310225_INSPECTIONS_20171231

NORTH CAROLIN
Department of Environmental Qual

Type of Visit: (q Cogt¢liance Inspection U Operation Review U Structure Evaluation U Technical Assistance I
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: rY i Arrival Time: ( r Departure Timer County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
(3re^• /l. -(-c`t'"(
Title:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
22D 2 z
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
La er
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
IFo9 V, 01
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
I) . $Onit , Ca aci_ P,o ,
Layers
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
I Beef Brood Cow
SWIRL,
01 Other
Turke s
Turkey Poults
Other
El
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes FNo
❑ NA ❑ NE
❑ Yes❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
Page 1 of 21412015 Continued

Facili Number: 1- jDate of Inspection: 18-71-71
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �Y?
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
Structure 5
ET'No ❑ NA ❑ NE
❑No ❑NA [3 NE
Structure 6
es No ❑ NA ❑ NE
❑ Yes EfrNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental reat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes 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 D`lTo'
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes j No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes 0<0
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes Oo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
es ❑ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes Q<o
❑ NA
❑ NE
the appropriate box.
❑ WUP El Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes o
[3 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?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes �Vo
❑ Yes ErNo
- ❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412015 Continued

Facility umber: 2 Z jDate of Inspection
'7
24r Did the facility fail to calibrate waste application equipment as required by the permit?
❑Yes
N�o
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
H 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
Jo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
ETNA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes ❑' I% o ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes E No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes MNo ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes Zr�No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes LJ 'moo ❑ NA ❑ NE
Comments (refer to question"#): Explain any YES answers and/or any additional recommendations or any other comments. -
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Do' I el
MA UTAM Phone:
Reviewer/Inspector Signature:
:1
�� Date:
Page 3 of 3
21412015

Type of Visit: (d Co Hance Inspection U Operation Review U Structure Evaluation () Technical Assistance
Reason for Visit: (-3/Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: � County: J Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: ULNr MA. rd C IL
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
Phone:
Integrator:
Certification Number: 226 2,;,
Certification Number:
b. Did the discharge reach waters of the State? (If yes, notify D W 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?
Longitude:
❑ Yes OlNo
❑ Yes [—]No
❑ Yes [—]No
❑ Yes [—]No /
❑ Yes CJ o
❑ Yes Zo
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Facili Number: - Date of Inspection: n
Waste Collection & Treatment
4. IS storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
2f 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: I ACoW l t A lYfT6 !i
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes o ❑ 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 E2/No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes /No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 2 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?
❑ YesVNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ NA
❑ NE
acres determination?
/
17. Does the facility lack adequate acreage for land application?
❑ Yes W 'P"
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes L� No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage &Permit readily available?
❑Yes N
❑ 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 � /Nn ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes L�J ' V o ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes � ❑ NA ❑ NE
25. hs 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 Io ❑ 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 the 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 0<0 ❑ NA ❑ NE
❑ Yes .:21Vo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
N
YL_1 No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
(Comments (refer to question.#): ExplainanyYES answers and/or any additional recommendations or any other comments. ;I
Use drawings of facility to better explain situations. (use additional Dages as necessarv):..
Reviewer/Inspector Name:
Reviewer/Inspector Signatm
Phone:
Date:
Page 3 of 3

(Type of Visit: 0 Colttpliance Inspection O Operation Review () Structure Evaluation Q Technical Assistance I
Reason for Visit: 4J0 Routine Q Complaint Q Follow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: y Arrival Time: ® Departure Time: County: D C/ (, A.1 Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
OnsiteRepresentative: 13g-E&%T 0TirHC-1,I Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Certification Number: Z2
Certification Number:
Latitude: Longitude:
Swine
Wean to Finish
Wean to Feeder
Design Current
Capacity Pop.
4400 1
Wet Poultry
Layer
INon-Layer
Design
Capacity
I
I
Current
Pop.
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Feeder to Finish
6tfoa L-o-6
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Layers
Design
a_PAC_
Current
Pao
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turke Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
n)Jo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
1-1 Yes
u1f) o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[lJ No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 21412015 Continued

Facili 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
r
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: (A&OwA I (A&MN 7-
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): -3 2, 3 3
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 ZNo ❑ NA ❑ NE
❑ Yes [2fNo ❑ 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? ❑YesN ❑ 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 dNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes eNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes [2/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?
❑ Yes
gN�o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes �o
INo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes ❑ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes FZ 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. ErYes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections []Monthly and 1" Rainfall Inspections MFludge 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

Faciji Number: Z Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑Yes
No ❑ NA ❑ NE
25. IS the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
ZNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
�o
No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[dNo ❑ 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
M 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
E�/No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
dNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of<facility to better explain situations (use additional pages as necessary).
p c o c/o c S rA iC s 1,04 OD 0,( A.A 0 ro C( (-Or,(,, (Stir FA2 r�•. AS
(b(Eni b`FdD �C OCh t•, f"�►JTS�j 1JECo &Gr G01"t2E Cr
21 ,) S�vnG� SufzvEY RcPo2t3 Nei' w�.rf-I GZcc�r�ps. SFNo
Reviewer/Inspector Name: ) D (i i � f{a Q �J C LU
Reviewer/Inspector Signature:
Page 3 of 3
Phone: `ci i -Ph9
Date:
114/2 k 5

Type of Visit: 0 Co Hance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: outine O Complaint O Follow-up 0 Referral O Emergency O Other 0 Denied Access
Date of Visit: Arrival Time: Tl= Departure Time: County: Region:
Farm Name: - Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: Eauj_r i Y z± 166uy Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number: A)o � Z
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
La er
Design
Capacity
14011
Pop.
Desigu Current
Cattle Capacity Pop.
Da' Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
D , P,oul
Layers
Design
Ga aci
Current
P,o
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
s
Turkey Poults
10ther
jBeef Brood Cow
MIMITurke
Other
NJ Other I
`Discharges and Stream Impacts ,
1. Is any discharge observed from any part of the operation? ❑ Yes O/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 DWQ)
❑ Yes ❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes n �fo
[:3 NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes No
�J
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

lFacility Number: jDate of Inspection:
Waste Collection & Treat4ient
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: ( L / 0V
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):� Z_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
EZNo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
WNo
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 environmen I threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes VNo ❑ 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 dNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes EY4 ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes EZ/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? ❑ Yes [�jJo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes u1No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes E3�io
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes F�No
❑ NA
❑ NE
Required Records & Documents
ZZo
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
Qrfees
❑ 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 Inspections
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Faci i Number: - Date of Inspection: 1 -
24,Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
VNo
❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
[:]Yes
❑ NA
❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes No
❑ NA
❑ NE
Other Issues
ZN(
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
❑ 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
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
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?
to
of
Reviewer/Inspector Name:
on rrl: r xptam any x nb answers anwor any aam
better explain situations (use additional oases as
❑ Yes &" ❑ NA ❑ NE
❑ Yes 4L 11Vo ❑ NA ❑ NE
❑ Yes zwo ❑ NA ❑ NE
❑ Yes YJ o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
ons or any other comments.
Phone:C
Reviewer/Inspector Signature:
Page 3 of 3
Date:

Reason for Visit: (25 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I Arrival Time: Departure Time:County: Ji(XIa;N Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
OnsiteRepresentative: jj(Lc-KtV A/-�C44&_V Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number: Z202�
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Wet Poultry
La er
!Mayer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
DairyCow
Wean to Feeder
DairyCalf
k'
Feeder to Finish
.4 (plDd
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
I) , P,oul
La ers
Design
Ca aci
Current
P,o ,
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
I
Pullets
lBeefBroodCow
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 Ej No ❑ NA ❑ NE
❑ Yes [—)No
❑ Yes ❑ No
❑ NA ❑ NE
❑ NA ❑ NE
[—]Yes ❑ N9 ❑ NA ❑ NE
❑ Yes U 'N ❑ NA ❑ NE
[:]Yes No ❑ NA ❑ NE
Page I of 21412011 Continued

Facility Number: VUS Date of Inspection, 5 t J
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: tA6rm�j CA(,c*) V
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 1w Ifs
5. Are there any immediate threats to the integrity of any of the structures observed?
❑Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
O/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 environmenta threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [] No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes E3 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ YesZNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑- Evidence of Wind Drift ❑ Application Outside of Approved
Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
e
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Wo
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
Ef No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Fa/No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
Yes
❑ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. [-]Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V 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 :6 No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Fnoili Number: " ?i Date of Inspection,
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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:
❑ No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ❑ No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ❑ No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.* w
Use drawings of facility to better explain situations (use additional pages as necessary).
17.) L t CAT6 #15 n/E") CO C -((ti A"/d" i o w,jt rL 'A k-C C late{ �E�lv� Js
Reviewer/Inspector Name:
Phone: L,:II ' / I b
Reviewer/Inspector Signature:
Date: 15"
Page 3 of 3 f 21412011

Type,of Visit: t) Comp ance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: 0 outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time:® Departure Time:® County: QJk9tQ,/ Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
OnsiteRepresentative: aLkkj7- It -_-Trr,14LlA� Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Certification Number: l /-Lo ZZ/
Certification Number:
Latitude: Longitude:
Swine
Wean to Finish
Design Current
C>apacity Pop.
Wet Poultry
Layer
]Non -Layer
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Dai Cow
Dai Calf
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Q
Dc 2 P,oul_ ,
Layers
Non -Layers
DjFsi2--nn-1WK0urrent
C•aPa
P,o
Dai Heifer
D Cow
-Dairy
Beef Stocker
Gilts
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Ni Other
Turke s
Turkey Poults
10ther
Discharges and Stream Imoacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
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 L_V 0 ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes [:]No
❑ NA ❑ NE
❑NA ❑NE
❑ Yes ❑ N ❑ NA ❑ NE
❑ Yes N ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page l of 21412011 Continued

r�
IlFacilityNumber: ZS Date of Inspection. I Zi
Waste Collection & Treatment 2410
--�[ /_
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ L� Yes 10
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3
Identifier: ���.fr 6a&J l A&wN /
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): S7G_ 71s,
❑ NA ❑ NE
❑ NA ❑ NE
Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes ZNo ❑ NA ❑ NE
❑ Yes C�'/No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes CJ N ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes do ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
/
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
M o
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved
Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
to
❑ NA
❑ NE
acres determination?
/No
17. Does the facility lack adequate acreage for land application?
❑ Yes
�
❑ NA
❑ NE
IS. Is there a lack of properly operating waste application equipment?
❑ Yes
�o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
PNo
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall []Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 2�to❑ 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 permr ? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
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
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes
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
❑ Yes
❑ Yes
❑ Yes
o ❑ NA ❑ NE
[ No ❑ NA ❑ NE
❑ NA
❑ NE
'o
No
❑ NA
❑ NE
O/Nc
❑ NA
❑ NE
No
NA
NE
❑
❑
Cff'No
❑ NA
❑ NE
3/No
❑ NA
❑ NE
❑ Yes gv�
o
Yes
o
❑ Yes
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
(Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawings of facility to better explain situations (use additional pages as necessarv).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: D —IV
Date: i'kv
2 4/201

Type of Visit: U Cort Hance Inspection V Operation Review U Structure Evaluation Q Technical Assistance
Reason for Visit: R utine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: S` Arrival Time: Departure Time: E: +S County: D(JeU� Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
OnsiteRepresentative: g00t OnTCHeLU
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Phone:
Integrator•
Certification Number:
Certification Number:
Latitude: Longitude:
Swine
Wean to Finish
Wean to Feeder
Design Current
Capacity Pop.
Wet Poultry
La er
Non -La er
Design
Capacity
Current
Pop.
Design Current
Cattle Capacity Pop.
Da Cow
DairyCalf
Feeder to Finish
& L Tip
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
I-
Layers
Design
Ca aci_
Current
Po
Dry Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullers
lBeefBroodCow
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 dNNo ❑ NA ❑ NE
❑ Yes [:]No
[-]Yes ❑ No
❑ Yes [-]No
❑ Yes t❑ Yes
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 21412011 Continued

Facility Number: - Da[eotlns ection:
Waste Collection & Treatment
4.'Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes En No
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3
Identifier: cA6,sz�k (Ai >,
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ) S P
❑NA ❑NE
❑ NA ❑ NE
Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes [] No ❑ NA ❑ NE
❑ Yes E/No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑Yes Nl ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes LL 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 YX0
❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind 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
[ff No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
EYes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
—❑
I I1NO
"YY
❑ NA
❑ NE
acres determination?
N
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
ErYes
[!�No
❑ NA
❑ NE
the appropriate box.
[ tVUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements ❑Other.
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 2INo ❑ 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 ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - Date of Inspection,
24: Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes a
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes No
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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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?
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes 2) No ❑ NA ❑ NE
[—]Yes YNNo ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes [jNo ❑ NA ❑ NE
❑ Yes U'VO
❑ Yes f�No
❑❑ Yes F
Yes ❑ Yes
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
IUomments (refer to question if): Explain any YES answers and/or any additional recommendations or any otber comments.,+I
Use drawings of facility to better explain situations (use additional pages as necessary).`
IS ,� Si3-6 O�E6ns 1'UVVIOVE0 #JC__'40H0
� 0. J p��l✓ �wn/{� . 06 E OS 06 %J IkJ 1 , OTC �t ,, /p cT,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: 5 S
2/4/2011
J

Division of Water Quality
%' Facility -Number ZC) Division of Sod and *Water Conservation
r
Q,Other,Agency
Type of Visit 6 Co pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 0 Arrival Time: Departure Time: County: DUPLE% Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: �ZN� TGNFtt- Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: F-10
M, M„ Longitude: mom, M"
` `" _'_".,Design
�Gurren[„.,a Destgn .Current' "`'� Dw'uestgn„ Current _
$wme Capactt}
Populahoo :: Wet Poultry Capanty.
Cattle - i e"
Population„ te Capac ty
,
a T �PopulaHon
❑
Wean to Finish
❑ Layer
❑ Dairy Cow
❑
Wean to Feeder
I
❑ Non -Layer
I
❑ Dairy Calf
Feeder to Finish t(
"ADDairy Heifer
❑Farrow to Wean
❑ Dry Cow
❑Farrow to Feeder
Dry Poultry w
= ❑Non-Dai
❑ Farrow to Finish
❑ Layers
` ❑ Beef Stocker
El Gilts
',; ❑ Non -Layers
❑ Beef Feeder
El Boars
❑ Pullets
❑ Beef Brood Co
❑ Turke s
Other a s ❑ TurkeyPouets
�. h
;IH
❑Other
❑ Other
P
NumbofStructures wok
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No ❑ NA
❑ NE
❑ Yes
❑ No ❑ NA
❑ NE
0
❑NA❑NE
❑Y
❑ Yes
❑NA❑NE
KNo
El Yes
❑ NA
❑ NE
12128104 Continued

Facility Number: J — Date of Inspection 0
paste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: LA 6-060 1 GA (rIU01) Z
Spillway?:
Designed Freeboard (in): 22 Observed Freeboard (in): ` I .7�
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes e<o ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes ,.jNo
❑ Yes (=1 No
❑ NA ❑ NE
❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes E N El NA [I 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 9/No ❑ 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 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
❑ Yes
O'Nd ❑ NA ❑ NE
OJ No ❑ NA ❑ NE
D/No ❑ NA ❑ NE
tN ElNA ❑ NE
Cl NA ❑ NE
Comments (refer to question.#): Explain any YES answers and/or; any recommendation or any,other comments
Use drawings of facility to better explain situations. (use additional pages,as necessary):'
n)N(ep Me N64) CoC F60_M2T kati (SMEC, `
IReviewer/Inspector Name i L/u Phone: 0AoI
Reviewer/Inspector Signature: Date:
..,._ 1 _r 2 11 1212R700 Continued

Facility Number: 3 — S' Date of Inspection 1 /D
R auired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? nYes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have components of the CAWMP readily available? If yes, check Yes ElNo ❑ NA ❑ NE
the appropriate box. 1? ❑ Checklists ❑ Design ❑ Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
D o
❑ 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
ZNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
2No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
r No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
dNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
VNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
V No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
El Yes
,,���
o
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
E(No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
UNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
ElYes
7No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

31
Type of Visit (f coo9�pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit a Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ElDenied Access
Date of Visit: V o9 Arrival Time: Departure Time: County: L Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Owner Email:
Phone:
Onsite Representative: C-'N tIZO - I Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
Operator Certification Number:
Back-up Certification Number:
Latitude: 000'0« Longitude: 000, 0
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify D WQ)
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 VJ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
[;VNo
❑ NA
❑ NE
❑ Yes
IJ No
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility Number: �j — a�J Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure l Structure 2 Structure 3 Structure 4
Identifier: VACric vi l CA 4 0oN Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): a3
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
[]Yes INo ❑ NA ❑ NE
❑ Yes I.,G No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? VJ Yes El No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes L/J No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) ,_,(
9. Does any part of the waste management system other than the waste structures require ❑ Yes E No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [Z No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [;j No ❑ NA ❑ NE
❑ Excessive Pending ❑ 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
o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ZNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
ENo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
ElYes
E 1No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
eNo
❑ NA
❑ NE
4.) LA&06✓ MP 2 roc- E rJ S to Bc r", L. _(-DIRE PLACED . I ea use
5(r4 W t�Ehf AotJ6
s-?,mkr_o(- aC 41ra�1 FSCWS waut_� TJgPftotl� 'Let pf.
TA4 K k- q a V Vo P-- Gi.ER Tp-f- e
Reviewer/Inspector Name I I Phone: ( ` PVC i)/ rV '-/,$ )S�
Reviewer/Inspector Signature: Date: �eA6/05
Pnnn 7 or i
12128104

Facility Number: — Date of Inspection IV O
Rjuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ 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 V Rain Inspections ❑ Weather Code
❑ NA ❑ NE
❑ Yes L/J No
❑ Yes 2fNo
El NA ❑NE
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes L�I //No El NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes EJ-No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
EGNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
INo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
GNo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ENo
❑ NA
❑ NE
Other Issues
29. Were anv additional nroblems noted which cause non-comoliance of the nermit or CAWMP? []Yes [2(No ❑ NA ❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
E 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?
ElO Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
�
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
C,J No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
&No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
ONo
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Division of Water Quality
Facility Nurob¢r `31 - a Z$ Division of Soil and Water Couservanon
Q Other Agency
Type of Visit Coptpliance Inspection 0 Operation Review 0 Structure Evaluation 0Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Dateof Visit: I 4 %. aQ Arrival Time: Departure Time: County: 3)1JPL-M%% Region:
Farm Name:
Owner Name:
Mailing Address: _
Physical Address: _
Facility Contact:
Onsite Representative:
Certified Operator: _
Back-up Operator: _
Location of Farm:
Title:
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = ' = Longitude: Q o F--] ,
Discharges & 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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
C. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
N
[I NA
❑ NE
El Yes
,LT/
I�No
❑ NA
❑ NE
Page I of 3 12128104 Continued

. Facility Number: 3 - a S Date of Inspection r P
.Waste Collection & Treatment
r4.
Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes do
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: LA(,-aat-)
Spillway?:
Designed Freeboard (in): 1 Q. S Ici, .S
Observed Freeboard (in): i 4 ' J
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes ETNo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes O 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 El NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 2 o ❑ 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 El[
Yes ,I o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ffNo ❑ NA [I NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or ] 0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifi ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
<o
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
El-Ko
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
Q - o
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
EI No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
El Yes
No
❑ NA
❑ NE
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
7.� M&EP AS6W LAG-owJ M> M&R-5 4-0iZ &T�-i 1.t4&'VtJS. LAC,/ L `
14As ircees o(j w6St sxoc , 2r-_► A.XfC AND tjO TF-
Reviewer/Inspector Name d Phone: 0 79 -73'96
Reviewer/Inspector Signature: Date: t t c's.
12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes E31No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check El Yes k" No ❑ NA ❑ NE
the approprimte box. ❑ WUP ❑ Checklists ❑ Desi n g [:]Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EKo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes la ivo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
o
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
r
"lo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
Cl,<o
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
E tvo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ILNo ❑ NA ❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
2<oo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
B<o
❑ 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
td lV o
❑ 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
E3No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
,�/
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El Yes
Id No
TTT�
❑ NA
El NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
N
❑ NA
❑ NE
Page 3 of 3 12128104

I CJ Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation
r - - 0 Other Agency
Type of Visit (3
^Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ll/Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I
Farm Name: _
Owner Name: _
Mailing Address:
Physical Address:
Facility Contact:
Arrival Time: i 3 J Departure Time: County:
Onsite Representative: f+.1410u oUE
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feedei
Farrow to Finish
Gilts
Boars
Other
❑ Other
Title:
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: o Longitude: � °
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer ❑ Non -La et
Dry Poultry
Region:
Design Current
Cattle Capacity Population:
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
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 2/No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
El Yes
No
El NA
El NE
❑ Yes
��
L 'fNo
❑ NA
❑ NE
12128104 Continued

ti
Facility Number: Date of Inspection J t $
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
El Yes
,_,(/
d 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: L19 (rw a ( (.fi (sap w ✓-
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 34 31
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
dNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
L/I No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental th at, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
�o ❑ 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
ElYes
CTNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
lL YNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
ElfI Yes
,.YYYYYY,{/
No ❑ NA ❑ NE
❑ Excessive Pending ❑ 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
L5 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
ErYes
El No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
Id No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
Io
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
V No
❑ NA
❑ NE
IComments (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):
tS3 L,LM( u>ECDE) rWb $So t1ECp3 Tv Q(_ t2.t5"' 69, COWS ?2ES t`MT, 9LIr Atar of
360 Zw r%4 '{,
Sw./ fl 4,q"T)1( PAgc_o AWAY ?ADG. PAPCQAA9fLKX.tJ PIULb35 or CA)'b0tGt:W6_ nSE23itSP 'h
W-IR , Ar.,..>UAL XN V616-Mitq NfE73 co ATCO. 4UvOf.0 Cv_GmeTUkJ ALSO,
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Phone:
Date:

Facility Number: 3 ( — Date of Inspection t S s
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropimte box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
❑ Yes LI /No ❑ NA ElNE
ElYes ENo ❑ NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
Yes
❑ No
❑ NA
❑ NE
❑ Waste Applic tion El Weekly Freeboard [I Waste Analysis El Soil Analysis ❑ Waste Transfers
El Annual Certification
El Rainfall LI Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l"
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?
El Yes
�dNo
L'7 No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Ea14o
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
D,&o
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
dyes
❑ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
E o
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ErNo ❑ NA ❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
E3No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
E;Ko
❑ 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
�:Ko
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
��
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El Yes
2 No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
CJ 4
❑ NA
❑ NE
Comments and/or Drawings:
12128104

�. Qf Division of Water Quality /
•Facility Number 3 d S 0 Division of Soil and Water Conservation v/
-- - -- " --- — -- 0 Other Agency -
Type of Visit Co Hance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Oii Arrival Time: Departure Time: County: Q u' FL- 3 Region:
Farm Name: _
Owner Name: _
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
Onsite Representative: fy�Sy C4 CL U Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
Operator Certification Number:
Back-up Certification Number:
Latitude: OF--]' I I " Longitude: I I o I I` I I"
Design Current
Design Current
Design Cdrrent�"-'
Swine Capacity Population
Wet Poultry
Capacity Population Cattle
Capacity Populatiopw?
❑ Wean to Finish
. ❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
1 ❑ Non -Layer
❑Dai Calf
h�
© Feeder to Finish LA60
_
❑ Dairy Heifer
_ ❑ Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
�❑
' ElNon-Dai
❑ Farrow to Finish
Layers
E ❑Beef Stocker
❑ Gilts
❑ Non -Layers
El Beef Feeder
.
ElBoars
'' ❑Pullets
❑ Beef Brood Co'
-- — —
❑ Turkeys
—
—
Other
❑ Turkey Poults
,. ❑ Other I
Other
Number.of Structures
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes G?fNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes db ZoElNA ❑ NE
❑ Yes ❑ NA ❑ NE
12128104 Continued

Facility_ Number: —5
Date of Inspection sI ob
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: CA6PofJ Vk I 'FK 7--
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes 2rNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes ,t-)'No ❑ NA ❑ NE
El Yes LJ No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes d ❑ 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 d No ❑ NA ❑ NE
maintenance or improvement?
Waste Application {/
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes n No
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ZNo
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑NA ❑NE ,
❑ NA ❑ NE
❑ 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) 3E2h .yI�A C.G) S GO
13. Soil type(s) 000-f�dult_
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ NA ❑ NE
,�(�❑ ❑ NA ❑ NE
o ❑ NA ❑ NE
I�JfIlo ❑ NA ❑ NE
L�J No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):'
at,) GET A'"OL)gZ STC tC=-0 - NL"'�,JgEIL Fiww- ss- G2fei - 10J0 PLAC,
V3 JZC-Zoftw' M4'r a��E Faf�tar►I��wl, c62 � ra, tl ,
Reviewer/Inspector Name ( Fj+, ( Phone: ?tD -Kj,(, - -7
Reviewer/Inspector Signature: Date: 2-4 /OIO
Page 2 of 3 12128104 Continued

Facility Number: — Date of Inspection aL
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes dNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes G No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
,,(/_
CJ Y es
❑ No
❑ NA
❑ NE
❑ Waste Applicaflon El Weekly Freeboard El Waste Analysis [I Soil Analysis El Waste Transfers
El Annual Certification
❑ Rainfall Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1"
Rain Inspections [I
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
dNNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
LJ No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
dNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
3 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
Ef No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ICJ No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes El No ❑ NA ❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ETNo
❑ 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
El�
/
� 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
93 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
�o
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
Z�`No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit JVRoutine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: o eparture Time: County:
Farm Name: c�+�l�/Owner Email:
Owner Name: 4 ti�`-'r'' Phone: _
Mailing Address:
Physical Address:
Facility Contact: n� Title:
Q
Onsite Representative: _�94✓ 7-
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Other
❑ Other
Region: _(!/,. e/;�V
Phone No:
Integrator:-.-'q6e'W
Operator Certification Number:
Back-up Certification Number:
Latitude: a c = I = Longitude: = o = , = «
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
I' ❑ Non -Layer I
- - -- - - - -.
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: EZJ
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes /No []NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0
[I NA
[I NE
❑ Yes
No
❑ Yes
��El
ILl No
❑ NA
❑ NE
ElYes
�No
❑ NA
❑ NE
12128104
Continued

.il- C.I
Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes XNo ❑ 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?: AJ.9 Afv
Designed Freeboard (in): 19,5 1?,5
Observed Freeboard (in): -'3%i' J�
5. Are there any immediate threats to the integrity of any of the structures observed?
,(
❑ Yes Y� No El NA El NE
(ie/ large trees, severe erosion, seepage, etc.)
(,,,,,,������(((
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes No ❑ NA ElNE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ILI No El NA El NE
maintenance/improvement? /�/
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes IJJ 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) ✓�07K/714I0A�- ie CA-Afryt4_ (l Wz6e 1i1�{�
13. Soiltype(s) n%
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes V(No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes /�No El NA ❑ NE
16. Did the facility fail to secure and/or operate per the imgation design or wettable acre determination',[] Yes �No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes ,m,(No [I NA [I NE
❑ Yes /yJ No ❑ NA ❑ NE
47-
/��C'p20FQ 2i� �if� �fzCo2�5 ©n Cv`5�05�/�F X7 Gf- ST
�3 i✓cff�5 ��� boo.✓ ���o�n�-5 D.� zy'��o2 A
/�i✓.o �� �rFoe Gv-�-� �'`ZD.✓ �/s/ems Gdz>� 2�� �� per,, n��
Reviewer/Inspector Name Phone: YfAV/`Llvzf-
Reviewer/Inspector Signature: Date:

i Tl-
Facility Number: — Date of Inspection
Required Records & Documents /
19. Did the facility fail to have Certificate of Coverage & Permit readily available? El Yes Ld No ElNA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes P(No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ZNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste TransfersCls ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
PrNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
10
VNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
JZ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
9'No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
P NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�'No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
ElNA
ElNE
and report the mortality rates that were higher than normal?
!!!
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
El Yes
ry1
yJ No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�No
❑ NA
❑ NE
�� 0�� C,sn�o�5 /`l��F...� G,>r�or,� L�p��s. /�Fc��t�,>E,✓a
ZW �r
12129104

II � P Q D'viston of Sot? and Water Conservah_on
��- Q' Other Agency
Type of Visit pTompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit g)r4outine O complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: S/ O Twe:
Facility Number 3 a
O Not O erational O Below Threshold
Permitted 0 Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold
Farm Name: �fFf_:..`..._I\_r0.yy��..........._ County: ..�1.1...it.p�.Ln_................ _..._._........__._.......
nT' . 1 ......._._ r............1........._._
OwnerName:.Am ar..l.._.pC..e.L'y1.:.-f-_ �Ct)11�iac_arh Phone No: ................. __... _................
Mailing Address:
FacilityContact: ....... ........ _.............. _.................... __._...._._._ Title: ............... _..... .... ....... ....................... Phone No: ............... f� .._..._......
�j 1 /40cr j� -s --
Onsite Representative: nay!_ ytkln _t.-_.. _..... Integrator: _ -............._-- .............__.......
Certified Operator:-_ .......... -' /lE/J ( /► )2�tNF1L QILB S5o2 it
_...___ ..__......__ Operator Certification Number: _.__._....._. T
Location of Farm:
swine ❑ Poultry ❑ Cattle ❑ Horse Latitude =' =" Longitude =• =' =11
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 gallmin?
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
Struuctture/ I Structur 2 Structure 3 Structure 4 Structure 5
Identifier: .......... .1._........ _._... _.__ ..__ _._..._....___..... __.___.........._..._._._ .....______.......---- -.....
Freeboard (inches):
12112103
❑ Yes 0'go
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes do
❑ Yes ❑'go
❑ Yes ❑ i�o
Structure 6
Continued

Number, — /wo/
acil3t:�3 Date of Inspection
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
(�No
seepage, etc.)
6.
Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
XNo
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
7.
immediate public health or environmental threat, notify DWQ)
Do any of the structures need maintenancelimprovement?
[]Yes
PrNo
8.
Does any part of the waste management system other than waste structures require maintenanceliimprovement?
❑ Yes
m No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
�No
elevation markings?
//
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
A No
11.
Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
VNo
Hydraulic Overload Froze Ground ❑ and/or Zinc
❑ Excessive Funding ❑ PAN�InXA_2�
12.
�pper
Crop type A6':g !u/GIl ✓. Cam. �1'-)i /L�fEC� 1 f _�$✓7 ✓`�J'R�/��
13.
Do the receiving crops differ with those designated i the Certified Animal Waste Management Plan (C/AWMP)?
❑ Yes
FNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
9No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
No
16.
Is there a lack of adequate waste application equipment?
[]Yes
gNo
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes No
liquid level of lagoon or storage pond with no agitation? /
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes XNo
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes #No
Air Quality representative immediately.
-r P=
Commits (refer to neshon #) _Fzphun any � am�vees and/or.any reconiinendahons:or any.other rnmmwts. _
9
r
Use drawings of facdrty-to better ezphun siboaboas (axe addr6onal pages as.necessary) Field Co
- ❑ py ❑ Final Notes
93) -3/-31103 �PJZ4 �ST /�GGvRT
/1%07f5 ; gF�•t�c Gf'�}sp6/� �/ .���ay �ilgpy
f�A-Rm,�
Reviewer/Inspector Name T
Reviewer/Inspector Signature: Date:
12112103 Continued

64t-
FacHity Number: 31 —,alf Date of Inspection y
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available? ,t
(ie/ WIT, checklists, design, maps, etc.) ❑ Yes yJ No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes VNo
❑ 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?
❑ Yes
No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
n
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
Yes
/
(ie/ discharge, freeboard problems, over application)
❑
No
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
V(No
28.
Does facility require a follow-up visit by same agency?
❑ Yes
R�No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
PNo
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
Yes
❑ No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
J9, No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
Po
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes
No
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
/"No
❑ 120 Minute Inspections ❑ Annual Certification Form
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit
ddruonal CbinmentsTand/or Dravnngs _ =
AT2112103

Type of Visit )Z) Compliance Inspection CI Operation Review 0 Lagoon Evaluation
Reason for Visit Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number 2 5
Date ofVisit: (Z OZ Time:rO IOD�
Not Overational 0 Below Threshold
0 Permitted 0 C-errttified 0 /CoonnddiitionaRy /Certified [3Registered Date Last Operated or Above Threshold:
1 Farm Name: f O ��C / l' `Q� /-(� Z County: ) Vie U "\
Owner Name: Ne�Sah %li'1'Cy-� Phone No:
Mailing Address:
Facility Contact:
Onsite Representative:
Certified Operator: _
1 Title:
Phone No:
ttpp
Integrator: !)r Ljn u
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude =a =. =- Longitude 0. 0' =
°.
.Swine -. :..Ca
Design —Current Design ` Current ..Design -. Current
aciry --Population --Poultry -` Ca achy' -Population Cattle - Ca iacity `Pimitlation
❑ La er 3 Da
❑Non -La er Non -Dairy
❑Other-
Total Design Capacity
Total SSLW `
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of: Lagoons ,�: ❑ Subsurface Drains Present ❑ Lagoon Area ❑ S rav Field Ares
Holding Ponds7Solid.Traps" ❑ No Liquid Waste Management Svstem
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Sprav 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: % 2-
Freeboard (inches):
05103101
❑ Yes JR No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes,,CTNo
' Yes ❑ No
❑ Yes_,QNo
Structure 6
Continued

Facility Number. - ZZ rj Date of Inspection IZ
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes �fN0
seepage, etc.) !f''
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes [:]No
9. Do any structures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11.
Is there evidences of over application? ❑ Excessive Pondd+ing ❑ PAN ❑ Hydraulic Overload
❑ Yes
❑ No
12.
Crop type craze, .SMa11 (jr'4 ti
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Reouired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? _
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
,Stu
Io J�LL,it
f
,,,�❑///Yes
y3 Yes
/❑
El No
Yes
❑ No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Gonui ents.(refecto questioi--#) Expliin aoyYES answtii a"d/or any recommendations'or:any othir.eomment& -
Use drawings of faelity#o better explsm sttoations. (ass additional pages as necessary): - -
_. _ _ ❑ Field Conv El Final Notes -
Z lit-a4 se4 vP qvt qp�°;'*�wtehf G✓i�% `�Jr. 6,rr_�Ac 4o dlo44C
IJ�rec
ihS�oeG1'0k, 400(a My. -/ e ijA5
/ y y �7d>< jOr✓ }h esen�e i�ScC71t'o1
19e
6u� Ctil/Pd t✓lJ; le i.RT r,- J-t -JlnC rg --n . Ne SAid Act t 4 e
Go �dI WC+-C ho� di ✓rt;t4ble •F°— inS�eC�.'or.-t -'0d4. 6je Sep v�
/
dhn gl4rDi%-�✓''1G�h� �r /2%/.7�OZ. a� �Octn, �o re✓ree./ �17e /eC°rdS, cot-t�J
_
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: /Z L
05103101 Continued

'Facility Number: 3 —zQ Date of Inspection D2-
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fans) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes �iNo
❑ Yes % No
❑ Yes FzrNo
❑ Yes ffYo
❑ Yes 'P'No
❑ Yes ❑ No
I-AdditionalComments and/or .Drawings:
, -- - ; - -
disGUSSPG✓ W,4A MIr. P/eG y'11re Ldur/i',j Otter j�l enc
L'onY6/J4-lio'� 4ket] Ae C4✓Yfile 4,� .-,rc-rlZrOw�t%'14e Gi-eek
gl0"2 f61e Ce-ee't Al i rfo(v.<bc-1wee&t 44e A c, berz vdct
4r;elo(s gpreei.15 T6 be deyl-qa,'- y 44e Greek; Ae� y /
ravto;`Lg 0144 Jhe eleelC nr\d 1„S�allr-n5 cq ca-}Je C�oss,'.t�r l✓0 3
d; scus'rC4 '"d /)I,-. 9/e�i late said he woudd 4,ke ca•-�lo� .�
l il3e yoke wtt4tt M/-. %�t�e�l �i,e 41egj V2n�ov' � Saute Sa�linyl
And �014kvGr -Ire2S Oh O;1e Sec4c'o-, taF la�d di ooYt Z ApI e
6e l r/otA lo( -fake ea--P Or 4koh 4Ire issues pWv oils%y
ho4ed / 411e 4ctep+, � Arfeg,-.d well �V4. 011ere4l'->'l,e 460'q
W'q"5 Ar!e well —jhe berrmvd,,I Gro
eni ; r4Is
ekr_,r-1
I o/ s�:ll 9,ra,>l k*5 been �lan¢ed,ThP arnq o{fouN�{
}fie sw;�,e J7ot,tsa�s is Well Yvlac✓ed ra/so.
plsrol sorne" ffXJP's dtxOL4 1o( ke incd✓rd'aied �,/'A res cl
4o -%lo �ee�i%� Aeeoq qd.e-kceh)` 4,9 14� oreek
r M' 1 rooLd �Vw-.cks .
05103101

Type of Visit *9 Compliance Inspection O Operation Review O Lagoon Evaluation
for Visit JBf Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number •3 2 �� Date of Visit:
Permitted D Certified [3 Conditionally Certified E3 Registered
Farm Name: ......-Po n .._K 9 0 P .r.,c St- 4 3
..............................................................................................
Owner Name:....._Ne�sot) P�t'L�e
.......................................................................................
Facility Contact:
Title:
Time: i3%.-s
Date Last Operated or Above Threshold:...
Coun
Phone No:
Phone No:
MailingAddress: ...................................................................................................................... ...................................................................................................................
Onsite Representative:NM 'P"er...,,,..9 Integrator:-
__ ... ,
..
Certified Operator: .................................................. .............................................................. Operator Certification Number:.........................................
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude =• �� �•�
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle
Capacity Population
❑ Wean to Feeder 10 Layer I I Dairy
Feeder to Finish 46 (* 1 O0 ILI Non -Layer 1 ❑ Non -Dair
y
❑ Farrow to Wean
❑ Farrow to Feeder - ❑ Other
❑ Farrow to Finish Total Design Capacity
,...' ❑ Gilts
❑Boars ;: , : ; TotaI.SSLW
Number of Lagoons ,I� ❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area `:.
;; Holding.Ponds / Solid Traps ; ;° ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ')5No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes )6 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? V) /A
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes J<No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes IgNo
3. Were there any adverse impacts or potential adverse impacts to the Waters.of the State other than from a discharge? ❑ Yes J No
01/01/01
Continued

Facility Number: 3 — 2 25 Date of Inspection •j 8�
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes IgNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier; I 2
...................... ........................... ........ .................................... .... I ................. _........... ........ _............ _........... ......... I.........................
Freeboard (inches): ......__3 3 .. Z_� • s
................................................................................................................................................................................................
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 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? XYes ❑ 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
V(No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
B No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
JJ No
12.
Crop type Lia�^t�/a(q �0.y CorylISw.g11 r�rq;h
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
ErNo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
]9 Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes_
*M No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
Jj No
17.
Are rock outcrops present?
❑ Yes
$ No
18. Is there a water supply well within 250 feet of the sprayfreld boundary? ❑ Unknown Yes ❑ No
Required Records & Documents IffOn-site JS Off -site
19. Fail to have Certificate of Coverage & General Permit or other Permit readily available? Yes []No
20. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) JO Yes ❑ No
1
21. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ig Yes ❑ No
22. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
23. Did the facility fail to have a actively certified operator in charge? ❑ Yes No
24. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes X No
25. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑Yes ® No
26. Does facility require a follow-up visit by same agency? ❑ Yes 29 No
27. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes XNo
Odor Issues
28. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below X Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
29. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes J9No
01/01/01 Continued

Facility Number: 31 2� Date of Inspection
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
32. 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.)
33. Do the animals feed storage bins fail to have appropriate cover?
34. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
Printed on: 1 /4/2001
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes
19 No
❑ Yes
J4 No
0 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
Comments (refer to question #) rlixplatn any Y ES answers and/or any recommendahons'orany oth, ercomments�'
Use drawings of facthty to better,ezplatti situations (use;addttional pages as
necessary) '❑ Field Co py ❑ Final Notes F
'1• 1 a'C .bvc 4t-ees,w00d7 vt9e4A4,ot-lGhd weeds Trod 14100tleswtba►tk-"err%s.
g• Rera:r ^v%AeX4en4 crackeA cleo,Kot44 p;pe aO Avt&se }1-$, PA+cL, leaks
otl ho,hae�Lses Ccsloec10111
7 houses
Fay;) i-l•tq needs A we&ble acres dejerrt;na��o�.
I
48-..
M. NeeA Ge-4,1-f;cAle a Cover-c a -b Coeneral Qe. '*".+.
ZG• NeeA inset-} a»� edfor con 0-o) Gl,ecklr'J}SgKd rvtor40►14
wlAna eW-vf ebteck l,-S+. NeeA 1^9eon des i jeW for b&44,% IoL)00 <s'-
Zl , kceordJ ka.ie b eer.& ; s fle cek. Keelo weekl1 f'reebPnro( recor4 .
heed 4e 0l4ctin fcx0 Soil 4e54S j wal4e gne,l7str. —It ke Sa--,Iplcrr fe,o
new so;l $we-'y4eahktlsis• I%re Wa54e, gnalyf:,r 4,4,a( w`lk:•"`
60 Aa-IS Off' AffItc.A4t'rt- 0" 4Ae Slek- 2 ,cn/mt, /reCr Sere-,14e, -j7fk-2-"
-,0r c&e,11 c -opt�i � SegSor, • Move4} a Notree-%Lb - 2000 alaP1 crti•��
40'l1
MAr, : L4 e li C.-Oibtlrs 4L,, 1 �nCk/acre C2`)� lS4 9ailac%e).
Ne4 e : Grower ;.i Se-#,'rtcj vP 4v yiot ze . Need4 4a /gave lnlctS4a PIa K
re.W--AeW\' }o -<6 ,/ &Lr,V�A{el %4c L,,ol!,p; pre c+'ces ti �t?�Ids
4" 6e VSea( Fo- w4s-A:, a pF cq� ov, _
Reviewer/Inspector Name Slto�t?!�/A 1��i�ll`S�zVTj'` . n T
Reviewer/Inspector Signature: Date:
01/01/01

Facility Number 31 — ZZ5 Lagoon Number ... i..... Lagoon Identifier
19 ACtive O Inactive
35. Surface Area (acres):
36. Embankment Height (feet):
37. Distance to Stream:
Latitude 35 Ot } 05
By GPS or Map? KGPS ❑ Map
38. Water supply well within 250 ft of the lagoon?
❑ On -site ❑ Off -site
39. Distance to WS or HOW (miles):
40. Overtopping from Outside Waters?
41. Constructed before 1993 NRCS Standards?
42. No verification of adherence to 1993 or subsequent
NRCS Standards?
43. Was groundwater encountered during construction?
44. Depth to Groundwater:
45. Spillway?
_h va4e-
46_Ade4uafe Marker?
47. Immediate threat to the integrity of the structure?
48. Freeboard & Storm Storage Requirement (inches):
rig. Aie rock otAYG✓ors prcSerra-:,� 111
Longitude '78 Di 3+}
GPS file number: 131 a 2 25-
1.82
A S{
pj less than 300 ft O 300 ft - 1000 ft O greater than 1000 ft
O Yes O No
0<5 05-10 g>10
O Yes V No O Unknown
O Yes ;gF No O Unknown
O Yes 39 No .O Unknown
O Yes O No OUnknown
39 Unknown
O Yes 36 No
JOYes IRNo No.' Sni
0 Yes 19 No

Facility Number 31 — ZZS Lagoon Number ... 2.... Lagoon Identifier.....................................................................
VActive OInactive Latitude [Ysl 5g Longitude r]g o7 2G
By GPS or Map? GPS ❑ Map GPS file number: 3 i c 2 25
35. Surface Area (acres):
36. Embankment Height (feet):
37. Distance to Stream:
38. Water supply well within 250 ft of the lagoon?
❑ On -site ❑ Off -site
39. Distance to WS or HOW (miles):
40. Overtopping from Outside Waters?
41. Constructed before 1993 NRCS Standards?
42. No verification of adherence to 1993 or subsequent
NRCS Standards?
43. Was groundwater encountered during construction?
44. Depth to Groundwater:
45. Spillway?
TnAdv
qq
46.AdequdW Marker?
47. Immediate threat to the integrity of the structure?
48. Freeboard & Storm Storage Requirement (inches):
4-1. Are fOGk oti )e-eejos 10-reseh4? No!
)less than 300 ft O 300 ft - 1000 ft O greater than 1000 ft
0 Yes ]9 No
0<5 05-10 JK>10
O Yes 0 No O Unknown
0 Yes ) 0 No O Unknown
O Yes O No JKUnknown
O Yes O No(Unknown
0 Unknown
O Yes ONo
e-M AW SM
10Yes JeNo
O Yes $ No

-- ,Division of Water Quality '
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit O.Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit oRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number .3) 22.5 Date of Visit: I
Permitted 0 Certified E3 Conditionally Certified E3Registered
Farm Name: ..... 'P40V k.._KKA o to-XkC..5 rj4e #._I_&_z..........
Owner Name: ......... V.0soh.Y.e.G.1.4.1at.......................................
...................... /
Facility Contact:
Title:
t3 0a Time: 9 :) S Printed (on: 10/26/2000
0 Not O erational 0 Below Threshold
Date Last Operated or Above Threshold: ..
County: w ).!:� .........................................................
Phone No:
Phone No:
MailingAddress: ..................................................................................................................... ..................................................................................... ..........................
Onsite Representative: .iK.c...b............................................................................... Integrator: .._W.t..........................o...lt-1s..................
Certified Operator: ................................................... ........................... ................................. Operator Certification Number:..........................................
Location of Farm:
Swine []Poultry []Cattle []Horse Latitude Longitude �• �'°°
Design Current
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current
Poultry Capacity Population
❑ Layer
ION n-Layer
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy
❑ Non -Dairy
Total Design Capacity
Total SSLW
Number of Lagoons JEI Subsurface Drains Present 110 Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps JE1 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any pan of the operation? ❑ Yes J4 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? ❑Yes 16 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? ;,? /,A .
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes 9No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes 1g No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes §4No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ONo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ................ I .................. ............_Z.................................................... .................................... .................................... ....................................
Freeboard (inches): 33 23 S
5100 Continued on back

Facility Number: 3/ -Z 2S Date of Inspection 12 13 Printed on: 10/26/2000
N
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 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? Z Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenancetimprovement? X Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ll No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11.
12.
Is there evidence of over application?
'' ❑ Excessive Ponddi`ng ❑ PAN ❑ Hydraulic Overload
Croptype 7cev-Muds r1ot•11-r�^�`'� C'�r'aiv�,-SoV/beC�v�S
❑ Yes
❑ No
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is fended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
XNo
16.
Is there a lack of adequate waste application equipment?
❑ Yes
ETNo
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
1ti-yi6lati0tts;oi• d4ffld nkies -were noted during this:visit. •You :will -teed** iio: fut•the'r • ; • : •
' .
' corresnorideitce: ab6uf 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): "
.rrokc wi'41, INir. Pi ecy f�,c b y�1,�t,e; Ile rA�d he W�vt(d ►toF be a61e
4o ottlethd dur;—j %hsree}ior., bVf 40- w,e io 9° al1¢�t� owlet do ��• M�-
Crecy Il,e �Is� sq;d 41b vt} lie lir,4 vtj;slolotccq h. r re covds t tq was
-4ryrny 4o f ,' -.d 4L cy,. we Dire 4V be ;r, con4a& Sow eAr, review moordl.
`d , -Ft—ees weeds bra,,, b&p, I g0oomis,
8. l�ec,;r leaks o+-t -6;0. Aot', -e-r.
m e: rj,&c 4v See recorolS-
IReviewer/Inspector Name S`fOljeWS I lY; 44 ), i t I
Reviewer/Inspector Signature: „„ Date: Z. 3 OD 5/00

Facility Number:_? -ZZS Date of Inspection I l3 OD Printed on: 10/26/2000
Odor Issues
26r Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ,g Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 29No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes M 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 JA 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 8 No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes J] No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes 2g No
Additional omments:an orDrawings;: - - - -
5/00

Facility Number 31 225 Date of Inspection 2/16/2000
Time of Inspection 14:15 24 hr. (hh:mm)
® Permitted ® Certified Q Conditionally Certified 0 Registered Not O erational Date Last Operated: ..........................
Farm Name: PorkKR0k.1ttc.Site.#L&.2.................................................................... County: D.uplin............................................... MRO.........
OwnerName: Nelson ..................................... rxuythe ..................................................... Phone No: 267,0011 ....................................................................
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
MailingAddress: PQJ3oz2211................................ _.............................. _.......................... Faisan.NC............................................................... 183.41 .............
Onsi[e Representative: ...................................................... . .................................................. Integrator: BJI:RYXA.'.a.R1.Gk1I'AlUIa,.IA.C..................................
Certified Operator: Nelsnn.................................... P.cecytha.Operator Certification Number 2206.4 .............................
Location of Farm:
Latitude 35 • 03 50 Longitude F 78 07 11 F 30
Discharees & Stream Impacts
I. Is any discharge observed from any part of the operation?
❑ Yes
❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated flow,in gal/min?
d. Does discharge bypass a lagoon system? (If yes„u6tify DWQ)
❑ Yes
❑ No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes
❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: .............back........................fwnt ............ .................................... ................................... ................................... ...................................
Freeboard(inches): ................ L9 ............... ............... 21 ................ ................................... .................................... .................................... .....................
..............
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
C] Yes
[]No
seepage, etc.)
3/23/99 �
Con4xued on back

Facility Nuprber. 31-225 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 4fi was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelunprovement?
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 Pending ❑ PAN
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(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?
2/16/2000
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
;A -No'vwlaiio ii « r'Cktii iericiei-iviie.rioied.duiing ttiis -viiii:. -Wti-.01're6eive no iurltier . - . -
.............................................................
.'rn'rracririoiiariria alvi�ik'kRii:. viciY.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.
❑ 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
loin freeboard check. Farm Manager (Tripp Brown (BOC)) was on facility and I did let him know the reason I was there, he did
me further permission to check freeboard levels.
Reviewer/Inspector Name trrreeil4t¢Vti1t¢C
..
Reviewer/Inspector SignatureDate.

(Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation O Other
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification @ Other ❑ Denied Access
Facility Number 31 225
Date of Visit 2n6n000 Printed on: 3232000
O Not Operational O Below Threshold
0 Permitted ®Certified ❑ Conditionally Certified Q Registered Date Last Operated or Above Threshold: .........................
Farm Name: POIkKR0.P.1ac.SiteAI.&2.................................................................... County: Ruplio................................................ W. jRQ.........
OwnerName: LYelana............................. _...... Prc the ... -...................................... _....... Phone No: Z67..9.011 ....................................................................
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
MailingAddress: PQBoa.22Il............................................................................................ Faiaon.mc...............................:.............................. 283.41 .............
Onsite Representative: ........................................................................................................... Integrator. Bruma'a.of.Canulina,.Inc.................................
Certified Operator: Nelsan. .................................... Pawy-tha .......................................... Operator Certification Number. 22064 .............................
Location of Farm:
® Swine ❑ Poultry ❑ Cattle Latitude 35 • F 03 50 - Longitude 78 • 07 30
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ............. back ............ ............ fwnt............. .................................... ................................... ................................... ...................................
Freeboard(inches): . .............. 9............... ............... 21........ _...... ............. _.................... .................................... .................................... ....................................

Facility Number: 31-225 Date of Inspection 2/16/2000 printed on:
5. Are there any immediate threats to the integrity of any of the structures observed? (le/ 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 DW Q)
7. Do any of the structures need maintenance/unprovement?
8. Does any part of the waste management system other than waste structures require maintenancefunprovement?
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 Pending ❑ PAN
12. Crop type
3/23/2000
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
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 reviewfmspection 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?
4 •LVo• violationi tir:tlefiiieucies•werc:uote l:dui9itg ttiii•viiit:. Yvti �vff recetve iau 1 iirAer. •' -
..........................................................
-'correstioadMcbabbdt't$is-vasit*.'•'•'•'•'•'•'-'.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.... .
❑ 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
Q Yes []No
❑ Yes ❑ No
idom freeboard check. Farm Manager (Tripp Brown (BOC)) was on facility and I did let him know the reason I was there, he did give
Rather permission to check freeboard levels.
Name

State of North Carolina
Department of Envirom
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Govel
Bill Holman, Secretary
Kerr T. Stevens, Director
Nelson Precythe
Pork KROP Inc Site #1 & 2
PO Box 220
Faison NC 28341
Dear Nelson Precythe:
War—
��iTL�D
JAN 0 6 2000
� - X A�
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
December 30, 1999
Subject: Fertilizer Application Recordkeeping
Animal Waste Management System
Facility Number 31-225
Duplin County
This letter is being sent to clarify the recordkeeping requirement for Plant Available Nitrogen (PAN)
application on fields that are part of your Certified Animal Waste Management Plan.
In order to show that the agronomic loading rates for the crops being grown are not being exceeded, you
must keep records of all sources of nitrogen that are being added to these sites. This would include nitrogen
from all types of animal waste as well as municipal and industrial sludges/residuals, and commercial fertilizers.
Beginning January 1, 2000, all nitrogen sources applied to land receiving animal waste are required to
be kept on the appropriate recordkeeping forms (i.e. IRRI, IRR2, DRYI, DRY2, DRY3, SLUR1, SLUR2,
SLD1, and SLD2) and maintained in the facility records for review. The Division of Water Quality (DWQ)
compliance inspectors and Division of Soil and Water operation reviewers will review all recordkeeping during
routine inspections. Facilities not documenting all sources of nitrogen application will be subject to an
appropriate enforcement action.
Please be advised that nothing in this letter should be taken as removing from you the responsibility or
liability for failure to comply with any State Rule, State Statute, Local County Ordinance, or permitting
requirement.
If you have any questions regarding this letter, please do not hesitate to contact Ms. Sonya Avant of the
DWQ staff at [phone] ext. 571.
Sincerel
Kerr T. Stevens, Director
Division of Water Quality
cc: Wilmington Regional Office
Duplin County Soil and Water Conservation District
Facility File
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper

-, 13Division of Soiland Water .Conservation -`Operation Review - -
,. 'E3 Division of Soil and Water Conservation -,Compliance Inspection' - -
;.® Division of Water Qualitymp . _ Co6ance Inspection
• E3 Other Agency -- Operations Review
® Routine O Com laint O Follow-up of DWQ inspection O Follow-u of DSWC review O Other
I r Facility Number I 2 25 Date of Inspection J 1 q9
Time of Inspection ®5 24 hr. (hh:mm)
Naermitted 0 Certified
� •+' 65. Q Conditionally Certified Q Registered Q Not O erational Date Last Operated:
Farm Name: rjr_k._._&�qp T;Fe5I b Z County:
.............................. ............. _D....
....v..........................................
OwnerName:..... Ne1s0•. Free ................................ y'is�'!e................................................................ Phone No:.......................................................................................
1
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
Mailing Address:
.......................................................1................................................................................................................................................... ..........................
OnsiteRepresentative: Nelson �rcGtl-t�c,Rgv.wgLSj.On g r
................. r 1 ..,,...,,,, In[e ra[or. 8,,, Dw,vl.. o� Cq�..l %na
...................................................................
Certified Operator: .......... tVcIsovx ......................................... �rec,.� �e................................. Operator CertificationNumber:_2Z.O.( .4 .................
Location of Farm:
Latitude =•=' =1 Longitude =• =' ="
Design Current.
Swine - Capacity Population
❑ Wean to Feeder
® Feeder to Finish
(oq oO
Salo
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
INuynber.of Lagoons
Holding Ponds / Solid Traps
Discharges & Stream Impacts
.. Design Current.-;- Design Current
Poultry >.Capacity Population -- Cattle - Capacity Population
❑ Layer - ❑ Dairy
❑ NonLayerI ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
No Liquid Waste
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
Identifier: Z 7.L
Freeboard (inches): ......... Z
•ay Field Area
❑ Yes . [0 No
❑ Yes ® No
[]Yes ® No
n /n
❑ Yes Z No
❑ Yes in No
❑ Yes ® No
❑ Yes ® No
Structure 3 Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes ® No
Continued on back

Facility Number: 31 — 2Z57 Date of Inspection 12/ I get
- 6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ® Yes ❑ No
Sm
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ® Yes lffNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? -
❑ Yes
19 No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
'® No
11.
Is there evidence of over application? ❑ Excessive Pending 1g PAN
® Yes
❑ No
12.
Croptype
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
N Yes
❑ No
14.
a) Does•the facility lack adequate acreage for land application?
❑ Yes
®No
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
®No
15.
Does the receiving crop need improvement?
® Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes ®No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
® Yes ❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
® Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes ® No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes ® No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes ® No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes ® No
24. Does facility require a follow-up visit by same agency?
❑ Yes ® No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
® Yes ❑ No
�I'VOVIOI3t}OtIS,OC'• (tCtIC1e,IIC1C5 •N'eCCIIOtef7(tIH'kllg i�i15, VISIt. • i_ULF Wl�l•CeCCIj'C il0 t�LLl't11Q1' , ...
'. corres on�ence.ailirtita(cis�isit_..........'.......'....'...'............
Comments (refer to question #) Explain any YES answers and/or any recommendations or any'other_comments.
'
-Use drawing$,of facility to better explain situation s..(use additional -pages -as necessary):
i, The ou��r wAlls oP loo+k Iw9oevtS sl,a tnlG( be mowed '4o +Lie foe oC41,c
wall }e rcw. r��� ``weeds, r q r/ry
��. tJ UcrgOpl�Grt-}:Ohs kx1Ve occvereA Oh full 3 i.t
pulls ;n rield 8 of 4.q 16s-i 0 e.A do Pull 6 0 c," SO /6s. TNese
r'esuN�d ;-t Par+ +"Oe S 4e+;nj w:+ti an irtcorrec+ 'PAM der 44e
resp�e+i✓e pulls, Ttie sl•ava: PAru ;r wri444< ctf _? S Ibr/4crc, bv} sl,o.ld
6e 235 16slgcre •fir pull 3 qnq 2 (0 0 Ibs/acre f'or ru Its S ekndB.
Also, Linty aloe 1;ca-}ions 4l^Q+ were mace du✓i" Nave'46 - 'Iq eind
(Reviewer/InspectorName I _,' S-/-oh:�W�(� ./ e��;,q' F- -,_�.`�1(19�.�.3q•J.-'3 OQ,—,
Reviewer/Inspector Signature: qp Date: 12./ 1
3/23/99

Facility Number:
Odor Issues
a --
Date of Inspection
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
® Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours? -
❑ Yes
® No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
® 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
g No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
® No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
® No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
$ No
II(crn+ 1 I
Accre c(;-�eo1 �ow c,�0J1 Se:r✓",v LyG, ,Sv,ovld 6e re.-noved -rror,, 'de.:.+.tudq q,-,c{
AeGred;}cd +,Wowat 44C 19CII -2000 small 9r-60r oroP• M'-' eect,-il,e
SI ould see A 4ez1,r; eel sPecic,h's�, 4odq.j 12-lil 1°I 40 11a✓e +Lc
e.,te.,JL'P,cy Anne✓td.vteh.+ adc(ed fo bt;s flgrl. -Tl1e SwgII G ain erOp
Slloudd' be, 91athkA /ASIi? %o AI(ow 44�-e Y J0-r (.,as4e
ovIIlg+iohS. 3 gc.c.red;i•�r9 -+lie Move. bcr a��licr4-Ears -bwti�d ^+Lc
Srvtal( 9rA;h, 4e dpull 8 will Ix eli gihq}e�(, PlfOn c
4InR4- 10v I 9 stiould Inane Neve--lb,-- clop /;ulFio, s Aared;fc�t 4o yr-1al19ra:n -
13. F-;eld 3 l.,qs Corn p14n+ed in 1+.604- plan is cctllir) -%r beev vc(a.
Crof5 i+ha+ Are ?Lq t4,d ;&I skou,(d v ,Ock crolos /it,
AISO,4kere ;r A httclrnh7 Se-4 •%o✓ 4 dull 4FZ h +,ield e?,Z-_f6
Tl,:s Meld ;s no1 ;,\ +e lolge. 14 be ade(cA }o p15t-, 9o; q
+0 6c spralederm.
IS. Work +o re"-dvc tAh6lLe5:✓,zbJe, tle06+V4;pn(;.e-Tcj�✓soh �vaSS��ro
SP ra��;e-ldS• APP I'f;n� I:v.%e c&cc.ordJ,-) 4o soil +es+ (gbaufi 1 �o� 4,,4Le
r� a-Gre) �+1—h Sko"fet lie1p +c„s Fr41am.
19, TL,c inSCG' c8n4-bl ,odor cov+'ol)gnd rv\ov+etW YVLA h4 e-VVkCKlL
Cke4l;S45
Stiould be &o^%rWed. Y 9
1Q, A new wAs4,e s,,,Kfle TkottIct be -lcckeY\. LJ4SIC Araly sis re ood God
6e-Fore and (00 days APe✓ i6e AoAe: otn 41,,e gnel�s;r, ` 9�AN l0 1 4y5
rol+es-1kottlol be GOrre(Ac-A on T122- Z's 1,, r^ ee-I Ise} c� r%
oil �flN /tit}os ,,, was+c
8. Be•r.hvdo, graze is eurrenlly 4kc ovtly crop in Ae t,.,as-I. 171aA.TL,e � , ,cr
eA� have �lav reviseol 40 6ern,v& h1,y s,r,ce All � berwtvdA ;s r✓u+
Al.- t(�,4 �1 so, small 9rgi.v OVe:see/� Sko'Alol iX eadCA 4, WoL . -Plan.
TL,:s tw/ :Il 9;✓e rvlorc. PA'AI deF:c:h o,no( need: 4o lae gdded ;n Order +0
gray 014 , - s�r,+c 12 It,,.r Fulls kowe beers rticde wh;ci, exceaA -}l,e
11tld,autlic lork(> tg -For ome irntgq� ,'ott e-vel,4 (29,Ono + g15/acre). Tke.
rvxnr,ker in la2 s
.5000 llokld 6e et+ reee+ +o ve1-4ical. H 6etles 41,a+ are
r.,0re +ingn 1 dear old sL.ettilcl be ccr.,oVed rro—\ /arrt. 16, gk-14
kewc a der: e01 -pu111Tl.e 9urt ;s c.urren4lttlt Pull,,A ot4l con+,colic-tor +o +l e
lewd draw" wl.-tp sl,ow;n9 4N - Fulls. TG,;s syld hDbe add�SSed it +ke w�3i23i
af-res ckP-+crrvna ,oh. T•F posslble, ;rririg4con e-Ven+s SL,ou10k be 50pAcect Far ik�i ap4
-Lr allr,,_r Proper uc4ake b1i crop 1�fw evet'l-ls•

_..,
Division of Soil and Water Conservation-OperationReview - '
r 0 Division of Soil -and WaterConservation Compliance Inspeeton
(Division of WaterQuality -.Compliance_ Inspection L
�[Vitbei Agency - Operation -Review ...
I Facility Number I
of DSWC review 0 Other
Date of Inspection 1 10-1-19 I
Time of Inspection 13'. 24 hr. (hh:mm)
0 Permitted E3 Certified 17 Conditionally Certified E3 Registered C
FarmName: .......^..' .......... ....... Lop ...�!:SQC�,............1.......`..,.,...Q�� .....................
Owner Name:..../..Y.7e�%:3..................... .... .(..rp...�.i�'�.:1!.l&...........................
Facility Contact: .............................................................................. Title:
MailingAddress: ..........................................................................................
Onsite Representative: .................................................................................
CertifiedOperator: ................................................... ..................................
Location of Farm:
County:
Phone No:
Last Operated:
Phone No:
Integrator:...... �.V._l./.......................................................
Operator Certification Number:
Latitude =• 01 =„ Longitude =• 01 =11
Design Current' - -
Swine Caoacity Ponulation Poultry
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
(Number of Lagoons -
Holding -Ponds / Solid Traps
Current. _ " Design Current
'o u Cattle Capacity Population
❑ Dairy
❑ Non -Dairy
❑"Other I- .
Total Design Capacity
Total) SSLW
❑Subsurface Drains Present ❑Lagoon Area IDSpray Field Area
" ❑ No Liquid Waste Management System I-
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c- If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ "Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
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: 131, �/
Freeboard(inches): ............................................................................................................................................................................. ...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
3/23/99 Continued on back

Facih y Numbe73 1 Date of Inspection 1p� 1-
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any strictures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste Aoolication
10.
11.
12.
Are there any buffers that need maintenance/improvement?
Is there evidence of over application? ❑ Excessive Pending ❑ PAN
Crop type
❑ Yes
❑ Yes
❑ No
❑ No
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes ❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes ❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes ❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes ❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes ❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes ❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes ❑ No
24.
Does facility require a follow-up visit by same agency?
❑ Yes ❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ❑ No
�q)'vi0l.$tidiis,ot- d4fflci nOt-S *W O, h0f9 I- (ding this visit. - YQU ,Will-t•eC2IVC lid fluI•thQ[ -, -: •
corres orideitce:abotitthisvisit::::::::::::::... .
Comments (refer to question #)t 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):. -
P&4;seo( (ower A Iotatr I W* bv.s _ and 611 tT 6;Na "Ile Ile .GrebtaroL t�
a �res?o#% Mt evW�r vvel Rb}ot �u115 as needtal. �a.Kw.-A
.ev- avty �sst6lc
N�tagDba
y DWQ once VI" of Trreard is tt\e+ 1Aoon r V`\ aa( 'ko2.
%jLm� is leokktAcq I hPvoik l Iitc-w\ +o \e"C' In d lap A
Reviewer/Inspector Name I -
C:
Reviewer/Inspector Signatur �� �,� j• /ems Date: M . / _ yq
3123/99

Division of Soil and-WaterConseryation'-`Operation Review. -
- Q Division of Soil: and Water Conservation c ComP �aeNnc- ection ` ,Insp -
-®,Division of Water Quality -;.Compliance Inspection
D.Other Agency -',Operation Review,,_
10 Routine 0 Complaint 0 Follow-uo of DWO inspection 0 Follow --on of DSWC review Sh Other
Facility Number 2� Date of Inspection ) �{
T ime meof Inspection 1 Z 3'0 24 hr. (hh:mm)
® Permitted E3 Certified 0 Conditionally Certified 0 Registered 0 Not O erational Date Last Operated:
..........................
FarmName: ......... i0. . `.......... ...l................................................................ County:.TDI/ t.!�I......................................................
Owner Name:..,.,. ...
c
.................................................................................................. Phone No:.......................................................................................
Facility Contact:
Mailing Address:
Title:
Onsite Representative: ....... f`'...................................................................................... Integrator:
Certified Operates.
Location of Farm:
Phone No:
Operator Certification Number:..........,
Latitude =•=1 =•. Longitude =• =' ="
Design Current
Capacity Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Design_ - Current
try ' Capacity . Population 'Cattle
Current
opulation
❑ Other
41 Total Desigp'Capacity
Total SSLW
'Number of Lagoons 0 ° ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
floldingPonds / Solid Traps ° ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was die conveyance man-made? ❑Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 2—
Freeboard(inches): ......._Z..B...................._._..................................................................................... ......................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, []Yes ❑ No
seepage, etc.)
3/23/99 Continued on back

Facility Number: 3 — Z Date of Inspection
b. Are there structures on -site which are not properly addressed and/or managed through a waste management or--�-�-L�
closure plan?
❑ Yes
❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
. ❑ No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
❑ No
12.
Crop type
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ❑ No
24. Does facility require a follow-up visit by same agency? ❑ Yes ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
yigla�igtis:oi fleticiencies were itofed• during this;visit: • You ;will .. 6*e 1io; further
etirres ondence about his
Comments:(refer ttiquestion #):- Explain any YES answersandlorany recommendations or`anyother comments. - >"
'Use drawings of facility to better explain situations.: (use additional pages as necessary):,_ -
Ski-rrG};ol-, -ro•• burr cot ie 4ot,%,,9e QssessNtan�. I-
Reviewer/Inspector Name 's stp l'teln%4 II r'JW4' ►ii
Reviewer/Inspector Signature: Date: 9 % a
3/23/99

Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality
(U Routine O Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of Inspection `� zq QQ
zL5
Time of Inspection 0 24 hr. (hh:mxnn)
13 Registered 19 Certified 0 Applied for Permit 0 Permitted JE3 Not Operational IDate Last Operated:
FarmName:........... A..wA,,........is&V......I...... ........................ county: ...... D1.hi.a......................................... .......................
Owner Name: ........ _............. 93A.n........... ......
cSL 1,At............................................ Phone No: ... Cy1`I•)SB'.�?�r..............................................
FacilityContact: .............................................................................. Title:................................................................ Phone No:
MailingAddress: ........... t._Q....... �id...17...Q..........t......................................................... ..........t>"+smrs..�1G..................... I............................ ..�$3_ !..........
Onsite Representative:........... �I!t, .......ux.t.0 tMz.............................................. Integrator:......... m0t.,S............................................................
CertifiedOperator................................................................................................................ Operator Certification Number ..........................................
Location of Farm:
Latitude =• =, 0" Longitude =• =' ="
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 tp No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes ® No
c. If discharge is observed, what is the estimated Flow in gal/min? N i&
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes lj 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 P 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

-- Facility Number: 31 —
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons-11oldine Ponds. Flush Pits. etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure l Structure 2 Structure 3 Structure 4
Identifier: l Z
.......................................................................................................................................
Freeboard(ft):........... Z..1.................. .............. 143 .............. ................................... ..............................
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste ADDlication
❑ Yes
fO No
❑ Yes
0 No
Structure 5 Structure 6
................................................................
.................................................................
❑ Yes
® No
❑ Yes
No .
02 Yes
❑ No
❑ Yes
No
14. Is there physical evidence of over application? ❑ Yes ®No
(If in excess of WMu
P, or runooff entering watersofthe State, notify DWQ) t
15. Crop type ............... b.ur .tlA.....................Slvw.11....tf.k1A......................X?ylxf S..............................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? WYes )dNo
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
1A No
18.
Does the receiving crop need improvement?
1P 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?
P Yes
❑ No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
22.
Does record keeping need improvement?
(Sa 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
RNo
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?
m Yes
❑ No
p No violations or deficiencies were noted'during this.vistt You4ill receive no'ftirther .
correspondence about this visit
CmEceGpYanswers and/or' any r ecommendahons or any other comments
a drawings of facib#y to better eicptam situahuns. (use ddtttona! pages as necessary) 8,r
Iz OtlCi tkl(% °� InSco� be ".A• Iris+ �ilirs a{ kyei. #I ' lwdd � eb�cr�•
7 ho�S ot. (oSoo� IK) Sttod�ti he �-W -F ttft4ej.
i8. ueX�.ve�a, Islnmu\t) Lc- tr��lrove� t CXLV W1 01, rtgvlUt— Ipr,si5 `eatr� 4uKs)l L6n��
'W2t'dS `i- Vo�lntCtY°���aSCeS. I J
IC, Soybt;,„;, �,. 4tcl\ti �•aw#7 . p ta. call, �r ��mt,dn,. ) I
z�t CtxrtP% PRN ow fJ walk anal sus s4too he Iabe�tP) or. 9ryt�� vcccrt]4 to Ca�GulOic N
�q\GMCCS,q��1. a``\�6 (4'�a°'A aVY&bar 6Y_ 5�°�') K[( S. SoybPh^•� siwtilt] 6- Added tv wvP or berml.da p(tr�.. J i✓� �r �ti 7
r`Ilu.O.\Jf4 N Oh 5) iv' POI 13-441 38.41b5�uc-3, 118•b''iIL]�.4-5, 237.4-le 145.5-1 7/25/97
Reviewer/Inspector Name �_ '-',
Reviewer/Inspector Signature: _ L'�dsa,1 / ii._ Date:

11
Site Requires Immediate Attention:
Facility No.��
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 8— 23 1995
Time:
Farm Name/Owner:
Mailing Address:
et5w
County: fA j01al Mt. 01iVe 2�
Integrator, 115row #1 S _ _ Phone: Zq3. 3CPOy
On Site Representative: Phone: '7/0 '754-
Physical Address/I
Type of Operation:
S wine
Poultry
Cattle _
Design Capacity: � ZUU Number of Animals on Site:
3 ZA0
DEM Certification Number. ACE DEM Certification Number: ACNEW
Latitude: Longitude: 01 '.30 Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes r No Actual Freeboard: & Ft. & Inches
Was any seepage observed from the lagoon(s)? Yes or&Was any erosion observed? Yes r No
Is adequate land available for spray? Yes or No Is thy cover crop adequate? Yes or No tjlA—
Cmp(s) being utilized: lit 11 n12nT C OS5T2l
— F
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellines?(Yes r No
100 Feet from Wells? Yes r No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes oIf Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)?I Yesbr No
Additional Comments: 6`6 - `-I A - nor LX05 t O/t
L. Lets
. Inspector Name
cc: Facility Assessment Unit
Use .-attachments if Needed.

Site Requires Immediate Attention:
Facility No. ^ i
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 17- Z3 1995
• Time: KY 20
Farm Name/Owner: Pork- IGYop I k e t soti I' �j rjeGN4A-e . 2
Mailing Address: 5-74,\t 25
County: FDO a I,/)
Integrator. r Phone: 2q3' ?JCO(Y�
On Site Representative: Phone:
Physical Address/Location: l'YOn, W a`57w I (7 1,50 IJ.}D ffiwrJe.,5 Cross 6e2r
•
Type of Operation: Swine ✓ Poultry _ Cattle Fln f
Design Capacity: ?7100 Number of Animals on Site: _?7ZGo
DEM Certification Number. ACE DEM Certification Number: ACNEW
Latitude: �7 ' /�3 ' Longitude: -79 ' 07 Elevation: Feet
cto UC Circle Yes or No '
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) �r No Actual Freeboard: —&—Ft. O Inches
Was any seepage observed from the lagoon(s)? Yes o Nt�C Was any erosion observed? Yes o N
Is adequate land available for spray?(Tes)br No Is the cover crop adequate? Y.es-er3da- ►J[A
Crop(s) being utilized:
'1t L.ol z
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? es r 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 o(s)
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? es r N�oL[ //
Additional Comments � 2/''OSrL/1 00T1
L. LWi5
• Inspector Name
cc: Facility Assessment Unit
Signature
Use Attachments if Needed.

OPERATIONS BRANCH - WQ Fax:[phone] Jul 18 '95 12:07 P.06/23
Site Requires Immediate Attention
• FacilityNumber: "
SITE VISITATION RECORD
DATE: 7- /'7 , 1995
Owner A&jnnes � -e Farm Name: P1il /`�G Az 627
County: J)
Agent Visiting Site: M ';� Phone: 'FIQ Zi56 Z/-1-/
Operator, Phone:
On Site Representative: Phone: -2, 3 6 oz
Physical Address: 4,2 2 W%f A (2 Zrh,_ Aea 44Ze n
Mailing Address:
Type of Operation: $wine Poultry Cattle
Design Capacity: 6 e Number of Animals on Site:`s -�
Latitude: 0 Longitude: 0 "
Type of Inspection: Ground .,�K_ Aerial
•
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) 9 'r No Actual. FreeboardZc Feet Inches
For facilities with more than one lagoon, please address the other lagoons' freeboard under the
comments section.
Was any seepage observed from the lagoon(s)? Yes orQ Was there erosion of the dam?: Yes or
Is adequate land available for land application? Yes or No Is the cover croc adequate? Yes or No II
Additional Comments:
Fox to (919) 715-35Z;4
S1
I