
!vim o �� yo ��2 �l _
n'1 Z0Z9tZ___0
12128104

W7 15:56 0 R BLIZZARD 910 2% IB69
O
�°Ter
z Zar �7 J cam'
%ti'rrm
\'.(. {f urev f �rllreriA r,l .�r,lem f11r��rrrl,rr.
(lion K. Bli72Sr'd. Jr.
rr r .Yh r .rl P. J i �e►dar urf�ear prrn7 W.ek� •f. 1r1u�.:. h.ym.. W. � �:

05—i5—POA 15:54 0 R BLIZZARD 910 296 1869 PAGE1
f s
5- tg'-eo 7
N. (: Witter Pollirri��{_c -(Jt Solent OperuforN
C �c It iT r�,(�Yl��rr7i �:ci r,Ii
Orioo R. Blizzard, Jr.
I +Si, f�L,Ir 11 I�;.y tr;L Lt=
1, u aua7r r r.rt vl I jm,,W,,, w,dvp rvnito", yr Irrtcw r, r "ter k e,r
MO. r ; �yffyy(.\[ufvf, � nr \ xrtlf ! lflxffNR
Maur F'. xral,�� �007
Chnuman

•l
ts-t5 1007 15:54 0 R BLIZZARD 910 2% 1869
s Prestage Farms, Inc.
Irrigation Equipment Field Calibration Form
Farm N ame: ^. 7 � r f F, c m � f - i -
Date of Field Calibration: C( -
Flow Meter Serial Number. r., .r bu 1.t1 iio.;
Equipment Number. ��
Measured ring size. NA _ inches
Ts ring size within 0.01" of original manufactured size?
" I Yes Or _No. If not, replace ring.
Pressure Gauge Readings At Pump: _r75 psi
At Traveler IA psi
At Sprinker/Gun: 3 psi
Expected Flow Rate (from manufactures chart): q<'r.•' GPM
Measured Flow Rate (from flow meter): _ GPM
.!"low rate variance greater than 10%
Yes No r
Expected Wetted Diameter (from the wettable acres determination): ft.
Measured Wetted Diameter:
Wetted diameter variance greater than 15% Wor measured flow variance greater than
10%: Yes No / If yes, then contact a technical specialist or irrigation dealer
for assistance.
Comments:
i
Calibrator: . R' . .'r�x rA
t.ignmrti
lnigakm Ugidpmrnt Fiaid C-4librnticm tram
Sri /0

gD)Iivision of Water Quality
Facility Number 3 % vision of Soil and Water Conservation
-- — - Q Other Agency
IType of Visit 0 Compliance Inspection Q Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral Q Emergency Q Other ❑ Denied Access
Date of Visit: + I Arrival Time: L7 ' y Departure Time: ��Q County:
Farm Name: Tr --r 1 Owner Email:
Owner Name: /'C. L.;�' 7 Z �Q.� c�� Phone: _
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: • /y �LJ:: ZZ" a -
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Region:
Latitude: = c 0 f = Longitude: ❑ ° ❑ 1
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La er
Other
❑ Other-
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
l
❑ Beef Feeder
❑ Beef Brood Co
I
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes /No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
PTNo
❑ NA
❑ NE
❑ Yes
19 No
❑ NA
❑ NE
12128104 Continued

Facility Number. — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3
Identifier:
Spillway?:
Designed Freeboard (in): ,
Observed Freeboard (in):
Structure 4
❑ Yes No
❑ Yes //////❑ No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ElNA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan? /
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes XNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes LQ 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 XNo El NA ❑ NE
maintenance or improvement?
Waste ApDlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes /eNo El NA ❑ NE
maintenance/improvement? ,�{
11. Is there evidence of incorrect application? If yes, check the appropriate box below. El1[J Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Wind o ❑ Evidence of Wind
ddJDrift El Application Outside of Area
12. Crop type(s) 6 L'� 5e,
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes "P No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ElYes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes �Zr No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ YesNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
�61_1_'s 6111�16'. _;;5'_
_Z
4Z, ZV,4
-29
Reviewer/Inspector Name Phone: f
Reviewer/Inspector Signature: f 7 Date: d
Page 2 of 3 12128104 Continued

Facility Number: Date of Inspection /
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WuP ❑ Checklists ❑ Design El Maps El Other
❑ Yes ;d,,(No El NA El NE
El Yes �/J No ❑ NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
/ICJ No
❑ NA
[INE
ElWaste Application ❑ Weekly Freeboard ElWaste Analysis ElSoil Analysis
❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
XNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes
XNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
P.No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
VNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
XJ No
❑ NA
El 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
,_,(
�[J No
El NA
[:3 NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
)XNo
❑ 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
XNo
❑ 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
PdNo
❑ 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
P(No
❑ NA
❑ NE
Additional Comments and/or Drawings:
`!
Page 3 of 3 12/2&04

f _ '.
Division of Water Quality
Facility Number �� 2 O Division of Soil and Water Conservation
O Other Agency
Type of Visit 0Compliance 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® !
,%,� Q Arrival TiTime: Departure Time: Q ounty:
Farm ]dame: �7 _ ��_ _ Owner Email:
Owner Name: d/ ze ��-.�Z z zk Phone:
Nailing Address:
Physical Address:
Facility Contact: Title: Q Phone No:
Onsite Representative: — �'._ � 16Z_Z 7_40W_ Integrator: lit��STAG+�
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Operator Certification Number:
Back-up Certification Number:
Region: 4"1 0
Latitude: = o = I ❑ Longitude: ❑ ° = i ❑
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
1' JE1 Non-Layet
Other
❑ Other__ -
Dry Poultry
❑ La ers
❑ 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
❑
Daia Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures: W;
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 ;6 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ElNA ElNE
El Yes Yes �I No ❑ NA ❑ NE
❑ Yes Z No ❑ NA ❑ NE
12128104 Continued

c y
Facility Number: — `�,
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: d!
Spillway?: At Ns
Designed Freeboard (in): /9
Observed Freeboard (in): y5Z r
G,00 �s „ rN 6C7�o
5. Are there any immediate threats o 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 )eNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes XNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes VNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) Uf /J'1 l/ oA �Ui(i4 Z! 1 _ <5, --
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? El Yes Pf 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 XNo ❑ NA ElNE
17. Does the facility lack adequate acreage for land application? ElYes Z No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes UNo ❑ NA ❑ NE
Camraettts {refer to question,#17: Explain any YES.answers andlor'any: reeoEnmendahonsmr„anyotiter comments:
raw] ecessarY) ;Usdwi �to beater ex lain situations. use additional a es as.n
Z5 i/46t- / 49IJtAz.�FO, ✓f_,eALL � fZEL
Loaffo Cae?'o AX / rar.'a `/cos, `2 /y,os 16, agrzG�,,1�
,gym W 0'4 S�r9�0, elceog'05 �,r 61F oE,P
Reviewer/Inspector Name I GW,C5 I Phone: N (o - 0691-
Reviewer/Inspector Signature: Date: /D 20 D
12128104 Continued

c' _ , i
Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes JZNo ❑ NA ❑ NE
the appropirate box.
❑ WUP El Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
Z No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
/No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
10;A
XNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
4No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
'0No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
VfNo
❑ 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
V(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
'A No
❑ NA
❑ NE
12128104

i Division of Water Quality
Division of Soil and Water Conservation
'D Oth6r. Agency
Type of Visit 0Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification ®.Other ❑ Denied Access
Facility Number Z, Date of Visit: 3 3 Time: g�
Not Operational 0 Below Threshold
M Permitted ® Certified rr0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: %Ci✓� ru✓m County:
Owner Name:
Mailing Address:
Facility Contact: Title:
Onsite Representative: /lW h P�
Certified Operator:
Location of Farm:
Phone No:
Phone No:
Integrator: kes i 4 �c
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 4 Du Longitude 0 °
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacitv Population Cattle Capacitv Population
❑ Wean to Feeder I 1 1 1[:] Layer I I ❑ Dairy
® Feeder to Finish I #Wi9 1 10 Nan -La er ILI Non-Dai
❑ Farrow to Wean _ _
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
I Number of Lagoons l I ILI Subsurface Drains Present JJLJ Lagoon Area ILJ Spray Field Area I,
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impact
acts
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 Coligction & 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 (inches):
05103101
0 Yes ❑ No
® Yes
❑ No
CS Yes
❑ No
,57e)0 41 fl
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes ❑ No
Structure 6
Continued

Facilitz- Number:
'3 r — t?Z Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maifitenancerimprovement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
❑ Yes ❑ No
RrYes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑Yes El No
® Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA ANP)?
❑ 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 or other Permit readily available?
❑Yes
❑ No
I & Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ VVUP, checklists, design, maps. etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ic! 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 notif.- regional DWQ of emergency situations as required by General Permit?
® Yes
❑ 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
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit+
Con3ments`{re%i• io gnesiaon #j. 'Eipisin a�iy YES snsweis and/or any,recommendattons or anv uther.,tomments:�_
Use drawings of facility to better explain situations. (use addihonel_pages iss ne-'i � F"❑ Field Copy Notes
•v �—Final
-�
ve, u/ z/9m 071-ed74A B PM j14 s '/,cl
�J/
ddn�
,�
1htr SC t v A C A0 /11 S�YF� a eeA Get e l1 /rs� 4/ /0Dn �! ,t"� /ry /v d ?11�1
lslt+ 5 evz e tiS,'vG/ )4 ". 7ie' yA 'jhAj OA >it e_ 411 %t[k,; 1
ReviewerAnspector Name .< � , j �
Reviewer/Inspector Signature: Date: % 3
05103101 l Continued

* . ft
Facility Number: 3/ — Date of Inspection / d
Odor issues
25. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
29. 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.c. broken fan belts, missing or
or broken fan blade(s). inoperable shutters. etc.)
1. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submersed fill pipe or a permanendtemporary cover?
❑ Yes ❑ No
❑ Yes ❑ No
EK Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Additional Comments and/or Drawings:
til'Cu 1�vaw see. IJooi h) by Ae
JJ � e �'trt►a ev����
GIVli Mtn �' e SB✓'v't�� �u.n �l SD r� C�%��� � �r, ��` �t�r� fa
e4 Ykp sysf� s�iv� a�u�h . 5ys zr-sr r��s 5� �D�•� 3:�3�.�,
w45 x file/ r � Ch i'c�L'1'� St,G of e(tl/ Wlt S �e G�j'a /`l2 rt!? �J /'�i AO 7 l �'
t+'e [ yI dru to 1'Pa �V AEG 4 /.c -A � P ,o e, -- sfiP�m �G��7 C' ve
7Tu e . A., S�'44" yew Mt f Ae- A4 57"kr1e,1 Ae- sy--e-, 4' art
tom �,' !� /�1� t- �u ��P�s w�.e u�,� �vl�r�. �� �O
/J✓Q ve,i r 0,1 07-E` �` �m en fP/.'n� LdQ�I /i d� A-1 ✓� A?.
40 �- no /f art Ot'l a � Ae, p-o 4Ief" by xV , z M
re
Ak" 5y0-eio 64s desrt5no� �y ,dean 1j)nP A . e;i -�e
e J'4 444
/7trtn15af-AGe, GU��P�S 1
_. %de- ?O ,%deel wF�e✓k✓vvn� 40- dral'A `tvt5 le,,,n,*P by %AI✓
5 �0 ldu S rO•rt Q�J i ��/ /r/a rCi� 5tif. e 5D , elr,
At b't nD
S�/10e s 7v kG 4v v 4 Iv6;olve 4,'-5 ?: Gl64ot.
�rr11�1/P5 7' 14o-b S 4oel e� -,x&1_e,4
05103101

Division of Water Quality 1 � .
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Fallow up 0 Emergency Notification Other ❑ Denied Access
Facility Number 1 Z Date of Visit:
Permitted [3 Certified [3 Conditionally Certified 0 Registered
Farm Name: �� r + _ Few wN
Owner Name: _ 0 D i .ZarA
Mailing Address:
Facility Contact:
Onsite Representative: 0 , ` 81 � 2 Z,4o-0(.
Certified Operator:
Location of Farm:
Title:
i Time O t s-
Not O erational OBelowThreshold
Date Last Operated or Above Threshold:
County:
Phone No:
r� Phone No:
Integrator:r v^eL4,,,
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �� �1 " Longitude �� �4 K
Design Current
Nwlne Capacity acity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Boars
Number of Lagoons
Holding Ponds I Solid Traps
Design Current Design Current
Poultry Capacitv Population Cattle Capacity Population
❑ Layer I I ❑ Dairy
❑ Non -Layer I 1 1, ❑ Non -Dairy I I d
❑ Other I ] I'
Total Design Capacity
Total SSLW
❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
❑ No Liquid Waste Management System '
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation? ❑ Yes ZNo
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) D Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection &"Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): 9 — 1 0
05103101 Continued

Facility Number: 31-41Z Date of Inspection I a
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes �No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes El No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste Aoulication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ hydraulic Overload ❑ Yes ❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ 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 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
❑ 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
01No
23,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
E�rNo
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
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #): Explain any YES -answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):. ❑Field Copy ❑Final Notes
Thar ;�S�eG4 i �� Was &ovie kv Me. `13 h'zza.rti -to l o r_g4e aeea5
sJ -}able -p 1'� C,,4', « OF cvct_4e - An o, pjo 1;cD4, o-i event t,jas
�`
CoV%tl vc4eA o,-1 { v i S i o>-, reG veS+ d V P ' v�or 4t-1C ins e c*, oL,7 , ei l 1'OtA T
*ke rt e (d W'."V wVvo.i"410 oi,ory,,c( i4 &,jo
de s'm;✓�t?c�l - Mgt-{ `>� a I, cc��gc��-. eve"we' T Vee, weI �nn
+C �. were ; des, 45r-
F0 rid ; / V'10f-F e . 0+1'e r areas led (c �•�t#)
Reviewer/Inspector Name s40 ew Gj t, r'S e S O
Reviewer/Inspector Signature: Date:
05103101 f Continued

Facility Number: -31-417 Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Additional Comments and/or Drawings:
i
iOki a��p�►tea-��a��S .The P1a� �s �o� 9�0-}�-►ems �i
4e 6-r-,uq614 in To 41ne eappltc_a4Fova,, &i
otpp I ; cr44 G«s 4a be- nta4e 4e 4'Ae , dev, 4 fP iecA AreC�5
Th s weNs deme a.F-le, Air. 311 zzctr,-t pho`Aec4 4�e
ogr-e'ico 4-h: f i e�n� rare, re fol'4;,ic -the /7o4ed 1n9ao+� level '0'
�eek;,29 gVa'1qeloce Arno" 41• e i- "LAC'1tge J,•-�9 44e level.
M�. T3r;zzcor0( 41,A-- tie bcl;evec(
6e wtcode; 4ke ;.•,-r fe64 o+� 7kg4 C��OpiiGrt-�.io�3 Gru�O�
be Maafe qnd 4l e flan 4kcj hots aly eae(7 �eez, r)afcd above
wehS me:tile. 1 ke i;^sFe'C' V+^ +,.gas D�a�e ;►-1 a Coorela4,ve
s- f ; e ►'4 'in oeel er' 4n
05103101

Type of Visit O'Compliance Inspection • Q Operation Review 0 Lagoon Evaluation f
Reason for Visit O Routine Q Complaint 0 Follow up 0 Emergency Notification .Other ❑ Denied Access Jj
I Date i� ►sit:
Facilit►�Number � i w � 2-
0 Permitted 0 Certified 0 Conditionally Certified 0 Registered
Farm Name: `Tc. ' #�
Owner ]Name: _ 0 1� �� 1 ; 2._? r a
Mailing Address.
Facility Contact: Title:
Onsite Representative: %•' i 7 _ c*.r.'
t si i' Time: I I :) sir
'Not O erational 0 Below Threshold
Date Last Operated or Above Threshold:
Counts:
Phone No:
Phone No:
Integrator:'
Certified Operator: Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude '� �ii Longitude ` -JI
Dischar2es & Stream Impacts
1. Is any discharge observed from any part of the operation'? ❑ Yes ZNo
Discharce originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the convevance man-made" ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. if discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
❑ Yes ❑ No
❑ Yes ❑ No
Z. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge'? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway �} Yes ❑ No
Structure I Structure , Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 19a 117
Freeboard (inches):
}-lC�
05103101 Continued

r
Facility Number: 3 — Z Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees. severe erosion.
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Aorilication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
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 or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie! WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie! irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22: Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, Freeboard problems. over application)
23. Did Reviewerllnspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes 1�1No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ No
❑ No
❑ No
❑ No
❑ No
❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
11
El Yes � No
❑ Yes 2rNo
❑ Yes ❑ No
❑ Yes ❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
-�;:�.�s�-s �t,,a,, _,x•,.a �.r� ��s�-�.r,•,..v� �,.- +�-�� �_a:-,�,:, r ��:x:� -r � ��•;�� , _ .fit
'Cantxneitts;(refer to gnestiort�#}'ExpLitn,an}� YES'answers aadlor any,��ecom�ttiendattons or,an other cosnments.K �
Lice drawtngsr�o�ffacrhty tobetter addttronai ' �❑
e�plarn sttuattons (use pages:as nec ary) . ❑Field Copy Ctnal Notes
ti3.��.�
-'`�r?��`�.�''�'�i�`-':�.��ir���°.`''�`ti .-.� �..r-rsr...-,. ?�
^.�l�c>;7.+ct�'�:�•�',;.."��ar:��€�'��
1 h,Y eV1S'�rto.� 1.►l'"-� e<��".� i,ji'��
S �' ; r+ 71 r �" C'4': �. Uv V4k? �'N L,'e 5
11r
rr�✓1Lt.L'tJ.�Ct` G�/
!.�
4
'4L'�
rYN- y0,C- 1'LCIA + I { E`V Cd'� /E"c - �'C:�'�-J I-\JE:�
/i'�f�Y
11J-ii!(cs-�'
V
�•�
Reviewerllnspector Name -�;��iniC� � t.I
Reviewer/]nspectorSignature: rs � T =': '� Date:
O5103101
Continued

r
Facility Number: f — Date of Inspection f r�
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27_ Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Y? 1 7 A t 1"f °•� 1 +Cif+^' F C' �; 1 ��. '�'• I .f �' f.-.r �Y1J'1.' �lr; •r ' K^��'
q 1 �
! C sr? , r (^;� Pr, Tr 41-v�- i o.'?3 Cti✓s, :� �-n:^ r ,' �z
r ,
nv ° l.ci 'c.-, C' �'� i^.�rtl�� +e- 4kc- ,lea.4 1i
h ; j' �1 S t'i•" ! C•.1 !1_ .S e4-� C. z n,jF Rf/1 J j } /•% 1 1) f�
4" �-� 1 � Y' 7 • I t t.� 11 ti. L.=t �,G ""L G i? n. �C: (.� �7 i-•:c:
ft �r � C' C -� i ; .. i iv'iC •l'': � Yli.; rF�d !'-f � /}e � F ^ 1
"_ '(ti !'1�L'f �" x-S� L`�}��f- �1 ��_:-F Jf_: •'^,1� 1. •t�L�`Gi
he l�fr,�;�C 1;1�.c'� �j�� �•���-�i•�ct-� %tr_5 �Ir��,n.�-,•� .�,�,/t,l� rl'7�!<t %a6�•.1�
05103101

4VDivision of Water Quality _-
0 Division of Soil and Water Conservation<,
.0 Other Agency h
Type of Visit OCompliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit O Routine {Complaint 0 Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Time: F/7 . b
13 Not O erational 6 Below Threshold
O Permitted 0 Certified 0 Conditionally Certified D Registered Date Last Operated or Above Threshold:
Farm Name: �-i; _ _ County:
Owner Name: _ 1). 12
_ _RL i 22f (Z LD Phone No:
Mailing Address:
Facility Contact: RR n Title: Phone No:
Onsite Representative: V 2 ��-! J_7 f-tan integrator:
Certified Operator: Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 4 " Longitude ' 1 a
Design Current
aw,pe t:a aciry ro uranon
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Number of Lagoons
Holding Ponds I Solid Traps
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
ElLayer ❑ Dairy
❑ Non -La er ❑ Non -Dal
❑ Other
Total Design Capacity
Total SSLW
1U Subsurface Drains Present FJI__I Lagoon Area JU Spray Field Area
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes [9'1vo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
05103101 Continued

Facility Number: 3— Date of Inspection t) cJ
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 anv of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
❑ Yes [tD-d-o
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA1VVMP)? ❑ 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
Renuired 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 ❑ 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 notiAl regional DWQ of emergency situations as required by General Permit?
(iel discharge. freeboard problems. over application) ❑ Yes [B%
,3. Did Reviewer,'inspector fail to discuss reyiew•iinspection with on -site representative? ❑ Yes [KNo
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
113 No rdolations or deficiencies were noted during this visit You will receive no further correspondence about this visit. "
Comments'{refer to gaesti6n): 'Ezplam any_YES answers snd/arateyrecotnmeadattous or am+: otter commentsUse
drawings of facility to better explain situations. (use addittonalpages as necessary) ❑Field Gapv El Final Notes , x
�AAe� 1°,...a 4'
Tqr IN.SpEcrlbk lJfis HE- fPt t2asks& 'rD 4 dDMP,_, tit=' al '1-f-{e- 7%atq
r= ptr_ M fvu- w I A-t�t Arc i CTk DES r�� M 1 ICic `D�uc, -T K�
_(AG`r TA-k'�'Njr�/�`�� ��c�-��Y r��c��c+�c �►�►sr,��
"O-tA4r lz '0r
T::7jj-�M 6ccYge72 --F) R A 6c2c q6 TK6 CQtve-4-i. AA6oD14 kt-Uak WF{iL&'
v Q c n 1 tc& 1Z tA a Q M4-:- r Fts
Reviewer/Inspector Name} !_ 'R5 , `3:%�=j
Reviewer/Inspector Signature: nJ Date:
05103101 continued

Facility Number: 31 — q Date of Inspection [�
or Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Additional Comments and/or, Drawings:-re
r-A N t,6u o LA-) enRT f4 UD i D Loe-r 11- R.oA-�S o kt
g lTiF-4K'D Rn"-TIN is
(,je�`�E (,t}�ei� Q3�Ve�� %d5 n.iCriB`o thL THE`��TuR["5. 1 d-
tD /q-t"�#���4 TD Cc�'Ew R7ts �2, t H-P��'Iz�D iH R-T
-Pay T:�I u C. f^S w e' i2.i- `p- -I M & i9-("Q, MS VKZ�-
W AT&-+Z w " A-5 tq-`O u L5 uZ , }-f er-t2L— co OS T4 O
0,(- �a7 D t� �5 rE[ cJ ffTa=`rQ - D ►� Ef!iC !�
(-0 �
05103101

d ..
Division of Water Quality
1p Division of Soil and WaterGonservation -
. �.
;, ..; • QaOther Agenc
Type of Visit ZO Compliance Inspection O Operation Review Q Lagoon Evaluation I
Reason for Visit (;� Routine O Complaint O Follow up O Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit:
Permitted 0 Certified © Conditionally Certified 0 Registered
Farm Name: ART _6 am
Owner Name: o_.R , bj,
Mailing Address:
Time:
Date Last Operated or Above Threshold: _
County: 0L��
Phone No:
Facility Contact: D Title: Phone No:
Onsite Representative: ZMQt Integrator-
Certified Operator:
Location of Farm:
Operator Certification Number:
[A Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �� 0` " Longitude 00 4
Design Current
nwme Uspacity Population
❑ Wean to Feeder
Feeder to Finish
Farrow to Wean i
i
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Design Current Design Current
Poultry Capacity Population Cattle capacity Population
❑ Layer I ❑ Dairy
❑ Non -Layer ❑ Non -Da'
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ILJ Subsurface Drains Present IILJ Lagoon Area ILJ Spray Field Area I
Holding Ponds / Solid 'Traps 10 No Liquid Waste Management S stem l l
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Was Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes /// �No
5tru ture I Structure 2 Structure 3 Structure 4 Structure 5 Structure fi
Idenkifier:
Freeboard (inches):
2_44-
05103101 Continued

r�
1.
Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes �] No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes /ONO
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 ❑ Hydraulic Overload ❑ Yes No
A—
12. Crop hype 3)i?" Rmdr) A d `DM N I I U1064
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 4 No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
ONO
b) Does the facility need a wettable acre determination?
❑ Yes
VrNo
c) This facility is pended for a wettable acre determination?
❑ Yes
V1 No
15.
Does the receiving crop need improvement?
❑ Yes
gNo
16.
Is there a lack of adequate waste application equipment?
❑ Yes
X No
Required Records & Documents
17, Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
ONO
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
❑ Yes
No
(ie/ WUP, checklists, design, maps, etc.)
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
VNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
VNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
[XNo
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
FrNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
PNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
0No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): ❑ Field Copy ❑ Final Notes
0�� : t�vF.�2 ci A>Qit7 MP , X 5 D
6,C �L /�J i✓`r o�
•8F� tllJfr �s�G 'j' � ��lZ �
��' ��'✓ ��rL�.s✓T,.���F
/Q�t�R ,os �i✓ 1�/Q�Fie
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date: O
05103101 Continued

if
Facility Number: IN — Date of inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge actor 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 XNO
❑ Yes VNo
❑ Yes [rNo
❑ Yes A No
❑ Yes 9No
❑ Yes 9No
❑ Yes ❑ No

iei j
Division of Water Quality
'0 Division of Soil and' Water Conservati©n "` ,_
°`O'Other'Agency
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit (D Routine O Complaint O Fallow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: 9/20/2002 Time: 10:00
Facility Number 31 92
0 Not Operational 0 Below Threshold
® Permitted ® Certified 13 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: .....................
Farm Name: art.l arm. County: I?P1iuR...............................................
\'E'T�tA..........
....................................................................
Owner Name. 0,&......................................... Daiszaxd..,ix............................ Phone No: 910-Z9.S-2S�............................. ................. ....
Mailing Address: 1164N.W.11A.993.................................... ..... KeaR10.�AIC.NC............................. ... 293.4.9 .............
................................. ...................
Facility Contact: .............................................................................. Title: ................................................................ Phone No:..................------...........................
Onsite Representative: O11`. liazar.d.Jr.
Integrator: l'rei gage.k Kms.................................
Certified Operator:.Orlo k................................ ftaud.& ..................................... Operator Certification Number: 1,$73Q .................... .........
Location of Farm:
:ast of Kenansville. East side of SR 1701 approx. I mile North of Hwy 24.
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 34 • 57 G 10 a Longitude 77 • 50 4 16 Gc
Design Current
Swine Canseity Ponulation
❑ Wean to Feeder
0 Feeder to Finish
4410
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer I JE] Non -Dairy
❑ Other
Total Design Capacity 4,410
Total SSLW 595,350
Number of Lagoons 1 1 I❑ Subsurface Drains Present jL1 Lagoon Area I❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes ®No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance roan -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/rnin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ®No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ..........1..and.2...........................................................................................................................................................................................
Freeboard (inches): 39
05103101 Continued

Facility Number: 31-92
Date of Inspection F9/20/20 22
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type' Coastal Bermuda (Graze) Small Grain Overseed
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ®No
❑ Yes ® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ W1JP, 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?
Ge/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): ❑ Field Copy ❑ Final Notes
17. Need to have newest Certificate of Coverage; I will send it if I have it in my files.
i
13. There is a large portion of pull 11 that is fescue. The waste plan calls for bermuda.
Please use caution spraying around surface drains.
Overall, the facility and crops are well maintained.
Please fill in holes in waterway that are holding water.
Reviewer/Inspector Name Stonewall Mathis
Reviewer/Inspector Signature: Date:
05103101 Continued

i
Type of Visit OCompliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit CYRoutine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility_ Number 3 I 2 Date of visit: Time: ' D t 00
Not Operational 0 Below Threshold
© Permitted © Certified D CCoronditionally Certified D Registered Date Last Operated or Above Threshold:
Farm Name: rl:k f ^_' County: -D uP I' -N ,.
Owner Name: 4 Z. -L_ru,-A Phone No:
Mailing Address:
Facility Contact: Title:
Onsite Representative: Q z LGt r�w
Certified Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ` a Longitude 0
Des gn:_ Current. m Design 'd -.:Current.-
.Sw�ine', Ca 8cih Po elation ._ vW 1 ouitn .' .. Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Giits
❑ Boars
`Destgn .- Current
the `Capacity' : Pennlatioz
apacity: ;,
it SSLV1�: -
Nannbee of i agoons '-';� ❑ Subsurface Drains Present ❑ La oon Area ❑ Spray Field Area r
Holding Ponds /Solid -Trans: - ❑ No Liquid Waste Management Svstem g
i char es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Laizoon ❑ 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 ves, 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 par[ 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: ! � -I--
Freeboard (inches):
05103101
3R
❑ Yes ONo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes Ao
❑ Yes ❑ No
❑ Yes .6No
Structure 6
Continued

Facility Number:
Date of Inspection E2O ,0
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes KNo
❑ Yes XNo
❑ Yes _ZNo
❑ Yes 'Fe"No
❑ Yes ONo
Waste Avolication
10. Are there any buffers that need maintenance/improvement? ❑ Yes XNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ETNo
12. Crop type 3e r— u d 'r, PG, 57 v ✓ f, 1-n a1 1 [ L� rG� '•
11 Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes El No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes EJ No
b) Does the facility need a wettable acre determination? ❑ Yes ZNo
c) This facility is pended for a wettable acre determination? ❑ Yes ;Mo
15. Does the receiving crop need improvement? ❑ Yes No
16. Is there a lack of adequate waste application equipment? ❑ Yes .dNo
Reguired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
,lYes ❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
❑ Yes
(ie/ WUP, checklists, design, maps, etc.)
)Zf'No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes (2No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes JZNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes ONO
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes 2rNo
(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 eNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes _JZNo
0 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
Cot i ents (re#er to questtnn #) E plain aby,YES answers"andfor any recommenclatioas'ar anv otter commefi ry
Use'drawmgs of fart7tty:ttibet#er esplatn situahorts ,(nse addttonal pages as necessary) v �Cvn F µ
� . Field v Final Notes
.
+-
1�%. Necei -�p Lt.o, /e kieweS Cc✓7�rF�'CGi�c �fC C Cove--,,Jqe; Wi j selid
,fs h. 'C1 v e i 4 1', �PI/%
T
�3 ! �ICre ;S A Io,, e fobT D� Aescve',
/011 pull 1S
w6Sae Plate, be,f--,L/ .
Pj eG.S¢ 145e Ga 04 ; oti Sr•^CtfAr ✓)G]� S V �/� G e
C,eorS Ave Well ✓ a����ia�e - Cc�n-1je
Reviewer/Inspector NameQ� ,1
Reviewer/Inspector Signature: Date: Z Z 7 Zo
05103101 Continued

Faciliry \umber: I — Z Date of Inspection Z4 Q
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation? 4
2T Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads. building structure.. and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e, broken fan belts. missing or
or broken fan blade(s), inoperable shutters. etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes 110 No
❑ Yes 12r'vo
❑ Yes _FdVo
❑ Yes ,2f No
❑ Yes ❑ No
❑ Yes ❑ No
Additional Comments, andlor.,Draivinigs:�':
please �;11 i�l GsaleS ►� wg-�4-�w�� had �,�.� hold,' , wcL4C .
O510310I

vrsion of Water. Quahty
—'e i4
Division of soil and WaterConservation
s L O:Other'Ageucy _
a
Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 'Piloutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
FFacility Number Date of Visit: 1.5ril Tiine: ® Printed on: 7/21/200()
... , ,..-- ... .. - - 10 Not Operational 0 Bellow Threshold
Permitted []Certified QL Conditionally Certified [:]Registered Date Last Operated or /Above Threshold: ...............
Farm Name: L..r� r�C.... e1..'.... Countv:..� VrD..!..!..'.2............... .......... ....... ......................
......................................................................... _ ...1
Owner Name..............Q �.! Z ZG( ✓t01 Phone No:.................................................................---...........------.
FacilityContact: ...... ................................... .............. ....................... .I'itle:................................................................ Phone No: .............................. ....................
MailingAddress:..................................................................................---......................................................................................................
.........-.......-............................................-.-........................
ve: ,dtJ8 i ZZit Integrator:...��eS.aCeOnsite Re resentati-`..................... ..............................................................
Certified Operator:....................................................................•--......................................... Operator Certification Number:..................
Location of Farm:
I I W
swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• ���«
Design Current Design Current Desigd Cti>irreat
-_;.
Ca ace
Po ulation
Pouttry Ca acr population Cattle Ca are Po ula on
= Wean to Feeder
10 Layer I Dairy
❑ Non -Layer ❑ Non -Dairy
Feeder to Finish
= Farrow to Wean
Farrow to Feeder
❑Other
Farrow to Finish
Total Design Capacity
Gilts
Boars
Total SSLW
r � IIImb !ii Lagoons ❑Subsurface Drains Present ❑ Lagnm Area ❑ Spray Field Area
=.
Hoig Poads /Solid Traps No Liquid Waste Management System ,
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon El Spray Field El 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
jttycre I Structure, 2 Structure ; Structure 4 Structure 5
Identilier:....... ............................. .................................... .................................... ....................................
Freeboard (inches): 360
S/00
❑ Yes Oi No
❑ Yes Jallo
❑ Yes 0140
h /a
❑ Yes P No
❑ Yes _EfNo
❑ Yes ,fNo
❑ Yes [E No
Structure 6
Continued on back

Faci14 Number: 3 f — z Date of Inspection IS-1111el Printed on: 7/21/2000
�5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes yj No
seepage. etc.) �`"
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes PINo
(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 J`No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes KNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ONo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes 2No
I L Is there evidence of over application? ❑ Excessive Pondingg❑ PAN ❑ Hydraulic Overload ❑ Yes 0No
12. Crop type -Re wry] V Ap Pei�y� 11_g cd l 6 r'a,vj
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes0No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes �i No
b) Does the facility need a wettable acre determination? ❑ Yes 101I0
c) This facility is pended for a wettable acre determination? ❑ Yes J2 No
15. Does the receiving crop need improvement? ❑ Yes _�?No
16. Is there a lack of adequate waste application equipment? ❑ Yes ,I;TNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes _ETNo
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 jj�No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes J2No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes fi No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes,,EfNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes 'Pilo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'! ❑ Yes _ o
24. Does facility require a follow-up visit by same agency? ❑ Yes /I0
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes,
No
io "yWaigns or dif d6ntkwere noted* durin4this:visit• Yoa' ii•rcevRo furthr0: . :
• Correspondence: about this visit. ::::::: :::: :::: :::: :::::::
lion #)- Explain any YES answers and/or any- recom
beetter.ciplain situations {use_ additional pages asxn
:.
Reviewer/Inspector Name 0 17 2 W a� �. _,. 4_ i1 rs ;_ s:r.
Reviewer/Inspector Signature: Date: S" /� �� 5100

Facility Number: �� — �, Date of Inspection IS7 111e91 I Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes eNo
28_ Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ YesJ�fNo
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 J'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 ,Er&o
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 01No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
5100

- a bivision of Soil aiid Water Conservation Operation Review -
i•,_ •
O-Division of Soil and Water Conservation- Compliance.InspectEon s
__.'.,Division of Water'Quality Compliance Inspection
13 Other A enc -Operation Review'
IQ Routine Q Comelaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number � � Date of Inspection
Time of Inspection —j- 24 hr. (hh:mm)
Permitted ❑ Certifie /© Conditionally Certified 0 Registered 13 Not O erational Date Last Operated:
FarmName: ............ ......................fia)ol............. ........---..---..... County:...... !ICL ..................... ....11...............
Owner Name:.........'..i............................l...f.�.Cc r�!L.......................... Phone No:..j..���.lT.�LL...-.ILT¢..........................
Facility Contact: 4.5t........... .........---•• Title: Cll'!l/..L.P� ............... Phone No: -yam
/_F`rr.........
Mailing Address.
..........1......................................................... ..............................�..................... .........................
.................
Onsite Representative:l �..!.�.......... �Z .41.1.. Intc rator:....... r(5..........�..........................
Certified Operator:.......(/4..,( ]............................ .� . %r z .................. Operator Certification Numm/ber:.... /,�,�,,, /,............
Location of Farm:
Latitude Longitude �• ��" -
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer FE§
Dairy
Feederto Finish µ p ❑ Non -Layer Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
El Boars Total SSLW
Number of Lagoons 10 Subsurface Drains Present jrn Lagoon Area I0 Spray Field Area
Holding Ponds) Solid Traps JE1 No Liquid Waste Management System
Discharges & Stream Impacts
I. is any discharge observed from any part of the operation (If yes, notify DWQ)? ❑Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. ll' discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach: ❑ Surface Waters [:]Waters of the State
c. If discharge is observed_ what is the estimated flow in gal/min''
d. Does discharge bypass a lagoon system?
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts to the waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity {freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3
Identifier:
Freeboard (inches): .... ..................
.....,e-r ...... 7 ............... .............................
Structure 4 Structure 5
❑ Yes
�Q No
❑ Yes
[,d No
XA
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes PS No
Structure G
1 /5/99 Continued on back

Facility Number: 3j — Date of Inspection
6. Arest Are -here uctures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
S. Does any part of the waste management system other than waste, structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence doff ver/application?
j {❑�Excessive Ponding ❑ PAN
12. Crop type I _� /%lil�/jil / 1 %mot /�/ Xjwt,1J/r� I
13. Do the receiving crops differ wkh tKose designi{t�d in the Certified Ar tmal
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?
I J?1'a�0
❑ Yes
IX No
❑ Yes
No
❑ Yes
(XNo
❑ Yes
A No
❑ Yes
No
❑ Yes
No
Waste Management Plan (CAWMP)?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
Rio vWafid is;or• deficiencies mere h6ted-diWing this;visit:- Yoit witl-t0dve Rio; ruither
,co rrespondeirce. a OU this visit. ...1. . . . . . . .
)mmentYrefer to;:ques& #):-E:eplain any -YES answer.
v �o...mmoWA: ' f.....� i.� q..vr.+1.ar—ariri mn
❑ Yes X No
❑ Yes P(No
❑ Yes KNo
❑ Yes R No
❑ Yes No
❑ Yes No
❑ Yes '%No
❑ Yes KNo
❑ Yes ONo
❑ Yes No
❑ Yes No
❑ Yes Q No
❑ Yes No
❑ Yes IONo
❑ Yes ANo
I1
Reviewer/Inspector Name Y,� I� r z _ -- _ �� •;
Reviewer/Inspector Signature �—J l 01? , Date: z f _,?wa
3/23/99

facility Number: _31 — 2 Date of Inspection 3'Z!'2+ro0
Odor I."ues
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes [$,No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes gNo
28. Is there any evidence of wind drift during land application? (i"e. residue on neighboring vegetation, asphalt, ❑ Yes KNo
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 LKNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes KNo
A, Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes LffNo
3/23199

rw © Division of Soil and Water. Conservation- Operation.Review.
El Division of Soil and;Water Conservation .Comptiance Inspection „
Division of Water Quality ,Compliance inspection z
v 0 Other Agency Operahti" Review$: a
10 Routine Q Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review 0 Other
Facility Number 2 Date of Inspection
Time of Inspection 24 hr. (hh:mm)
iff Permitted © Certified 0 Conditionally Certified 0 Registered JE3 Not Operational I Date Last Operated:
Farm Name �T�.......�-�..''' County: ..tl.l..n........................................................
............... ...L......................................................_...._....._.... / Gj
Owner Name: Q ' �• �� t � z �,�d} � Phone No: C �............................................................................
Facility Contact: .................................. .....................Title:........._...._... ----..... Phone No:................. .
Mailingaddress:......................................................................................................................................................... ..........................
J 1 T
Onsite Representative: �• r ' q . J :_ Integrator: ifs
} .......................................
Certified Operator:................................................................................................................ Operator Certification Number:........................................:.
Location of Farm:
i
..........................................................................................................................................................................................................................................................................
Latitude 0 ° •s Longitude �� �4 «
_ Design Current _- Design: Eiirrerit Design Current
Swine Capacity Population .. _Poultry Capacity Population Cattle Capacity Population .:.
❑ Wean to Feeder
19 Feeder to Finish
Q
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
r
Number of-I:agoons - . : ❑Subsurface Drains Present ❑Lagoon Area JE1Spray Field Area
Holding:Ponds i`S6iid Traps F
10 No Liquid Waste Management System w
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 9No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes 8 No
b. If discharge is ohserved, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes tZ No
c. if discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) []Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes M No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes Er No
Structure t Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ? Z
Freeboard(inches): ........... Y .24.............. ......... s.............. .................................... ................................... ................................... ...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion, ❑ Yes 0 No
seepage, etc.)
3/23/99 Continued on back

Facility Number: 7 -- Z Date of Inspection
6`-Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? . ❑ Yes 9 No
(If any of questions 4-5 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? 9) Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes H No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes 2(No
Waste A1101iCation
10. Are there any buffers that need maintenance/improvement?
❑ Yes
No
It. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
No
12. Cro t e
p yp
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?
JffYes
❑ 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
IffNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(le/ WUP, checklists, design, maps, etc.)
❑ Yes
F4 No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
'M Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
]g 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
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
fR No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ONo
viol'attcjns:o"r deficiencies •mere n... dirrtng tl�is;visit:... will .666ye Rio fui-ther • ; • ; •
• correspondence. ahi i this visit. . -
Commentsc(refer. to"question #). Expla�n.any YES answers ai d/©r any recommendations ohany-other eotnments:'
Use,dfawin of facili to better=tiilaicsituations use additionalt a es as necessa - r-
t. Cert{i�ve oaf'-t�s To es-41,--rA fro3Pc-yCeVe+'"' olq bad - •
ch 1,o�ydan 1-mlhf &-,rp�,�Il op?Ivio b�iee i lgjeo?'_0 .
�v1} -t ",J $p !� lav) - Fame.,' t7ms -restive am2WK-2 ,
t r0f d e s i nc4 I" wa s4e 14 )1) q Yld Cr-Of
ac-fall L � -F�+dl �?�au id be.2,e SRyvle. -Da ),io4 eipfl
an F-escUe ot0s;Ae, of Se�o�-,��:j ti,��d�W • _
Reviewer/Inspector Name l-' t
Reviewer/Inspector Signature:
Date: d'/57,
3/23/99

Facility Number: 3� — Z Date of Inspection
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
�gNo
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
'1!9 No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
JK 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
JK 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
Yes
XNo
shutters, etc.)
❑
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
J'No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
d No
omrnents'an=_ or: raw�ngs:
FOR L - =
jS. j„ Jee4 mar CV JC rv'On7 h ce4Cd ih 9F. A!a LVgn' 4e jj et-a4 , •
c r'e cs on i,,14s�e �r�h d� �'?0 wl�-�c,Z, ;,r� ;�c�� P f"
I of eS i ct h. V] f ! Z -�ro ►'yj Y' ✓' i �1'� J �:'j d G S iV'1 j S ►'1G T �'1
e ✓1 a v a we%S�-e � i'2 r-i rt +o .sLtoW
LJa s-� � ]� Ha � �n w �e
GarreC- o,Greccgcs ,.ark jr,r;Ca- ioY� d@5f r� -a� +o
)Y)60rFo�u]l 4�1Z, ,J
�q. ,FA►j end O,Crc ad,G -rr,, vres IPAN 6aia�-14es
6-k,,t4id �e col%re_ A OV)
VIf'M-
n o e-S rq yt nC� -tCr� rt�t n e w +O
( I J ,/ I
O� d rk re O h o ►r''t'l -
3/23/99

F �{ [3 Division of Soil and Water Conservation [3 Other Agency
jPIDivision of Water Quality
Routine 0 Complaint Q Follow-up of DWQ inspection O Follow-up of DSWC review 0 Other
Date of Inspection U G
Facility Number a-
Tirne of Inspection dv 24 hr. (hh:mm)
© Registered © Certified 0 Applied for Permit Wermitted W Not Operational Date Last Operated:
..........................
FarmName:........^` ........................ ..... County: 1 ............................................
Owner. .................................................................... Phone No: .... ....1.1�}.'a r4 � �.�-�............................
...................................
FacilityContact:..r..........0.....................I........................................... Title: ...................jr........................................... Phone No:
y...--.---..........................................
Mailing Address:..11�...4........�." F�...�C ...��!., 1.1�V�............h. ., t}-Sn.`� 1�1`.�.��C......��...1............. ... .............
Onsite Representative: ........................ Integrator:...!.'. .... ...................
Certified Operator,........................................................... .. :................... Operator Certification Number ..........................................
Latitude ' " Longitude • 4 46
❑ Wean to Feeder
Feeder to Finish
6
(G
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes • ErNo
2. Is any discharge observed from any part of the operation? ❑ Yes [KNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ONo
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes C 'No
c. If discharge is observed, what is the estimated flow in gaUmin?tAA
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes iM No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
P(No
4_ Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
MNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
(4 No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
14 No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
25 No
7I25/47

Facility Number: — Q�
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons.Holding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1
Structure 2 Structure 3
Identifier:
.............. .................
................ ....................
...............
Freeboard (ft): ...........:.ate.. .........
10. Is seepage observed from any of the structures?
Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(if any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
❑ Yes KNo
❑ Yes qNo
Structure 5 Structure 6
15. Crop type y°.... (.. Y15. ......................................................I... ..........................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Ulan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24, Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0-No.violations-ot: dericiene-ies.were'noted-ducing' this.visit.- You;will receive•noliiriher-
:: correspondence t bfluf this -'Visit.'., :. .
❑ Yes 10 No
❑ Yes ONO
ffYes ❑ No
❑ Yes ff No
❑ Yes ;4 No
❑ Yes ONO
❑ Yes [XNo
OYes ❑ No
❑ Yes MNo
❑ Yes ff No
❑ Yes 0 No
f.Yes ❑ No
❑ Yes KNo
❑ Yes ONO
❑ Yes "No
,s �1
t,G�.(.�
�� PL�� spy a� Ge��-.� 'P-e►-�� «��-� +-��..�s� �� �i� ���',r �e-
7/25/97
Reviewer/inspector Name
Reviewer/Inspector Signature: 11_1� U - Date: �610W CT8

I
❑ DSWC Animal Feedlot Operation Review
ODWQ Animal Feedlot Operation Site Inspection
le Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other _
Z Date of Inspection
Facility Number 9 9�
Time of Inspection t .K : 3 24 hr. (hh:mm)
Registered 0 Certified CI Applied for Permit © Permitted 113 Not Operational I Date Last Operated:
1
FarmName: .... Ta.r... v....s.......................................... ............................... County: ..... �.v.�.�.�.�.................................. �i.t...�.�.
OwFner Name:...1� :..£,..................................... ........Ir........................ Phone No: .... C. }.. �.. .�......Z.q..�t........ Z .l ....................
FacilityContact: .............................................................................. Title:.........................
Mailing Address: ....1.�..�. ..... ........ . C-..s. S �.... ..... R n1. .............
Onsite Rep resentative:.....0..:.A1...,....... -.---.... .......................
Certified Operator:.....&-J.i. ....... ...........Yr}-r.......................................
Location of Farm:
.................................... Phone No:...............................................
?f , ..Y:.i.J.. .,......t�..t ................ ..3.`1.....
Interrator:.....P.r - --.1V-............................I................
Operator Certification Number:---2— U-1..6..---......
.O.Y..!.....!:".a:�..........�..i.,t�.¢..............5. 1.�..D.i...t......�,T..f... ...�-,a.x.t.Y�r..a.n..........�......>�.s.,.........+.:�.�z.Y..�:�......a ...�.vs...... .�.,n..r:i.
-. W. t �........... ........2.tj.........:............................................................-................................................................... ................................... ..........
Latitude I -; • 1 5 i l: 1 )D :` Longitude I ri (• 1 5 D ' I I t :°
Swine
Design Current Design , Current
Capacity Population Poultry Capacity Population Cattle
❑ Wean to Feeder
Feeder.to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Layer I ❑ Dairy
❑ Non -Layer I I JE1 Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
'Number of Lagoons / Holding Ponds �! J ❑Subsurface Drains Present ❑ t,agoon Area ❑Spray Field Area
❑ No Liquid Waste Management System
M
General
1. Are there'any buffers that need maintenance/improvement? ❑ Yes ® No
2. Is any discharge observed from any part of the operation'? ❑ Yes ® No
DischarLyze oritinated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ® No
b. If discharge is observed. dill it reach Surface Water') If yes. notify DWQ) ❑ Yes ® No
c. If dischar,-,e is observed, what is the estimated flow in �,al/min?
d. Does discharge bypass a lagoon system'? Of yes, notify DWQ) ❑ Yes 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 6�[No
5. Does any part of the waste management system (other than lagoons/holding ponds) require El Yes [9No
maintenance/improvement?
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 KNo
7/25/97 Continued on back

Facility Number: 3 I — 4 Z
8, Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes S'No
Structures (Lagoons,Iiolding Ponds. Flush fits, etc.)
9. • Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier: .............. .........................................
Freeboard (ft): ...... Z.:75........
10. Is seepage observed from any of the structures? ❑ Yes 0 No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type .... .xvS.�I G r..:.................... ..................--...-- ..... .........................
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 ReviewerAnspector fail to discuss review/inspection with on -site representative?
22- Does record keeping need improvement?
For Certified or.Permitted Facilities Onl •
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
5&Ndviolatio'ns or deficiencies. were noted during this visit. You'will receive- ho ftirtlier
correspondence about this. visit'.-,
❑ Yes KNo
❑ Yes ® No
❑ Yes 19 No
❑ Yes E9 No
[:]Yes ,® No
❑ Yes 21 No
W Yes ❑ No
❑ Yes [RNO
❑ Yes No
❑ Yes No
RYes ❑ No
19 Yes 1l No
❑ Yes E9 No
❑ Yes W No
t�. tOh cey— 15 . t.OrrB c (, Wta�,& f'tL L!,-- S 1✓1 -sr
Z�• i'.i L c + L"i r r i a` a i`i vie e4 � o �2 ✓�^ 9 tL' ( 1A
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7/25/97
Reviewer/Inspector Name QLFtA ("
Reviewer/Inspector Signature:
Date:

Site Requires Immediate Attention: CVO
Facility No. 2
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERA
TIONSITVISITATION RECORD
DATE: 1995
61zle�
2Farm Name/Owner: "I2 dJ 1 Z-Pk fivw J 3I
Mailing Address-: 1` i i7i3 S 1%Iri
County:
Integrator: Phone:
On Site Representative: j5Z> A)iAA� Phone: _ 1$ _ 36$.
Physical Address/Location: d M1, 11 K UUr; iV Ci Z, ` _ coy
`6fR 17al 6 � n / e-,-' Sri
Type of Operation: Swine —4.,/ Poultry Cattle
Design Capacity: Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude:Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches es, r No 'Actual Freeboard:Ft. Inches
Was any seepage observed from the lagoon(s)? Yes r N as any erosion observed? Yes No
• Is adequate land available far s ray? Yes or No Is the cover crop adequate? Yes No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings Ye rNo
100 Feet from Wells . Ye or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes 90
If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acr age with cover crop)? Yes or No
Additional Comments: 727 5eg&4 0/1/
Ilk 415R,
Inspector Name S' ature
cc: Facility Assessment Unit Use Attachments if Needed.