310141_INSPECTIONS_20171231

-.A�
NORTH CAROLINA
Department of Environmental Qual

Type of Visit: [( Compliance Inspection U Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit:outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: ® County: lr' Regibn7 I`�V
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: K .W � e"( _ Integrator:
Phone:
Certified Operator: Certification Number: ti - t Lon
Back-up Operator: Certification Number:
Location of Farm: Latitude:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Design Current Design C►►arrant
Wet Poultry Capacity Pop. Cattle Capacity Pap.
Layer Daja Cow
Wean to Feeder
I
INon-Layer
I
EEI Dairy Calf
Feeder to Finish
320
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design urrent Dry Cow
I] . P,oultr. C_a aci P,o P. Non -Dairy
Layers Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other J01
Turke s
Turkey Poults
10ther
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?
❑ Yes 1Vo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes❑/No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes N ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA [—]'NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facili Number: - Date of Insection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? 0 Yes )2'go ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in)
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes .2No ❑ NA ❑ NE
❑ Yes _[2-1<o ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes jn'�4o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes',OlNo ❑ 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 [:].Wo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ YesE]'No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes�No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ONO ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ YesjrNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes jTNo ❑ 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 EfNo ❑ NA ❑ NE
❑ Yes 2fNo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ;?fNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes P14o ❑ 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 oNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �; � o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: 131 - Date of Inspection: -717
•24. Did the facility fail to calibrate waste application equipment as required by the permit? *i❑ Yes No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes Q-I�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 ONo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No "ZNA ❑ 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 E No ❑ NA ❑ NE
❑ Yes�No ❑ NA ❑ NE
❑ Yes J21<o ❑NA ❑NE
❑ Yes ETNO ❑ NA ❑ NE
❑ Yes 1!!3 No
❑ Yes No
❑ Yes TdNG
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments^(refer to,gti6stioti#) E,xp'la►n`any YES answejrs,and/or any additional recommendations or gny other comments .
Use drawings of facility to.better a plainwsitiiations (use additionai;pages'as=neeessary) ' ' I
a
Reviewer/Inspector Name:
MW
I�.[I'Al Phone: I h
Reviewer/Inspector Signature:
Page 3 of 3
Date:

Type of Visit: QD Co Toliance Inspection O 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: Departure Time: County: . b Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title:
Onsite Representative: C)0-N ik p't) Mzu'a-/ _ Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number: l f I Y6
Certification Number:
Longitude:
Design C►urrent Design C-ourrent Design Current
SMapacity Pop. Wet Poultry pa a Capacity Pap.
Wean to Finish La er Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design C■■urrent
Dr, P,oul_tr, Ca aci_ P,o
Layers
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Qther
NJ Other
Turkeys
Turkey Poults
10ther
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation? [:]Yes No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes VNo ❑ NA ❑ NE
Page I of 3 21412015 Continued

Facili Number: - Date of Inspection:
L
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
OlNo ❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
YNo
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment 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 P/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 WNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 6 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes a� ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes rNo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes
❑ Yes rNo
❑ Yes -Cl/No
❑ Yes YNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: 1jILI I Date of Inspection:
24..Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Eo ❑ NA 0 NE
25.its the facility out of compliance with permit conditions related to sludge? If yes, check [—]Yes YNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑Yes VNo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
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 PIN/0 ❑ NA ❑ NE
❑ Yes No 0 NA 0 NE
32, Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�No ❑ NA ❑ NE
VNo ❑NA ❑NE
o ❑ NA ❑ NE
Commezits(refer to question #): Explain any YES answers and/or any additional recommendations or any, other comments.
Use drawings of.facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signatur
Page 3 of 3
Phone [phone]
Date: KLS 11b
2/ /201

Type of Visit: &Compliance Inspection 0 Operation Review p Structure Evaluation O Technical Assistance
Reason for Visit: 4E�f Routine O Complaint O Follow-up O Referral Q Emergency O Other O Denied Access
Date of Visit: j Arrival Time: � Departure Time: County: //'L Region: 4dI&O
Farm Name:1912 Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: Sh2zz L [ ?1/a0 '
Certified Operator:
Title:
Phone:
Phone:
Integrator:
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude: Longitude:
Design
Swine Capacity
C►urrent
Pop.
Design t!urrent Design Current
Wet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish
La er Dai Cow
Wean to Feeder
Non -La er Dai Calf
Feeder to Finish
Dai Heifer
Farrow to Wean
Farrow to Feeder
Design Current Dry Cow
P. Non -Dairy
Layers Beef Stocker
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turkey Pouets
Other
Discharp,es and Stream Impacts
I. 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 DW R)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3.' Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ,❑-No ❑ NA ❑ NE
❑ Yes-1:1No
❑ Yes rJ�' o
❑NA ❑NE
0 NA , ❑ NE
❑ Yes _Q-No ❑ NA ❑ NE
❑ Yes Q44o ❑ NA ❑ NE
❑ Yes ❑-Aia_ ❑ NA ❑ NE
Page I of 3 1 /Ga/ 5 5pO� 21412015 Continued

FaciliNumber: Date of Inspection:
Waste Collection & Treatment
4As storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
PrNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
0 Yes
�fNo
❑ NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 2'
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ETNo
❑ 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
eJ 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 oNo
❑ 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 q 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?
/12
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes /25 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 0 Evidence of Wind Drift
❑ Application Outside of Approved Area
12, Crop Type(s)
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
.' No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[2,No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
�No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
qNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[;I -No
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes n No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [:]Yes P No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard PrWaste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [ No ❑ NA ❑ NE
Page 2 of 3 lQ W f rou u I `�� Lo t -- Y► V s 5 ed 21412014 Condnut
u d
hJ
t�

Type of Visit: ,Z Compliance Inspection O Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Routine Q Complaint O Follow-up O Referral Q Emergency O Other Denied Access
Date of Visit: Arrival Time: eparture Time: County: Region:
Farm Name _ � Owner Email:
Owner Name: Phone.
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: /' Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swlne Capacity Pop.
Wean to Finish
Design Current Design Current
Wet Poultry Capacity Pop. Cattle Capacity Pap.
I I Layer I jDaigCow
Wean to Feeder
I
iNon-Layer
I
Dairy Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dairy Heifer
Design Dry Cow
Dr Point Ca aci P,o Non-Dai
ILayers Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
I lBeef Brood Cow
Other
Other
Turke s
Turke Pouets
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ,❑''No ❑ NA ❑ NE
❑ Yes _[a"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 Feno ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes E�rNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes j2No ❑ NA ❑ NE
of the State other than from a discharge? T
Page I of 3
21412014 Continued

Facility Number: Date of Inspection:
Waste ColLection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes �No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ^�
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):yl
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
VNo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
ff No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
0 No
❑ NA
[] NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
FfNo
❑ 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
ZNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved
Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
[-]Yes
o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
El Yes
YNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
VfNo
❑ NA
❑ NE
acres determination?
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
[21 No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes,,j
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[;'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. 0 Yes 10No
❑ Waste Application ❑ Weekly Freeboard [A Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ t20 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ,[!I No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ff No
❑ NA [] NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: - Date of inspection: L
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 0 No ❑ NA ❑ NE
25. Irathe 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 0 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes VNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 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
Z 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:
jo
32. Were any additional problems noted which cause non-compliance of the permit or CAW W?
❑ Yes
No
g
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ YesVNo
o
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
❑ NA
❑ NE
Comments (refer to question #):.Explain any YES answers and/or any additional recommendations or°anyother comments.
Use drawings of facility to better explain situations (use additional, pages as necessary)."
_f1ef
(IlVe,�l k� 12-1-3 Illy
V /e/i//If,
-Wa_!5 �, 4-0
rVQy �- -5u re, PckPIPI��
Cc,.-)tAS NX65?4�E7AC_ld9)
/FQ1-y;T d­ records /00k-Ljc3c�'d
6,76
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412 di4

Type of Visit: AD Com Hance Inspection U Operation Review O Structure Evaluation (� Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency C) Other O Denied Access
Date of Visit: / Arrival Time: Departure Time: County: , Region:
Farm Name: 'Jb Owner Email: 40
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: S/W" a
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: Mz&
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Design Current
Wet Pointry Capacity Pop.
Layer
Design Current
Cattle C►apacity Pop.
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Design Current
Dr P,ouItr. Ca aci P,o ,
Layers
Daiiy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
[:]Yes ffNo ❑ NA [D NE
[] Yes ,k7] No
❑ Yes .!1'No
❑NA []NE
❑ NA C] NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ZNo ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes J�j No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ZNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility Number: - Date of Inspection -
Waste Collection & Treatment
4. Is'storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes Z]No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes 9No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): !�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes ONo
❑ 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 ,E;?rNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes j2No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes E:�No ❑ NA ❑ NE
maintenance or improvement?
_Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes P No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [:]Yes ,❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Base Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes 3allo
[:]Yes VrNo
❑ Yes P No
❑ Yes No
❑ Yes No
❑ Yes CZNo
[:]Yes 0 No
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ];I -No
❑ Waste Application ❑ Weekly Freeboard Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [� No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - Date of Ins ection-
24. Did the facility fail to calibrate waste application equipment as required by the permit?
[] Yes
C'No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
[�fNo
❑ 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
V] No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
p No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes fn 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.
34. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes 0 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 �TNo
0 NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes P. No
P.
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El Yes
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
0 Yes [ZrNo
❑ 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).
1 N
C��6q C
O Z
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
u)rd a �j U5 f
_tV C 0vo ,
pq)r;� . F&A'_)e
Was Je a nr-19 sl
� [6 rjr) C
Phone: ;z g--IV
Date: 1 l
21412011

Type of Visit: )2Mompliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Routine 0 Complaint O Follow-up O Referral O Emergency 0 Other 0 Denied Access
Date of Visit: (-/ Arrival Time: D eparture Time: County: Lt lyt Region: "o"j
Farm Name: �6Otf (� G� Owner Email: —�
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: [� ( Title:
Onsite Representative: Shyr
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Phone:
Integrator: SU
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Wet Poultry
La er
Non -Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Feeder to Finish
D . P,oult ,
La ers
Design
Ca aci
Current
P,o ,
Dairy Heifer
Cow
Non -Dairy
Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes Ef No ❑ NA ❑ NE
❑ Yes ZNo ❑ NA ❑ NE
❑ Yes �o ❑ NA ❑ NE
❑ Yes ff No ❑ NA ❑ NE
❑ Yes �No [] NA ❑ NE
❑ Yes P No + [] NA ❑ NE
Page 1 of 3 21412011 Continued

Facili Number: Date of inspection: Ilef Z
waste Collection & Treatment
4fflls storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ,ErNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes la�No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?: O
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes -E::fNo ❑ 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 C'No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes YJ 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 E3 No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes ETNo
[DNA
❑ NE
• maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �No
❑ NA
D 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 J2'*N5o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ED"No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [-]Yes En"No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes 12rNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes jo-No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes J�TNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes 4 fjNo
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ENo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes `�ffNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E:fNo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
[DNA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: - jDate of Inspection:
24. Did tt a 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 JZ 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 M No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ZNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document [] Yes 0 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 A 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 VNo
❑ 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 JZNo
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes ZNo
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes ZNo
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
[:]Yes PNo
❑ 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). .
.. . .
0
8 q 1Z 1� v r
v c
S �
fi
Reviewer/Inspector Name: G i Phone: ��� �. , -L
Reviewer/Inspector Signature: Date:
Page 3 of 3 21412011

Type of Visit: 1porompliance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: Routine Q Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: eparture Time: County:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: s d
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Region: W,24?
- ,
Design Current - Design Current. Design Current
Swine EapacityPop' Wet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish
Layer
Dairy Cow
Wean to Feeder
Non -Layer
I
Dai Calf
Feeder to Finish
Farrow to Wean
Design Current
DBE P,oult . C*_a a�i. P,o
Dairy Heifer
Dry Cow
Farrow to Feeder
Non -Dairy
Farrow to Finish
La ers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Turkeys
Turkey Poults
Other
Other
Dischar gs 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)?
❑ Yes )Z-No ❑ NA ❑ NE
❑ Yes '❑No [3 NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ..fNo ❑ 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 eNo ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facili Number: Date of Inspection: `
Waste .Collec 'on & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes/eNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes )2no
❑ NA
❑ NE
Structure 1 Structuree22 Structure 3 Structure 4
Structure 5 Structure 6
1
Identifier: y
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ��.--
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes o
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes E�'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 lf!�No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [-]Yes KNo ❑ 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 ZrNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes XTNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes PrNo
❑ 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.,jEl-No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes �o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ NA
❑ NE
acres determination?
,Callo
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 J?No
❑ NA
❑ NE
Required Records & Documents
19, Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Ycs. 'No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes ;;�^No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes,No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes e?No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes E(No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes Z.No
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge
levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes ONo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[] Yes ZfNo
❑ NA ❑ NE
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes ZNo
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes 2�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 VNo
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? [:]Yes Y1,40 ❑ 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).
01
!F3
0,. 58
/• D
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
e ,Sol I k 5 �- haJ 00(_J" 1 .SC'nf d4�C
Be cup- 4o c& i�71a8e,
SC1l0P.U,) C­oc )tic(,
o rcr�r—v_�o a�r�s� - re co
�OcXJ�r
Phone: r `<
Date:
214120 1

hty,
Fa"tlitoumber,
iilfal
Type of Visit _.Coompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit 4! Routine O Complaint O Foliow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: ip-6u
Arrival Time: .`lJG Departure Time: County-, Region:Farm Name:Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator: —
Back-up Operator: _
Location of Farm:
0
Latitude: =
Phone No:
Integrator:
Operator Certi ication Number:
Back-up Certification Number:
= { Longitude: = o = ,
Design Current
.- Des�ga Current $... Desegn 4Currenk
.
` Swine
Ca ace Po ulation
p' h « P
„,
Wet Poiu,, Ca aci P<o - Cattle = �a aci Po ulahon
rY p h p
�m
.ulahan
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
> ❑ Wean to Feeder
❑ Non -La er
❑ Dairy Calf
El Feeder to Finish
_ »t
�-�
❑Dai Heifer
El Farrow to WeanD
_
Poolt v„
❑ D Cow
El Farrow to Feeder
❑ Non-Dai
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
, ❑ Non -Layers
❑Beef Feeder
❑ Boars
� El Pullets
❑ Beef Brood Co
❑ Turke
Other. tip.
s
❑ Turkey Poults
`}
❑ Other
��A❑ OtherNurnber�o-
•
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)
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 RNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
0 No
❑ Yes
ErNo
❑ NA
❑ NE
❑ Yes
E/J No
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of Inspection
Wasie 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): '3 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 12 No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes P No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? [:]Yes ZNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes J'No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes g No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes J2 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes FfNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ZNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes Z No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes 0 No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes ZrNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes i No ❑ NA ❑ NE
-7;1 ..,
,-` : doorayoCn(refer touestion:#) Ex lain an .YES answers andr any recommennther comments
,
Use drawings of facility to better explam situations (use, additional, pages as necessary)r
Reviewertins ector Name Phone:
Reviewer/inspector Signature: Date:
Pa 2 f 3 1 /28/04 Continued
ge o

Facility Number: 3 — Date of Inspection
. Re u red Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ,l No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. E� Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard FzrWaste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes )�l No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
1�[No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�' o
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
P'No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
ONo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
9No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
J?No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[] Yes
P�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
PNo
❑ 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
ZNo
❑ 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
[20&�o
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
2No
❑ NA
❑ NE
Additional Comments andl r Drawings:
©
w rT
e
v to
a 31Lv
o ri y 1
/42ju l a.r�
a P11- JrGGo�►��` S
Page 3 of 3 12128104

Type of Visit j?tampliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit_016outine O Complaint 0 Follow up O Referral O Emergency Q Other ❑ Denied Access
Date of Visit:
Farm Name:
Time: lL!.iLJ Departure Time: County:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Region
Location of Farm: Latitude: = o = I = " Longitude: = o = I = "
Design
Current
Design Current Design Current
Swine
Gapci ty
Population
Wet Poultry Capacity Population Cattle Capacity Population
❑ can to Finish
❑ Layer
❑ DairyCow
❑ can to Feeder
on -Layer
❑ DairyCalf
❑ Feeder to Finish
❑ DairyHeifer
❑ Farrow to Wean
Dry Poultry ❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ La ers
El Beef Stocker
❑ Gilts
❑Non -La ers ❑Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Co
❑ Turkeys
Other
❑ Other
❑Turkef Poults
❑Other Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes E o
❑ NA
El NE
Discharge originated at: El Structure ❑ Application Field El Other
4
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 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 l
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes rCJ No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ YesANo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes C] No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Y No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.) 4
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 ;�'No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ;KNo ❑ 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 t6o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes gdNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect 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 Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
KNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
R No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
VjNo
❑ NA
[:1 NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
V] No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
'V No
❑ NA
❑ NE

Facility Number: — Date of inspection I WX MY
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 94
o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes PNo ❑ NA ❑ NE
the appropirate box. ❑ WUp ❑ Checklists ❑ Design
g ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
PNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ONo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
o
ElNA
[INE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
Zo
❑ 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
VNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
WNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
PNo
❑ 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
[f 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
QfNo
❑ 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
U] No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
dN o
❑ NA
❑ NE
Page 3 of 3 12128104

i1r
IType of Visit (D Coompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit _0 Routine O Complaint O Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I «LoWMI Arrival Time:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Departure Time: County:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other -- -
Owner Email:
Phone:
hone No:
Integrator
Operator Certificatio Number:
Back-up Certification Number:
Region{ _/4
Latitude: = c = = Longitude: EJ° =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharus & 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 Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 0'No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
ElYes
ET'No
❑ NA
❑ NE
❑ Yes
ETNo
❑ NA
❑ NE
12128104 Continued

Facility Number: 31 Date of Inspection 0
Waste Collection & Treatment
4. If storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ja 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: l ��
Spillway?:
Designed Freeboard (in):�
Observed Freeboard (in): _/2 Q
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes �No
❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes 2 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 L3"No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes [-No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes 1�3"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 No
❑ NA ❑ NE
1p
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN [--IPAN > 10% or ] 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window
%� I Evidence of Wind Drift ❑ Application Outside of Area` ,p
12. Crop type(s) `3clz / joy : C �Z >f-��� �" � �� (�) , J 6 L " �Ji
1
0
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
❑ No
❑ NA
❑ NE
Reviewer/Inspector Name (f.: ✓ .�%:G C +'' _=� Phone: /(/(n _ lot
Reviewer/inspector Signature: l Date: l o7 �C)gj ­
1212810 Continued

Facility Number: Date of Inspection o7 a
Rewdred kecords & Documents
19. 16id the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ETNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ,214o ❑ 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. ❑ Ycs..,� 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
[?"%
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ZNo
❑ 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?
42Yes
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
�TNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
PNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
J�'No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ yes
;2,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
qNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
�No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
_[3No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes ;�Mo ❑ NA ❑ NE
Additional Comments and/or Drawings:
�-
sel�
e y- eC�z rtcp
ao� le u-(�A S G'3
e r rn --5
- VeLOC3 S 1't-ea+ d- O r c9,Q c
12128104

Type of Visit P Compliance Inspection O Operation Review O Lagoon Evaluation
outine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Reason for Visit A
Facility Number r Date of visit: .2 f 'Tune:
O Not Operational Q Below Threshold
© Permitted [3Certified% I CondiitionaW Certified 13Registered Date Last Opera or Above Threshold:
Farm Name: o Z /J f- �' County: .1_2/1� .. __.W... .. .
Owner Name: _ . _ _ _ _ , . _ . ,. _.__. ...__ . _.. Phone No:
?Mailing Address:
Facility Contact: _Title: _ _. Phone No:
Omsite Representative:Q Integrator.
Certified Operator: Operator Certification Numbe
Location of Farm:
1'V
❑ Swine ❑ poultry ❑ Cattle ❑ Horse Latitude �• �" Longitude �� �� �"
Desiggn Current Des3ga
'rCnrreat DesegaCorreat
Swine
�Po �ion"pY �: _
"P�Cattie •' 'tioa '
Po ;Po
�.
Dairy
Feeder to Finish
piSC� & Stream Implets
1. Is any discharge observed from any part of the operation? ❑ Yes ANo
Discharge originated at: [I Lagoon [I Spray Field [I 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 El 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 0'No
3- Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? [I Yes .t-No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes'm&
Structure 1 Struc� 2 Structure 3 Structure 4 Structure 5 Structure 6
.. Identifier: - /
Freeboard (inches): 90
.12112103 Continued

"Fa cility NumberDate 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?
(H 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 maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste APPOcation
10. Are there any buffers that need maintenancelimprovement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑
12. Crop type
13. Do the receiving crops differ with those
Zinc
in the Certified Animal Waste Management Plan (CAWMI .
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not'disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
y
Reviewer/inspector Name
Reviewer/Inspector Signature:
❑ Yes ,E No
❑ Yes ;ErNo
❑ Yes XNo
❑ Yes A No
❑ Yes J!fNo
❑ Yes )dNo
❑ Yes 4dNo
5 ,
Yes .0 No
❑ yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ,EfNo
❑ Yes j3'No
❑ Yes 00
❑ Yes 0No
❑ Yes fd No
❑ Yes dN0
❑ Field Copy ❑ Final Notes
Date:
I2f12103 (:onanuea

t
Facility, Number: 3 —
Date of Inspection V37 i
Requireditecords & Documents
21.fFail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ief WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
25. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/inspector fail to discuss reviewfmspection with on -site representative?
28_ Does facility require a follow-up visit by same agency?
Z9. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Form Oicrw Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes-'E3'T10
❑ Yes 'allo
❑ Yes PAlo
❑ Yes ,ONo
❑ Yes 8'Ro
❑ Yes �DNo
❑ Yes ONo
❑ Yes O'FTo
❑ Yes ❑pia
;wl
Yes ❑ No
❑ Yes OIio
❑ Yes 13wo
❑ Yes .QNo
❑ Yes ONO
O'Yes ❑ No
12112103

Type of Visit g5 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit �i Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of visit: UW21LQATimn
Not O erational Below Threshold
Permitted 13Certified 0 Conditionally Ce%A<P--,
0 Registered Date Last Operat or Above Threshold:
Farm Name: County: uP&E/V_-
Owner Name: A).'e S�Z,5- 2 Phone No:
Mailing Address:
Facility Contact: Title:
Onsite Representative: .S O
Certified Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certification Number:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' ' 0" Longitude ' 4 OK
Wean to Feeder JU Layer I I Dai
Feeder to Finish IY87Y4 I0 Non -Layer I I Non -
Farrow to Wean v ^
Farrow to Feeder ❑ Other
Farrow to Finish Total Design Capaci
Gilts
Boars ,. I Total SSL
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 gat/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 AXNo
No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ONo
Sjnscture 1 cture 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: # t+ _
Freeboard (inches):
05103101 Continued

Facility Number: —' 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 ABpllication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ I xwssive Poi
12. Crop type Q I A-16 /Ad:sl 1 u
13. Do the receiving crops differ wil those designated in tb^ a Cerrti
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?
RNuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fait 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. Fait to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes VN,
❑ Yes PNo
❑ Yes A No
❑ Yes 4 No
❑ Yes PNo
❑ Yes 0,No
El Yes ko
F r F
❑ Yes No
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes o
ElYes CJ No
❑ Yes 'P(No
❑ Yes ;WNO
o
❑ Yes d
❑ Yes 9NO
❑ Yes )ANo
❑ Yes RfNo
❑ 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.
.: Yc."Y#'--"[HLwc+�
Cominentsr(refer to 'gtiesttnp #) Explain any YE5 answers'andlor-:any recbmmendatlons or�any other commen k'
Use drawings•of facRityto betterleiptain situations (use[additrbblifi ges as necessary) Field Copy ❑ Final Notes
y
3l �> �� N �5 0 >�� ✓�sFQ n >g�
4-
,;57�G���"b 14P,oGzC y-TLo� G�rn+�t'J
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Number: — Date of Inspection
O-dor 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?
Additional OIIlment53II or- t•SW1n S >. `�
fit.. �.,: �,�s . �: v
15) �VIPC A)�90 �%47`00L
� . � emu �
�5o,��fFzE�os A�aE,�
05103161
❑ Yes ❑ No
❑ YesN
o
El Yes
❑ Yes 1A No
❑ Yes o
ElYes No
❑ Yes ❑ No

(Type of Visit Q Compliance Inspection O Operation Review O Lagoon Evaluation I
for Visit
Routine O Complaint, O Fonow up O Emergency Notification O Other 1 ❑ Denied Access
Facility Number Date of Visit: a- % Time:
Q Nat Operational Q Below Threshold
Permitted ©Certified O Conditionally Certified Q Registered Date Last Operated or Above Threshold: ... . _.. __. .
Farm Name: )
......oa ............................. �'........................ County:........ --.\..................................._. .
Owner Name: ................................................... ........ ................................................ .............. Phone No: ............................................... ............... ............
w.
Facility Contact:
Title:
Phone No:
MailingAddress:..................................................................................................................... ........... I.........
_.......... .. Integrator:W..
Onsite Representative:.. ! Q ................. .... �" ...
-y ................ ........... _..._..------
Certified Operator: ................................................... ............................................................. Operator Certification Number: .................... _...... ...
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • ' « Longitude • 6 I�u
Swine Design . Current - Design Current7 Desaig�n Cusreat
Ca aci Population Poultry Ca ci Pa uhiition Cattle Ca ci Po tfon=-
❑Wean to Feeder ❑ Layer I I Dairy
Feeder to Finish ❑ Non -Layer I I ❑ Non -Dairy
❑ Farrow to Wean
a0 Farrow to Feeder I0 Other
❑ Farrow to Finish Total Design Capadty -
Gilts
❑ Boars Total
Number:of Lagoons ❑ La ❑Subsurface Drains Present oon Area❑Spray Field g Area
Hiding Ponds.l Solid Traps, �� . No Liquid Waste Management System Y
Discharees & 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 kfNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 6No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes [YNo
Structure I Structure 2 Structure 3- Structure 4 Structure 5 Structure 6
Identifier: ...............
..........
....................
.....
.........
.......
................................
................
.......
.....................................
Freeboard (inches): q Q 3 L(
5/00 Continued on back

Facility Number: '3 -- Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, Yes K 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 fi(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 P'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 �J No
Waste Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes qNo
11. Is there evideng of over application? []Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes kNo
12. Crop type t) , Li rn , <Ca
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes RNo
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
06No
15.
Does the receiving crop need improvement?
❑ Yes
gNo
16.
Is there a lack of adequate waste application equipment?
❑ Yes
O No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
P(No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie! WUP, checklists, design, maps, etc.)
❑ 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?
❑ Yes
kNo
(iel discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
)0 No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
J�rNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
)9No
•Yi0fpkti0 s A d�fiej6pitiM 4V A pQte# during �his'vjsitt . Yon will-Xec�iye �iti furtbgr . .
.-:-corresnorideiace:a�autithis:visit:•.....:•:•:•:•:•.•
:..........:.•..:•.•..•.•:•:•.•.•.
Conunents`(refer to_gixeshon f#) ;Explaiii•any YES answers audlor any recotnmendations or,any other comments..; �..�.
`) 16 Ate 4- Q<< � ►-e -�d -F.�� 4 PAIL 3.
_I.- . j"
Reviewerllnspector Name�,��
Reviewer/Inspector Signature: \ V, I= L A '*_� Date: IS-Lr-13-01 5100

Facility Number: 3t — Date of Inspection '--' • • Printed on: 7/21/2000
Odor Issues
25. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below XYes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes �No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 4No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes �fNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc_) ❑ Yes KNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 4No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes JZNo
AdditionaLComments and/or .rawings:. -
,&I
57-�O "--X' G
ti
Ly 4
0. Vt—Z { V2c vL-IJ
'Wl
5100

iltivtston of Water Quality
Soil Water Conservation
J.
O_DrvE 0'fi of and
-3 t -
Other Agency
�2
of Visit g(Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit t)� Routine Q Complaint O Fallow up O Emergency Notification p Other ❑ Denied Access
Facility Number L`
Bate of Visit: k �Ge Time: S Printed on: 7/21/2000
O Not O erational O Below Threshold
O(Permitted © Certifed © Conditionally Certified © Registered . Date Last Operated or Above Threshold: ...............
Farm Name: ..... .................`~`r............ County:..
Owner Name: .............................
Facility Contact: .....................................
Mailing Address: .....................................
Onsite Representative: OU.P Q.✓
Certified Operator: ..................................
Location of Farm:
Phone No:
Title:
Phone No:
................................................................................................ ....-- ..........................
Integrator: LA
........................ *-----_.-_--------_
•1... .......... I- .__---......I.......•... Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude a C ' Longitude •
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer ❑ Dairy
Feeder to Finish $� ❑Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons a- ❑ Subsurface Drains Present ❑ Lag--n Area I0 Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impact~
1. 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 ratan -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 XNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes )�rNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes WNo
Structure I Structure 2 Structure , Structure 4 Structure 5 Structure 6
Identifier: ....................................
Freeboard (inches): lL
5100 Continued on back

Rcility Number: "3— Date of Inspection 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
,<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
XNo
(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
)YNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
(] Yes
XNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
kYes
❑'No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
ONO
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
NNo
12. Crop type tC�k-`-� — -
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
)ECNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
A�No
b) Does the facility need a wettable acre determination?
❑ Yes
&No
c) This facility is pended for a wettable acre determination?
❑ Yes
b_;rNo
15. Does the receiving crop need improvement?
❑ Yes
PNo .
16. Is there a lack of adequate waste application equipment?
❑ Yes
J<No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
D<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
jNrNo
19, Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
,WYes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
XNo
21- Did the facility fail to have a actively certified operator in charge?
❑ Yes
XNo
22- Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes )<No
23. Did Reviewer/Inspector fail to discuss reviewhnspection with on -site representative'? ❑ Yes J4 No
24. Does facility require a follow-up visit by same agency? ❑ Yes ONO
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes VNo
0: �4Wati6ris oi- deficiencies were noted O(Wifig this:visit' • Y66 will receive irid fuft.
her
: Torres otidene'e: abauti 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): t
�`�� -} � �--�►�=} � U-. fie.. � S��-� 1S � ��4 '9�����--'�'
Reviewer/Inspecto r Name DPS,� [� 3yJl-3 QQ
Reviewerllnspector Signature: Date:
5/00

acilitNumber. ` — f{` Date of itxspection 3C1 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 9Yes ❑ 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 9No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 6No
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 O(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 4 No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ViNo
32. Do the flush tanks lack a submerged fill pipe or a pennanent/temporary cover? ❑ Yes tR)No
honk omments andVor:, rawtngs:
� � , a�� �--��� cue+=�,\ t"-�}- �-��v.Y�-'►--�Y�
L'AV, \�-e-
J
5100

Division of Soil an"th•Water Conservatton-'Operation,Review
e_ w
0 Division of Soil 'and_Water Conserva4on Compliance L�specti6n y ``
Division of Water Quality ;Compliance Lispechdn =:
Other Agency Operatiotn Review , _...
Routine 0 Com laint Q Follow-up of DWQ inspection OFollow-up of DSWC review Q Other
Facility Number Date of Inspection
Time of Inspection 24 hr. (hh:mm)
Permitted 0 Certified 13 Conditionally Certified 0 Registered [3 Not 4 erational Date Last Operated: /f
Farm Name: ..... W�A. ......... !RI.....1ly4,K..rK.................................................- County:....- i..k�............................... `.-u.............
OwnerName: ......90,A.�f............. r.L�I I:............................-............-................... Phone No:......1.���)...���-..�.'7�.......... ..............
/ C
Facility Contact: . , !A�................ .1 .l ►-1/............... Title:......Q�!1%h:Li/........... . Phone No:......-...... .............................................................
Mailing Address:..1J•t/ ....'ll� ... .....,Ql([ll�.`�. ✓! •[�......................... P¢.Q..
cl.... ....... .... ..........
Onsite Representative:... i��(...................... dfa� Integrator. 44V.......................................................
..................................... ..........
Certified Operator:...... ............................. a. L,¢!}................................ Operator Certification Number:..........................................
Location of Farm:
Latitude ' ° bi Longitude • 4 6.
Design Current ' `. _ Design` Current Design Current
Capacity Population ,'Poulfry_. Capacity Population ' Cattle': Capacity Population'-
❑ Wean to Feeder
C& Feeder to Finish
[�
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ID Spray Field Area
Hotding",Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 14 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made" ❑ Yes 10 No
b. If discharge is observed, did it reach Water of the State? (If yeas, notify DWQ) ❑ Yes allo
c. If discharge is observed, what is the estimated flow in gal/min? WV %i
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ANo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes M No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? -❑ Yes W 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: � ". � (r-V1,.&)
Freeboard(inches): ....... ...................................2..........................................................................................................................................................
5- Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 0 No
seepage, etc.)
3/23/99 Continued on hack

F,gcility Number:
Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(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?
❑ Yes
K No
❑ Yes
A No
❑ Yes
IgNo
❑ Yes
No
❑ Yes
No
It. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
No
12. Crop type &P SA,
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
jl No
16. Is there a lack of adequate waste application equipment?
Cl Yes
No
Reauired Records & Documents
IT
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
0 No
I&
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
KNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
P(No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
O No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
Wo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24. Does facility require a follow-up visit by same agency?
❑ Yes
IX No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
jW No
0: �4o yiol'ati6ris:oe- lief ciendieg were p9ted• dtWirid this:visit: - Y;ott will -t&4 4y iiti futther
- r . . esponde' - : aba�ut_ this :visit_ : : :
Comments°(refer to questidn #). Explain any YES answers`andlor any recommendations or-any�otirer comments .
Use drawings of facility to better explain situations (use additional -pages as necessary)
Reviewer/Inspector Name
Reviewer/inspector Signature:"1„ Date:
� • a�] ��/�� ��� 7�� �1�r 3/23/99

Facility Number: 3 — (� Date of I nspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below AYes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes KNo
28, Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes x 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 4No
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 'V No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes J6No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes No
JAdditional Comments and/or. Drawings:
r
3/23/99

Name of Farni/Facility
Location of Farm./Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
I.,
Structural Height
Lagoon Surface Area, Acres
Upstream S1ope,xH:1V
Embankment Sliding?
(Check One, Describe if Yes)
Lagoon Dike Inspection Report
P P
/ — flocs k r0 55ore> Z-
�o� y 510 �r _�(� l o
Names of Inspectors,1'�d�%
F b dFet --
Yes No
Seepage? Yes No
(Check One, Describe if Yes) - -
Erosion? Yes No
(Check One, Describe if Yes)
Condition of
Vegetative Cover
(Grass, Trees)
ree oar , e
Top Width, Feet
Downstream Slope, xH:1V
Did Dike Overtop? Yes No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? Yes No
Engineering Study Needed? Yes No
Is Dam Jurisdictional to the Dam Safety Law of 1967?
Other Comments
Yes No

0
CC 4U/%�,
Name of Farm/Facility
Location of Farm/Facility
Lag
P�ke IT�e
ort
_4�17t, - N1 , , ,
Owner's Name, Address
and Telephone Number
k
Date of Inspection Names of Inspectors /ll OJ
low,l /
Structural Height, Feet Freeboard, Feet q
Lagoon Surface Area, Acres he c Top Width, Feet 0
Upstream S1ope,xH:IV-3 Downstream Slope, xH:1V
Embankment Sliding? Yes T� No
(Check One, Describe if Yes)
Seepage? Yes_ No
(Check One, Describe if Yes) L - -
Erosion? Yes o
(Check One, Describe if Yes)
Condition of 60 d �e
Vegetative Cover
(Grass, Trees)
Did Dike Overtop? Yes No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? Yes No
Engineering Study Needed? Yes _�LNo
Is Dam Jurisdictional to the Dam Safety Law of 1967? Yes No
� f
Other Comments
<,CjTf..,f,J_ Lee
y

G6
1

Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
Structural Height, Feet
Lagoon Surface Area, Acres
Upstream S1ope,xH:IV
Embankment Sliding?
(Check One, Describe if Yes)
Seepage?
(Check One, Describe if Yes)
Erosion?
(Check One, Describe if Yes)
on Di
M b6X
0--e
sp(Gctio �.eport
O rr`
Names of Inspectors
(� Freeboard, Feet
' ` Top Width, Feet
*J
1 Downstream Slope, xH:1V
Yes 4 No
31 )q
Yes x No 00-5st ��- 1 C ur t je
- hu-1 i A104
Yes_ No
Condition of
Vegetative Cover
(Grass, Trees)
Did Dike Overtop? Yes No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? _% _ Yes No
Engineering Study Needed? Yes No
Is Dam Jurisdictional to the Dam Safety Law of 1967? Yes No
n f (}
Other Comme is i r a" l^ c r �y ��" Y so
ec, r
r
d far^ pre f- 0
n c j

r;
?0

f
version -).9.99
DAQ Animal Odor Complaint Form
All information needs to be completed in order to assess the complaint as it pertains to regulation
2D.1800. Since 2D.1800 objectionable odor complaints are based on a known location, anonymous
complaints must give the exact location of where the objectionable odor has been smelled.
Explain to complainant that this information is necessary to process the complaint.
PLEASE write neatly, this form will be part of the complaint record
D£NR Representative: � _ _ Division: Location: Wilt©
Date Rec'd.: `f" Zz 9 Time Rec'd.:� ��—
(While on the phone, use -Street Atlas and directions from the caller to find the exact
location of complaint. Verify the locatim found on the map by describing nearby roads
and terrain features to complainant. In Street Atlas, place a LatlLong map note by right
clicking the mouse at the verified location.)
OI1
/``
Latitude `� t 31 Longitude -7- p`t Sc`
circle one
Is the odor occurring right now? n b If yes,how strong : (noticeable, offensive, unbearable)
(download weather-Nm http://weather-noaa.gov/weather/currenVKELM.htinl or
from http://tgsv7.nws.noaa-gov/weather/current/KILM.html and attach to thisform..)
If the odor is not occurring right now, when was the last occurrence? Daze: &191i'v rime
{If the occurence was within the last 24 hours .download from web. If the occurence was greater than 24
hours ago print file from s: lagslweatherl and attach to form.)
Complainant Information '/ /fin
Name (Last, First) :
Address 1 : 9I 1-Street/Location of Observed Objectional Odor
Rp2 Aiez 4 9,4 , ie.;�
City : 4ief 11 A C C__y - Zip
Address 2 : Mailing
City : Zip
Phone: Home _C�ld) Zf- 33C Work
Type of dwelling/location from which complaint originates:
(house,, church, business, park, etc.)
Specific Complaint for this Day:
(r, rative. be � e ifi " posy' e if ditional information is gi Ten) uf4 � A

Regional Animal Odor Complaint Form, pace 2
Further Complaint Details :
circle one
How long have you lived / worked at location ? Pa4rS
Do you suspect one particular animal farm?
.If yes: Do you know the owner's name ? a6b �h or•��- .
Do you ow the owner's address?
R 'c"t-
Tvne suspected animal oneration-
wine
ou _ -
cattle
dairy
other
fat rrt a e u
Do you know the owner's phone#?L 1
Wha�ccurring to cause These odors: circle all that apply =
praying ' 0CC vr•S :
When did spraying start?When did spraying end?
ttter Land Applicatlo
When was litter. applied? Qt When was litter plowed in? tYLr s
ind from Particu ar irection
'Indicate Direction N, NE, E, SE, S, SW; W; NW -CA 4n
Lagoon Turnover / Weather Event
Sudden temperature change? Recent Rain/Hail/Sleet?.
Close proximity to Animal Houses
Can you seethe houses from your property?, Z C
Close proximity to Lagoon
Can you see the lagoons from your propertyless 2 ��
Close proximity to Spray fie]
Can you see the spraying from your grope S�
Other .
A
Other
-
i -
How often does objectionable`odor occur : _'�eeG d� S 0,1
• x '"_' . At what times does the objectional'odor occur most often
Under what weather conditions does odor occur Ca4l 7
3 Current Weather conditions
Temperature Humidity Apprx Rainfall over the last few days
Wind direction Wind Speed " T
i Explained the Process in Handling These Complaints:Ye / No
.'
y
is Complainant willing to do Logbooks? Ye / No: F r'
Other Cohiments.. , ..
Regional Office Post-Ca11 Check
Im
1. Did complainant claim health effects? Gy no; if yes then copy and send faun to Env. Health
=2.'Did they have water Quality concerns? (!a/ no'; if yes then copy and send form to WQ O
(such as spills, runoffs, smells in creeks, evidence of drift on property, etc.) (�~
3. Was Complaint added to the DAQ Animal Odor Database? initials 1 dale
cc: DAQ Central Files via Technical Services Section

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ttl r_nt 1� �alie�r Condition, - 11 ilnEin...national Airport NIC:. Uniled ~hies
hrtp:rl«•�atiicr.nuaa.�o.�ru_ai6�r.::urreni.�1�1l.Al.iztnt
Main Page
Current
Conditions
- in the United
States
- world wide
Forecasts
Watches and
Warnings
Coned
Observubons
FAQ
Glossary
1 of3
Current Weather Conditions
Wilmington, New Hanover International Airport, NC, United
States
(KIl_M) 34-16-06N 077-54-22W 9M
Conditions at _Apr 19, 1999 - 06:53 AM EDT
1999.04.19 1053 UTC
Wind
Calm
Visibility
10 mile(s)
Sky conditions
mostly clear
Temperature
48.0 F (8.9 C)
Dew Point
43.0 F (6.1 C)
Relative Humidity
82%
Pressure
30.16-in. Hg (1021 hPa)
(altimeter)
ob
KILM 191053Z 00000KT 10SM FEW035 09106
A3016 RMK AO2 SLP211 T00890061
Maximum and Minimum Temperatures
Maximum Minimum
Temperature Temperature
F (C) F (C)
61.0 (16.1) 46.0 (7.8)
In the 6 hours preceding Apr 19, 1999 -
01:53 AM EDT 1 1999,04.19 0553 UTC
68.0 (20.0) 45.0 (7.2)
In the 24 hours preceding Apr 19, 1999 -
12.-53 AM EDT 1 1999.04.19 0453 UTC
24 Hour Summary
Time EDT
Temperature
Point
Pressure
(UTC)
F (C)
F (C)
Inches (hPa)
Latest 7 AM (")
Apr 19
48.0 (8.9)
43.0 (6.1)
30.16 (1021)
6 AM (10)
Apr 19
50.0 (10.0)
44.1 (6.7)
30.15 (1020)
5 AM (9)
48.9 (9.4)
44.1 (6.7)
30.14 (1020)
4 AM (8)
Apr 19
46.9 (8.3)
43.0 (6.1)
30.14 (1020)
Wind Weather
MPH
Calm
Calm
Calm
Calm
4/19/99 7:36 AM

u r"il Wcziliw tnndiliozi: - Witmin...nalional Airport. %C_ Unil�d tilar��
ht31�:I;ti�Catit�r.noaa,gor;��c;ath:r,cu;r�nt't�f':.; :.ii::r�
3 AM (7)
Apr 19
46.9 (8.3)
42.1 (5,6)
30.15 (1020)
Calm
2 AM (6)
Apr 19
46.9 (8.3)
43.0 (6.1)
30.16 (1021)
Calm
1 AM (5)
Apr 19
48.9 (9.4)
44.1 (6.7)
30.18 (1022)
Calm
Midnight
(4) Apr 19
51.1 (10.6)
43.0 (6.1)
30.17 (1021)
Calm
11 PM (3)
Apr 18
51,1 (10.6)
43.0 (6.1)
30.17 (1021)
Calm
10 PM (2)
Apr 18
52.0 (11.1)
41.0 (5.0)
30.16 (1021)
Calm
9 PM (1)
Apr 18
54 0 (12 2)
41.0 (5.0)
30.14 (1020)
Calm
8 PM (0)
Apr 18
61.0 06.1)
35.1 (1.7)
30.11 (1019)
WSW 5
7 PM (23)
Apr 18
64.9 (18.3)
33-1 (0.6)
30.1 (1019)
WNW 10
6 PM (22)
Apr 18
66.9 (19 A)
33.1 (0.6)
30.08 (1018)
WNW 10
5 PM (21)
Apr 18
66 (19)
33 (1)
30.07 (1018)
W 14
4 PM (20)
Apr 18
68.0 (20.0)
34.0 (1.1)
30.08 (1018)
W 18
3 PM (19)
Apr 18
66.9 (19.4)
33.1 (0.6)
30.09 (1018)
W 14
2 PM (18)
Apr 18
66.0 (18.9)
33.1 (0.6)
30.1 (1019)
W 17
1 PM (17)
Apr 18
66 (19)
33 (1)
30.1 (1019)
WSW 16
Noon (16)
Apr 18
64 0 (17.8)
33.1 (O.B)
30.13 (1020)
W 16
11 AM (15)
Apr 18
60.1 (15.6)
32.0 (0.0)
30.13 (1020)
W 12
10 AM (14)
Apr 18
59.0 (15.0)
34.0 (1.1)
30.12 (1019)
WNW 9
9 AM (13)
Apr 18
55.0 (12.8)
34.0 (1.1)
30,12 (1019)
W 12
Oldest 8 AM (12)
Apr 18
48.9 (9.4)
35.1 (1.7)
30-11 (1019)
W 6
EDT Time
Temperature
Pont
Pressure
Wind Weather
(UTC)
F(C)
F(C)
inches(hPa)
(MPH)
The information presented here is taken from products produced by the U.S. National
Weather Service and other national and international agencies. The U.S. National Weather
Service does not present this as official information. Please refer to our disclaimer for further
information.
Welcome Seamh NWS FAQ Feedback
._ ...................... ............................................................---------._...._.------..._....._...........__._......_._.......... -........... -....... --- ........... -....... -............... -.......... --..... ..................................
Author: Allan Darling, NWS Office of Systems Operations
2 of 3 4/19/99 7:56 AM

Curr.n[ 1k conditiou�z - WilnIin... na[ional Airport. N'C. Uni[ed ti[atc:; lrup:r:L+Ca[iier.noaa.Lo%'iN%,eathzr:;:urren►'Kil.;�i.l:in,.
National Weather Service
i'
3 of 3 4/19199 7:56 AM

C;UMM1 W eathzr Conditions - Wittnin-..natiunal :airport- NC:. United State:
hn�a►ccath�r.nuaa� v►:►�cat] caCK!1_Ni.;�
Main Page
Current
Conditions
- in the United
states
- world wide
Forecasts
W=hes and
Warnings
Coded
Observations
FAQ
Glossary
Current Weather Conditions
Wilmington, New Hanover International Airport, NC, United
States
(KILM) 34-16-06N 077-54-22W 9M
Conditions at Apr 20, 1999 - 07:53 AM EDT
1999.04.20 1153 UTC
Wind
from the SSW (200 degrees) at 9 MPH (8 KT)
Visibility
10 mile(s)
Sky conditions
mostly clear
Temperature
62.1 F (16.7 C)
Dew Point
54.0 F (12.2 C)
Relative Humidity
74%
Pressure
30.02 in. Hg (1016 hPa)
(altimeter)
_
Pressure
0.01 inches (0.4 hPa) lower than three hours ago
tendency
ob
.KILM 201153Z 20008KT 10SM FEW080 17112
A3002 RMK AO2 SLP166 T01670122 10167 20128
.56004
Maximum and Minimum Temperatures
Maximum Minimum
Temperature Temperature
F (C) F (C)
62.1 (16.7) 55.0 (12.8)
73.9 (23.3) 46.0 (7.8)
24 Hour Summary
Time
EDT
(UTC)
Latest 8 AM (12)
Apr 20
7 AM (11)
Apr 20
In the 6 hours preceding Apr 20,- 1999 -
07:53 AM EDT 11999.04.20 1153 UTC
In the 24 hours preceding Apr 20, 1999 -
12:53 AM EDT 11999.04.20 0453 UTC
Temperature
Dew
in
Pressure
Wind Weather
F (C)
F
Inches (hPa)
MPH
62.1 (16.7)
54.0
(12.2)
30.02 (1016)
SSW 9
57.0 (13.9)
(1.0)
30.03 (1016)
SSW 8
1 of 3 4/20/99 8:22 ANI

C:urrenl Weather Condition? - WRmin...nalional Airport. NC. United titatc�
httl):/,Weathcr.noaa.tLn.vweathtricurrL!nt'KII-N;.htFu
6 AM 0(10) 55.9 (13.3)
Apr 25
(10'6} 1.
30.03 (1016)
SW 8
AM (9) 57.0 (13.9)
51(1 0..1
30.04 (1017)
SW 8
4 AM (8) 57.0 (13.9)
53.1�
30.04 (1017)
SW 6
3 AM 0m 59.0 (15.0)
54.0
4. 2)
30.05 (1017)
SW 8
22 AM (6) 59.0 (15.0)
12 2)
30.07 (1018)
SSW 8
11 AM0(5) 57.0 (13.9)
Apr 2Midnight
(210)
30.08 (1018)
S 5
Apr 20 57.9 (14.4)
52.0)
30.09 (1018)
SSW 4
111 P 9 (3) 59.0 (15.0)
5 .0
. 30.09 (1018)
SSW 6
10 P 9 (2) 60.1 (15.6)
50. 0)
30.09 (1018)
SW 8
PM (1) 62.1 (16.7)
Apr 198
(8-9)48.0
30.09 (1018)
SW 9
PM �(0) 64.0 (17.8)
6.1
30.07 (1018)
SSW 11
77 PM (23) 66.9 (19.4)
Apr 196
44.1
'.1
30.06 (1017)
SSW 10
PM (22) 70.0 (21.1)
Apr 195
45.1
30.05 (1017)
SW 12
PM�(21) 71.1 (21.7)
Apr 144
{1.0 .
30.04 (1017)
SW 13
PM�(20) 73.9 (23.3)
32 8)
30.06 (1017)
WSW 14
3 PM (19) 73.9 (23.3)
Apr
37,0)
30.08 (1018)
W 10
22 PrM�(18) 71.1 (21.7)
3 .1
30.1 (1019)
Variable
1 PM917) 71.1 (21.7)
Apr 1Noon
��)
30.12 (1019)
W 11
06) 70.0 (21.1)
Apr 1911
36.0
30.14 (1020)
WSW 13
AM (15) 69.1 (20.6)
Apr 19100
39.0
3 9)
30.15 (1020)
WSW 14
AM (14) 66.0 (18.9)
4 )
30.16 (1021)
Variable
Apr 19Oldest
99 AM (13) 62.1 (16.7)
Apr 19EDT
4 3
30.16 (1021)
Variable
Temperature
Prime ort
Pressure
-Wind Weather
(UTC) F(C)
F(C)
Inches(hPa)
(MPH)
The information presented here is taken from products produced by the U.S. National
Weather Service and other national and international agencies. The U.S. National Weather
Service does not present this as official information. Please refer to our disclaimer for further
information.
Welcome Such KWS FAQ Feedback
2 of 3 420/99 8:22 AM

Current Wcatiter Condition: - WIhnin...nationa3 .airport_ INC:. United State:
I) tpartc--all`KIL-MAJIISn
....... .....
Author: Allan Darling, NWS Office of Systems Operations
National Weather Service
3 of 3 4/20/99 8:22 AM

Division of Soil andVVa#Review' Conservation -,Operation- .-j _
Division of Soil and -Water Conservation Compliance )inspection
Division of Water Qn"aldy .Compliance 'Inspection,A
ther Agency, Opetation:Rev�ew,. r ,.
0 Routine Q Cum laint O Follow-uE of DW2 inspection Q Follow -tip of DSWC review Other
Facility Number Date of Inspection
Time of Inspection
[3 Permitted [3 Certified [] Conditionally Certified © Registered 0 Not Operational
"L Farm Name: .....c,, .._...-�4�U��a.�_.......1.... Cm ............................ County: ..........
Owner Name:..........�1-...L lib�Q,r.......................................................... Phone No:..........
Facility Contact:_................................."...................
Mailing Address: ......................................................
Onsite Representative: ........................................
Certified Operator: ..........................................
Location of Farm:
........ Title:
24 hr. (hh:mm)
Last Operated: ................
1,
Phone No:
................................... ......................................... ..... ......... I ........ ...
............................ Integrator: .....we r..................
........................... Operator Certification Number:,,
A
........................................................................ ....................... .............. ........................................................................... ................. ............ ....................................... I........
Latitude ' 4 •4 Longitude • 6 is
' - Design Current -` jDesigri Current Design Current
Swine Ca achy Po ulation Poultry` ,Capacity Population Cattle Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
1Nutnber of.Lagoons - ❑Subsurface Drains Present ❑Lagoon Area ❑ Spray l+ieid Area
Holding Ponds / Solid Traps 10 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ,
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: s,
... .
Freeboard (inches): ........... ................... ............�....................................................-....---........._........._...... ...........................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
[:]Yes [:]No
❑ Yes ❑ No
❑ Yes ❑ No
1KYes ❑ No
Structure 6
❑ Yes ❑ No
Continued on back
3/23/99

111*iciliiy Number: — 1LA Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
`-�—=- �--I
❑ Yes
1:1 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)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency? i.
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
yiolatioris:or• def ciencies mere noted• during 4bis:visit: • Voii wit... Rio further
. .....
corres orit�ence: abauti this .visit:
❑ Yes ❑ No
[]Yes ❑ No .
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Eomnents (refer to question #): Explain anyanswers and/or any recon;mendations or any other comments: °,-
- _ -
Use=drawings of facility #a better explain situations (use additional pages as necessary):
`
# 1 dbw� -� �q A
VA b mid-0c,66er-
SVr &Y rtcoyots Cwrr4.
Reviewer/Inspector Name " - ,
l-za
Reviewer/Inspector Signatu Date:
3/23/99

Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
Lagoon Dike Inspection Report
r
P P
-
S l o 14,- Po /4-o f ,, 13 < L /C
LA L AYU /o (?S- 37)
Names of Inspectors
Structural Height, et Freeboard, Feet
Lagoon Surface Area, Acres
Upstream S1ope,xH: IV
Embankment Sliding? Yes
(Check One, Describe if Yes)
M
Seepage? Yes No
(Check One, Describe if Yes)
Erosion? Yes No
(Check One, Describe if Yes)
Condition of
Vegetative Cover
(Grass, Trees)
Did Dike Overtop?
Top Width, Feet
Downstream Slope, xH: I V
Yes No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? Yes No
Engineering Study Needed? Yes No
Is Dam Jurisdictional to the Dam Safety Law of 1967?
Other Comments
Yes No

t
i'��
''
�,i
`�
�,� � �
}
. s� `�
� �- s� o
�� � �
�� � _
{� .,
i,:�.` '
.._ : �:4,.. ,. ..

Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
Structural Height, Feet
Lagoon Surface Area, Acres
Upstream Slope,xH:lV
Embankment Slitting?
(Check One, Describe if Yes)
i..,-Elf- ---
wh IOU
a Names of Inspectors
Freeboard, Feet I -
Top Width, Feet
+ f
_ Downstream Slope, xH:1 V
Yes No
Seepage?
(Check. One, Describe if Yes)
Yes 2_ No
- -
A � � ► ' e
Erosion?
(Check One, Describe if Yes)
Condition of
Vegetative Cover
(Grass, Trees)
Did Dike Overtop?
Yes _ No
{l e, V c 60 J /„ I t 0 rhfjJ A /'I` e
Follow -Up inspection Needed?
Engineering Study Needed?
Yes %� No If Yes, Depth of Overtopping, Feet
Yes No
Yes )LNo
Is Darn Jurisdictional to the Dam Safety Law of 1467? Yes No j
Other Comments
o Jcr o yr i cr
-C L 0
�a

7ZI

r
LZ5ot�) A
Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
ToAy
0- -C
sprectioWl�eport
O (G/ �"r.rr�.
i
Structural Height, Feet L% ��
^_ Freeboard, Feet 1d
Lagoon Surface Area, Acres P t3 -- I Top Width, Feet _ !
%j
3 ly j
Names of Inspectors
Upstream S1ope,xH:1 V Downstream Slope, x1l:1 V
Embankment Sliding? Yes No
(Check One, Describe if Yes)
Seepage?
(Check One, Describe if Yes)
Erosion?
(Check One, Describe if Yes)
Condition of
Vegetative Cover
(Grass, Trees)
Did Dike Overtop?
Follow -Up Inspection Needed?
Engineering Study Needed?
�
Yes X No P05C,'�Ia j I C,� ✓�t P
�y.f5u�
Yes ' ( No
Yes / , No If Yes, Depth of Overtopping, Feet
Yes No
Yes No
Is Darn Jurisdictional to the Dam Safety fL�aw of 1967? Yes No
Other Comzne is I C a- 1 < < f �v err-s Y :l
Other Cornrne�ts
r� 4
� �f� C ��� ram+ , NQ2 C� �c� <IIC'�i�•� c� r ��
�P�p✓crJ� Ra�SnS
d�fror^
cv<'S v �ir_ ► � pr-F C �P- Tj
s r d

t,,

Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality
ij! Routine O Complaint O Follow-up of DWQ inspection O Follow-up o f DSNVC review O Other
Date of Inspection
Facility Number
Time of Inspection r! 6 24 hr. (hh:mm)
0 Registered JWCertified [3 Applied for Permit JgPermitted 10 Not Operational I Date Last Operated:
FarmName: ..................&b�..I..�....lskah�.........�nu.............................................. County:.......�t,��+.!..................................--- ..........
Owner Name: ........ ....................... t 4........................................... Phone No:...� `t �o�?.t i --.. �. ?` .................
Facility Contact . .............................................. . Title:................ ....... Phone No:
Mailing Address: ............. �.. ... ........................... 6.&.........
Onsite Representative: ...............U.P........5W.c+'r ........................................... ... Integrator:......1. .. ..................................................
Certified Operator: ................................................... .......................... .................................... Operator Certification Number ...... .......................
Location of Farm:
............. ....Q.V .......5W.t..... ok.... Siz . a-.7.3l��S...z-�ilt.5....4?.��Y................. ............... ............................ I ......... .................
.................. . .. .--------...------...---- _ ............. I.............................rV
..........................................................................
Latitude =0=` 0" Longitude • =° =11
I3esrgn �..Cur'rent
x
Desikn :,Current:,
Destgn 'Current
Somme Capacity Population
Poultry
Capacity Population Cattle
Capacity Population r
❑ Wean to Feeder
❑ Layer
❑Dairy
Feeder to Finish LE
I ❑ Non -La rl
1 , ❑ Non -Dairy
❑ Farrow to Wean
j-
,: ❑ Farrow to Feeder
❑Other
❑ Farrow to Finish
TOW Design Capacity
' ❑ Gilts
A
❑ soars
:Total=SSLW
Number of Lagoons !Holding Ponds '
Subsurface Drains Present
❑ S
agoo
❑ L n Area
ield Area
❑Spray Field ri
71 m
_
,
❑ No Liquid Waste Management System
General
1.
Are there any buffers that need maintenancelimprovement?
❑ Yes
® No
2.
Is any discharge observed from any part of the operation?
❑ Yes
® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
® No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
fR 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
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
No
5.
Does any part of the waste management system (other than lagoons/holding ponds) require
Yes
❑ No
maintenance/improvement?
6.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
(4 No
7.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
QQ No
7/25/97

s
Facility Number: 3 --
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes No
Structures (Lagoons.Holding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: .................i................ ......................._.........................._............................_..........................._.................._...._...
...................................
Freeboard(ft):.............. 14............ ...............3:7, ..........................................................................................................................................................
10.
Is seepage observed from any of the structures?
❑ Yes
® No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
(i No
12.
Do any of the structures need maintenance/improvement?
'p Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
® No
(If in excess of W(MP, or ruunoff entering waters of the State{, notify DWQ)
15.
Crop type . !.ttl t............... S.scv4-.................smA�.....iyxim...................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
r'mNo
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
No
18.
Does the receiving crop need improvement?
❑ Yes
No
19.
Is there a lack of available waste application equipment?
❑ Yes
® No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
(A No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
99 No
22.
Does record keeping need improvement?
$1 Yes
P;No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
[4 No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
P No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
(JA No
0•No'violations-or. deficiencies. were- noted,during this.visit.- You,wvill receive•ino-ftirilier :
correspQndeuce about this'visit:- : - .: ::: .
Co"�.Av& CAe r\.;'�s V� s" �'6"
# [ W�. C'Wl i+' ta"k .
t z__ Co,, itjtme e-RyAm nni, W&'tls 0+ ("Tar, .
7/25/97
•
Reviewer/Inspector Name
Reviewer/Inspector Signature: ��_� `�_, Date:

Routine
of
Facility Number 31 141
© Registered ® Certified [a Applied for Permit ® Permitted
Ilow-up of DSWC review O Other
Date of Inspection 1121198
Time of Inspection i6U0 24 hr. (hh:mm)
113 Not Opera Date Last Operated:
Farm Name: Upbby.Shalar.Eamn.................... County: Djapliut....... ......................................... [�'.Ui.Q -
OwnerName: Upbby...................................... Sholar.......................................................... Phone No: 285.-.3979........ -..........................................................
Facility Contact: BQbby..Sb.(daft................................................. Title: .0yme1:................................................. Phone No:...................................................
Mailing Address: SQX. ]agQlal.l .U1'...................................................................... 1...allace..�!iC.........._................... ....................... 2 4trZO..............
Onsite Representative:J$oblby.5holar............................................................................. Integrator: h1=blyFAmAyFa=...................... . ..................
Certified Operator: R.Qhby.M............................... Sbobx............................................... Operator Certification Number:1814.6 .............................
Location of Farm:
Latitude 34 • 44 ° 12Gi Longitude 77 • 47 6 52
Design Current -Design Current _. _- _ Design Current
Swine Capacity Population
Poultry ^
=Capacity Population"., ,Cattle
Capacity Population -.
❑ Wean to Feeder
❑ Layer
❑Dairy
® Feeder to Finish
4896
JE1 Non -Layer
I
Non -Dairy
Farrow to Wean
Farrow to Feeder
JEI Other
LTF�an_owto Finish
-TotalDesign:Capacity
4,896
(jilts
Total SSLW
660,960
LJ Boars
.Number of Lagoons./ Holding Ponds 2 ; ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
❑ No Liquid Waste Management System -
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
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed; did it reach Surface Water? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If 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 ❑ No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes [:]No
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 ❑ No
7/25/97 Continued on back

(Facility Number: 31-141
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes ❑ No
Structures (Lagoons,Holding Ponds Flush Pits. etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate? ® Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: ..........9malrl............ ....... .tar.......................................................................
Freeboard(ft):.............. 13.3 .............. .............. LOS............. ................................... ............................... ..... ...... ..............................
........... ..........
...............
10. Is seepage observed from any of the structures?
❑ Yes
❑ No
11..Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
❑ No
12. Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
❑ No
Waste Application
14. Is there physical evidence of over application?
❑ Yes
❑ No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type..........................................................................................................................................................__...............................................................--••---•
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
❑ No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
❑ No
18, Does the receiving crop need improvement?
❑ Yes
❑ No
19. , Is there a lack of available waste application equipment?
❑ Yes
❑ No
20. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
21, Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
22. Does record keeping need improvement?
❑ Yes
❑ No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
❑ No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
❑ No
No.violations:or deficiencies.were-noted Anring� this :visit. Nou_ will receive no further
correspondence about this visit.: ...............
done as a follow up for freeboard. Notice of Referral will be sent to DWQ-WiRO due to lack of adequate storage.
7/25197
Reviewer/Inspector Name John M
Reviewer/inspector Signature:
Date:
Farility Nmimhwr' i1-141 nl #a nrincnanann 1191io—

Facility Number
Farm Status: Registered ❑ Applied for Permit
Certified ❑ Permitted
Date of Inspection
Time of Inspection 24 hr. (hh:mm)
Total Time (in fraction of hours
(ex:1.25 for 1 hr 15 min)) Spent on Review U
or Ins eetion includes travel andprocessing)
❑ Not Operational Date Last Operated: ... ..._..... _ .._... ... .......
FarmName: .. lYsQ LCC...�..... `�1�✓k:4 _ .. _........ __.........._ County:...... ..._ W.... _................._ .
Land Owner Name: _ .. Olfa . _ _. _.....__..... ............... _........ Phone No:
Facility Conctact: ga16�...... Sfk r.AaC..... ....M....... Title:—.0.d)17uZ.... ..._.... ...... Phone No: ` � ...............
Mailing Address: %...��L�,,EpIl+... ��,,tt }}.. �LI.�......... _.. �..... .._ ..... _ .... �?�ill..� .... ..... _.. �a.._.... ... _......
Onsite Representative:...) .... ...... ...... ......... _......... Integrator: __ u
Certified Operator:.....II�1]]�.... ��1�p 1�............................ _.... » .. Operator Certification Number: � .... _....� .
Location of Farm: I
715 ... ..4
Latitude �•�` L�.J" Longitude ©• �6
TvDe of ODeration and Design Capacity
=�Desi n Current -Des[ Current F-Des� n ,: Current
Swine g .x aS�"�g ,
elation ; Poultry �> a Ca' act P0011
lahon' � Cattle � .Ca act Po ulafion
❑ Wean to Feeder❑ ❑ Dairy
Feeder to Finish ¢ ❑ Non -La er ❑ �� Non Da
Farrow to Wean�� t�rtx. _�NO
z �5.
Farrow to FeederTxta� Design-Capacpy�:
Farrow to Finish� �
�� ❑Other ,� � � . � � �� ,�� � � E � . � ..�,
k'Number ofL vans /�Holdtn Ponds ❑ Subsurface Drains PresentMg ;I
k
€ i wrc a ❑ Lagoon Area � ❑ Spray Field Area
�. ., ..max
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water`? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes Q No
❑ Yes 6& No
❑ Yes It No
❑ Yes EA No
ILA
❑ Yes F4 No
❑ Yes Eallo
❑ Yes R No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenancelimprovement?
4/30/97
q Yes ❑ No
Continued on back

Facility Number: .•.3�....-•—....1..�._
"r 6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 10No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes 5§-No
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
f4 No
StructureslLa;oons and/or Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Yes
❑ No
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
zf.... .....�. �. ,- ..... ......... :.............. ..... .....
........
.... ... .
10. Is seepage observed from any of the structures?
❑ Yes
,aNo
11. Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
No
12. Do any of the structures need maintenance/improvement?
® Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
01 No
Waste Application
14. Is there physical evidence of over application?
❑ Yes
)A No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type _...5�. �QltC1t1�.............. ......... ........ ...... ........ ...'. ............. ...............
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
No
17, Does the facility have a lack of adequate acreage for land application?
❑ Yes
No
18.
Does the receiving crop need improvement?
❑ Yes
NJ No
19.
Is there a lack of available waste application equipment?
❑ Yes
No
20.
Does facility require a follow-up visit by same agency?
Yes
❑ No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
ftr!CeEdfied
jEacilities
22.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
No
23.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
P No
24.
Does record keeping need improvement?
❑ Yes
q No
Comments _(refer to question #� Explain`any YESanswers and/or, any recommendations ar any_ other comments
Use drawings of facility to better explain situations: (use addjtiona_! pages as necessary) - n � � ,�`,, �, ,�� �a
-
�raGeSS of Jevelo�t s Olds,
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Reviewer/InspectorSignature- j
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Date:
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cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97

Site Requires Immediate Attention: / V d
Facility No. 3
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS S VISITATION RECORD
DATE: �. , 1995
Time:
Farm Name/Owner:
Mailing Address:, 'K /
County: Dl/pI >n/
Integrator. _- ./ZZ
On Site Representative:
Physical Address/Location:
Phone:
Phone:
Q"TTFR� W
Type of Operation: ''Swine X_ Poultry Cattle
`/ Design Capacity: ci 16 Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: ' ' Longitude: 77 ° �' �" Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 ear 24 hour storm event
(approximately I Foot + 7 inches) Yes or No Actual Freeboard: ~�Ft. Inches
• Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or No
Is adequate land available fors y? Yes or No Is the cover crop adequate? Yes or No
Crop(s) being utilized: _ - I1A�rJq - -- _ - --
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwelling,s? es r No
100 Feet from Wells? es r 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 a state by man-made ditch, flushing system, or other
similar man-made devices? Yes No If Yes, Please Explain.
Does the facility maintain adequate w e management records (volumes of manure, land applied,
spray irrigated on specific 2 eage with cover crop)? Yes or No
Additio al Comments: C%1 �-� y r�G �/� u% - /q9 �� - -
0
cc: Facility Assessment Unit Use Attachments if Needed.

Site Requires Immediate Attention:
Facility No. _l 1- i y / R
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
Time: / a cx.
Farm Name/Owner: 13
Mailing Address:
County. 0 , rk-
Integrator: 14 10L ' Phone:
On Site Representative: Phone:
Physical Address/Location-
Type of Operation: Swine .' ✓
Design Capacity:
Poultry . Cattle
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 f 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) PorNo Actual Freeboard: __�_Ft. Inches
Was any seepage observed from the lagoon(s)? Yes or.No Was any erosion observed? Yes or No
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Yes or No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes 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 or No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No
Additional Comments:
Inspect r Name
Signature
cc: Facility Assessment Unit I Use Attachments if Needed.