310322_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

z
Type of Visit: Q Com Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral() Emergency O Other p Denied Access
Date of Visit: I S770zYZ�r Arrival Time: WP I Departure Time: County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: Title: Phone:
a� " OnsiteRepresentative: �� -'
!! -ok e"g Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean t inish I ILayer I
Design Current
Cattle Capacity Pvp.
Dairy Cow
W to Feeder
Non -La ej.IF'Aaci
DairyCalf
eeder to Finish
Y-9
DairyHeifer
Farrow to Wean
Farrow to Feeder
Current
U . l ouItn
ILayers
D Cow
Non -Dairy
Farrow to Finish
Beef Stocker
Gilts
Non -Layers
NP,
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
urke 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?
❑ Yes ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No ❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No ❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
3< NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
L__I 1Vo ❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facili Number: �f _ _ _3 Z. Z, Date of lns ection: , -7
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes D-t 1oo NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [] No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): rj lJ 3Z-
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes D'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 E]' No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑Yes C3'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 �WA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
o ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[] Yes
No ❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window [] Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
UJINZ ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
[] Yes
No ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
EnrNo ❑ 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
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[] Yes
No ❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements [—]Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections [:]Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [] Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection: z_
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes L_ -K_o ❑ NA ❑ NE
25. Is t*he facility out of compliance with permit conditions related to sludge? Ifyes, check [] Yes [3-N4o ❑ 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 �o❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No El NA ❑ NE
Other Issues
28. Did the facility fait 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?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes [3-No ^❑ NA ❑ NE
❑ Yes [?1'q`o[:] NA ❑ NE
❑ Yes []-T46—'0 NA ❑ NE
0 Yes []'19-o_ ❑ NA ❑ NE
❑ Yes [2-W ❑ NA ❑ NE
❑ Yes e- N ❑ NA ❑ NE
❑ Yes [] Wa NA ❑ NE
Phone: 7T 7�a�f
Date: it Z 1
21412015

(Type of Visit: d raoutine
pliance Inspection O Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: '� j{� Arrival Time: ® Departure Time: County: 1; 0 Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
- Title:
Onsite Representative: �(Jt�-�� N 1 y L�
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Phone:
Integrator:
Certification Number: 1 120 Ts
Certification Number:
Longitude:
Design
Swine Capacity
Current
P,op.
Design Current
Wet Poultry Capacity Pop.
Layer
13Non-Layer
Cattle
DairyCow
Design Current
Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
DairyCalf
64
Design C+urrent
D PIOu_Itrr Capac_i P,o
Layers I
DairyHeifer
D Cow
Non-Da'
113eef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
I M
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
0 NA
❑ NE
❑ Yes [] No
❑ Yes [%SNo
❑ Yes �No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

Facili Number: - Date of Inspection: %p
Waste Collection & Treatment
4'. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [:]Yes No 0 NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LA CrcrO W I LA&WI�1
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes Zo ❑ 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 dNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes o
❑ 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 0 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
gNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes VNo
❑ NA
C] NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes o
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes [ No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes o
JNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists [:]Design [:]Maps [:]Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 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 Inspectio211141"o
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - Date of Ins ection: 10124lib
24.-Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
o ❑ NA ❑ NE
1
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ YesVo
❑ 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
o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
�o ❑ 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?
WNo
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
[:]Yes
ILJ NNo ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[] Yes
No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? [:]Yes d.3No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No [] NA ❑ NE
Comments (refer to"question ##): Explain any YES answers and/or any additional recommendations or any other comments. --
Use drawings of facility to better ex -plain situations (use additional naQes as necessarv).
r
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone b —
Date:
/4/20l

(Type of Visit: VConglfiiance Inspection O Operation Review Q Structure Evaluation O Technical Assistance I
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency 0 Other O Denied Access
Date of Visit: Iq Arrival Time: lS��� Departure Time: County: Region:
Farm Name: Owner Email. -
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: I Title: Phone:
Onsite Representative: id !Yi'1 j N lq d m, L� Integrator:
Certified Operator: Certification Number: IR613
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design C►urrent Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish Layer
Design
Cattle Capacity
Dairy Cow
Current
Pop.
Wean to Feeder
Non -Layer
Calf
Feeder to Finish
—Dairy
Design Current
D , I;oW Ca aci P,qP.
Layers
Dairy Heifer
D Cow
Non -Dairy
Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Non -Layers
Beef Feeder
Pullets
Beef Brood Cow
LJjGiIts
Turke s
Turke 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?
❑ Yes Cj No ❑ NA ❑ NE
❑ Yes [] No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWR)
❑ Yes ❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes V'vo�
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3
21412014 Continued

Facile Number: - 37 JDate of Inspection: /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LA Ll.76-UN LA&ZW
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): C i
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes rNo ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a [:]Yes I__l 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 environmen
.taj threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑Yes ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes .2No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes El"No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. []Yes Z 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
Ef No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
6�l
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
t 5*N o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
64
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
9
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
rN
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists [3 Design ❑ Maps ❑ Lease Agreements ❑Other: 11
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? [3 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 21412014 Continued

Facility Number: -� Date of inspection: ►�
' 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 provide documentation of an actively certified operator in charge? ❑Yes o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes �"" ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ZNo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
/ No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
Ef No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Vo
❑ NA
❑ NE
Continents (referito question;#)., Explairr'any. YES,answers and/oe any, addid6nal recommendations'or�aiiy other cominents. :
Use drawings offaeility to,better explain -situations (use additional- pages -as-neeessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signatut
Page 3 of 3
Phone: 1 ; J 00
Date:
2/4 2015

(Type of Visit: Q rRoutine
pliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit: O Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: 'L� Arrival Time: Departure Time: County:PWO'' h/ Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: 'ja�jrl>J
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Design Current
Wet Poultry C*apacity Pop.
Layer
Cattle
Dairy Cow
Design
C*apacity
Current
Pop.
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish
Design Current
DE. P�oult . iGa aci_ P■o .
Layers
Dairy Heifer
D Cow
Non -Dairy
Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Qther
OtherI
Turkeys
Turkey Poults
10ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
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 n No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes o ❑ NA ❑ NE
❑ YesVN
[3NA ❑ NE
❑ Yes❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Facility Number: jDate of inspection: IQ 12,
Waste Collection & Treatment
As storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes QlNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [:]No ❑ NA ❑ NE
WW
Structure (1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: L.�1 I LA J !/
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 32__
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
❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes 40 ❑ 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 '
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes if No
❑ NA
❑ NE
acres determination?
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
❑ 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 P Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes F:rNo ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Faciti umber: - Date of Inspection: Z
I PIE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
r ❑ �j�No ❑ ❑
25. 1s 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 l.d l o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 45"'" ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes Ro ❑ 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 2rNo ❑ 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
ON-0 ❑ NA
❑ NE
❑ Application Field ❑ Lagoon/storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No ❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ETNo ❑ NA
❑ NE
34, Does the facility require a follow-up visit by the same agency?
❑ Yes
0 No ❑ NA
❑ NE
Comments (refer twquestion ) .,Eiplalwany.YE answers and/or any additional recommendations;6r-any-other comments �
Use drawings of facility=to better ezplain situations (use additional pages as.necessl ry) :
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Date:
WIV�r
4

i
Facility Nun
Type of Visit:
Reason for Visit:
Date of Visit: f
Farm Name:
e Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Arrival Time: 1 ! 3S 1 Departure Time: County: k � Region:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: ,� /TTitlle:
y
Onsite Representative: Ca is 1 j9T�l f i
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number: 'RO q 3 1
Certification Number:
Longitude:
Design Current
Design
Current
Design Current
Swine Capacity Pop.
Wet P
Capacity
Pop.
Cattle Capacity Pop.
Wean to Finish
La er
Non -La er
I
I
Dairy Cow
Dairy Calf
Dairy Heifer
Wean to Feeder
Feeder to Finish
Farrow to Wean
Design
Current
Dry Cow
Farrow to Feeder
Dr, $ouIte.
Ga aci
PLo
Non -Dairy
Farrow to Finish
I Layers
Non -La ers
Pullets
Beef Stocker
Beef Feeder
Beef Brood Cow
Gilts
Boars
Turkeys
Other
Turkey Poults
Other
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 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
❑ 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
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facility Number: Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 111 Structure 2 q Structure 3 Structure 4 Structure 5
Identifier: 1 �tr
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Zg
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?
No ❑ NA ❑ NE
❑ No ❑ NA ❑ NE
Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes 2�No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental hreat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes VNo
NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes 9&0
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes <No ❑-NA ONE
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
E!j No ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
o ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[3 o ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Efr No ❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[,,Ado ❑ 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 [DNA ❑ 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 NA ❑ NE
Page 2 of 3 21412011 Continued

Faciti Number: - Date of Inspection: b fall"
24. Did the facility fail to calibrate waste application equipment as required by the pen -nit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes E�Ko ❑ 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 D<o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes LJ 1 o ❑ 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 [ j4o ❑ 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 <o ❑ 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 ffl"No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes ja-No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes L Vo ❑ NA ❑ NE
Comments (refer to question #1): Explain any YES answers and/or any additional recommendations or any other comments.,: -
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Dater
I

Type of Visit: U Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: 42YRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time: ® County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Owner Email:
Phone:
Title: Phone:
Onsite Representative: LJO N ► -YHA r0'UA_ R_ Integrator:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Design Current Design Current
Wet Poultry Capacity Pop. Cattle Capacity Pop.
Layer Dairy Cow
Wean to Feeder
Non -La er
FEJ Dairy Calf
Feeder to Finish
DairyHeifer
Farrow to Wean
Farrow to Feeder
Design Current D Cow
D . P,oultr. Ca aci P,o Non -Dairy
Layers Beef Stocker
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cowd I
Wither
Other
Turke s
Turkey 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 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)
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 E(NN
❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
Page I of 3 21412011 Continued

'acili Number: Date of ins ection: 10
Waste Collection & Treatment
a 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
•
0Yes
Rio
❑ 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&,oylJ
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
o
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require [:]Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes CfNo ❑ NA ❑ NE
maintenance or improvement?
I l . Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 6 1 0 ❑ 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 I__I No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑1< ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [q--10 ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP [:]Checklists [] Design ❑ Maps ❑ Lease Agreements
❑ Yes Q ❑ NA ❑ NE
❑ Yes O❑ Wb ❑ NA ❑ NE
❑ Yes [ No ❑ NA ❑ NE
❑ Yes to ❑ NA ❑ NE
❑ 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 D Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" 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 L- peo ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

)(•acili Number: jDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes [TNo ❑ NA ❑ NE
ti
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes g�'o ❑ NA ❑ NE
the appropriate box(es) below.
[] Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? [:)Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes to ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes L d l"o ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ZfNo ❑ 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?
❑ Yes aio ❑ NA
❑ Yes No ❑ NA
❑ Yes I ,}'No ❑ NA
❑ Yes c ❑ NA
❑ Yes ®' o ❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
Comments,`(refer to question:#): Explain -any YE&answers ;and/or any additioni&recommendati smr anyother.. comments: ,.
use drawings of facility to better explain situations'(use.additional pages as necessary).':
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: % 7 / J
Date: 0 Al t.
21 i2011

Type of Visit: C�Co fiance Inspection Q Operation Review Q Structure Evaluation O Technical Assistance
Reason for Visit: rutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: Departure Time:_13 o County: YgLa Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: c-Tn ktalw 4A- - lu _
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Owner Email:
Phone:
Phone:
Integrator:
Certification Number: �Yr6
Certification Number:
Longitude:
Design
Swine C•apa.city
Wean to Finish
Current Design Current
1'op. Wet Poultry Capacity Pop.
La er
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
Non -La er
Dairy Calf
Feeder to Finish rj5
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Design Current
D , P,Oultr, C•_a aci_ P,o ,
Layers
Dry Cow
Ron -Dairy
Farrow to Finish
Beef Stocker
Gilts
Non -Layers
113eef Feeder
Boars
Pullets
113eef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
�No❑
1. Is any discharge observed from any part of the operation?
❑ Yes
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
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

I
Facility Number: - Date of Inspection: /rs 1-1t i
Waste Collection & Treatment
4.tls 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: {1600 LA&VW Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): L y�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes F., 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 dNo ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental rest, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes gZo ❑ 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 /io ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [] Yes ff No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes To ❑ 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
15. Does the land improvement? ErYes
LyNo
❑ NA
NA
❑ NE
NE
receiving crop and/or application site need
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑Yes
VNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes I� N
❑ Yes No
❑ Yes [�To
[:]Yes F2/No
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
❑ Other:
21. Does record keeping need improvement? if yes, check the appropriate box below. ❑ Yes L2 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 N ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ElYes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

iFacili Number: Date of Ins ection: !6 3 It
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ENo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes6N_/0 ❑ 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 PNo ❑ NA ❑ NE
Other lssues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
[:]Yes No ❑ NA ❑ NE
[:]Yes ld 1V o ❑ NA ❑ NE
❑ Yes To ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
[:]Yes [rNo
[—]Yes
0 Yes rNo
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments
Use drawings of facilitv to better explain situations (use additional nacres as necessarv).
rS) L Olt A*66 . KCE �' C�O� [.rME T1'01C.ET
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 73 VS
Date:
21412011

Div►sion of Water Quality
Faciltty :N urriber , 3c7 D',Dtvision of Soil and Water Consgy:ai n
} « d
D"Other.Agency_
Type of Visit d Co pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Fallow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: /4 /0 Arrival Timel"307 Departure Time: County: Region:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: C )UA) ft _k) Mw- Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: Elo 0 ' ❑ « Longitude: ❑ ° = i
Design Cunt DesignC rreurrent Design Current,
�-�
Swine CapacEtyPopulation' Y Wet PaultrY Capacity Population,,...."Cattle _CapacityPopulah©n K
w.
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
S
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
su ❑ Layer
❑ Dairy Cow
W, ❑ Non -Layer
❑ Dai Calf
'u 1DP
1?oultry �r
❑ Layers
�
❑ Dairy Heifer
; [ID Cow
❑ Non-Dai
❑Beef Stocker
❑ Non -Layers
ex ❑Beef Feeder
El Pullets
❑ Beef Brood G
❑
Turkeys
O 11 U-F ❑ Turkev Poults - ;
❑ Other ❑ Oth mtt
.... F r
Discharges & Stream Im acts
I . Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes /No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑
El Yes
No ❑ NA
❑ NE
ElYes
❑ o
ElNA
❑ NE
12128104
Continued

Facility Number: — Z Date of Inspection G t !p
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 22 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 'Z15 3 3
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ZNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed Cl 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 t7heat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes o ElNA ElNE
8. Do any of the stuctures lack adequate markers as required by the permit? ElYes WNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes I/J No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes VNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
7No Cl NA
❑ NE
/
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
o ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
El yes❑
VNoNA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
o ❑ NA
❑ NE
Comments (refer to question #): Explain any: YES answers and/or any recommendations or any other comments
[Ise, drawings of facility to better explain situations. (use additignal pages as, necessary): - =
I
ReviewerlInspector Name t.1o� .- •. Phone U 6-
Reviewer/inspector Signature: / Date: 16
Page 2 of 3 12128104 ' Continued

Faci ty Number: 3 3 Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP El Checklists ❑Design El Maps El Other
❑ Yes VNo ❑ NA ❑ NE
❑ Waste Transfers ❑ Annual Certification
❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 4 ❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Rainfall ❑ Stocking
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
❑ Yes Y I No ❑ NA ❑ NE
❑ Yes Rio ❑ NA ❑ NE
❑ Yes
LJ No
❑ NA
❑ NE
❑ Yes
[lo
❑ NA
❑ NE
❑ Yes
ETN' o
❑ NA
❑ NE
❑ Yes
LI No
❑ NA
❑ NE
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
Ll No
❑ NA
❑ NE
❑ Yes
['No
❑ NA
❑ NE
❑ Yes
eNo
❑ NA
❑ NE
❑ Yes
CJ N o
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

3 ZZ
Type of Visit 0-1ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit C,/Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I 0 Arrival Time: 9 OD Departure Time: County: DQP%.� Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Phone:
Title: Phone No:
KA
Onsite Representative: �0 1"11. qrJ -+t— y4 Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude
Operator Certification Number:
Back-up Certification Number:
0 0 A = Longitude: = ° =
Design Current Design Current Design Current
Capacity Population et Poultry Capacity Population Cattle Capacity Populatioo
rWeanFinish ❑ La er ❑ Dai Cow
o Feeder Non -Layer Dairy Calf
® Feeder to Finish
❑ Farrow to Wean
U1 n
coo
DrY Poultry
❑ Layers
❑Non -La Non -Layers
El Pullets
❑ Turkeys
❑ Dairy Heifer
❑ Dry Cow
ElNon-Dairy
❑ Farrow to Feeder
El Farrow to Finish
Gilts
oars
El Beef Stocker
El Beef Feeder
❑ Beef Brood Co
Other
❑ Other
Number of Structures:
❑ Turkey Pouets
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than, from a discharge?
Page 1 of 3
❑ Yes M No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
U�
❑ NA
❑ NE
❑ Yes
IJ No
❑ NA
❑ NE
12128104 Continued

Facility Number: 3 —717,
Date of Inspection
i
Waste Collection & Treatment
1
4. Is storage capacity (structural plus storm
storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: 1A 6m -j 1 LA t,;,rowj Z
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): YL .36
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes 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 t eat, notify DWQ
7. Do any of the structures need maintenance or improvement? ElYes ElNA ❑ 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 0 Yes ;3 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes O No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift [:]Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes :[g]o ❑ NA El NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes El
NA El NE
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? El Yes Ze
o ElNA ElNE
17. Does the facility lack adequate acreage for land application? ❑ Yes
❑ NA El NE
18. is there a lack of properly operating waste application equipment? ❑ Yes ❑ NA ❑ NE
Comments {refer fo question #)-Egpla�n any YES answers andlor any teeammendatrans or anv otherycomments
Use drawings of facility to better explain situations. (use additional pages as necessary):
.'2 r FFN S L.VLZ'x e Sv A.V& *e Z f�iL- ILA-tz jo
t
Reviewer/Inspector Name Phone: 1027G
7 3)1$
Reviewer/Inspector Signature: Date: `7 36
12128104 Continued

I
)Facility Number: — 32, Date of Inspection a 1.1
Rtguired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes LJ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check ❑ Yes WNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
LJ No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1"
Rain Inspections ❑
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
["No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[TNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Q No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
® Yes
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
UKNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
rJ No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ NA
El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
�L"No
{J 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
2 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
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?
❑ Yes
No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Comments and/or Drawings:
Page 3 of 3 12128104

- Division of Water Quality
i aciiity Number JWQ Divislon of Soil and Water Conservation
Q Other Agency
Type of Visit Co pliance Inspection Operation Review Structure Evaluation Technical Assistance
Reason for Visit Routine Complaint Follow up Referral Emergency Other ❑Denied Access
Date of Visit: % li ( Arrival Time: ® Departure Time: County: 1. Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: 0 ��7�419IJ %�yL[ CIZ
Certified Operator:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Latitude: = o =' = Longitude: = ° = i =
Design Current
Swine Capacity P pu�la�h�on
Design Current Design
Wet Poultry Capacity Population Cattle C►apacity
Current
Population
❑ Wean to Finish
❑ Layer
❑Dai Cow
❑ Wean to Feeder
10 Non -Layer
iry Calf
Feeder to Finish
Dairy Heifer
❑ Farrow to Wean
Dry Poultry ❑ Dry Cow
❑ Non -Dairy
❑ Layers
❑ Beef Stocker
[I Non-Layers ❑ Beef Feeder
El Pullets ❑ Beef Brood Co
❑ Farrow to Feeder
El Farrow to Finish
❑ Gilts
❑ Boars
❑ Turke s
❑ Turkey Pouets
❑Other
Number of Structures: a
Other
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
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
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes [�No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
Page 1 of 3 12128104 Continued

Facility Number: 3 1—
Date of Inspection
Waste Collection & Treatment
14. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
7ZNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structure 1 Structure2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: i WAI CA6&0/
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): it
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
ElYes
CNo ❑ 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
P(No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
[:1 Yes
L3'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
IJ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ENo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
ENo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
,�No
( No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�No
❑ NA
❑ NE
1 m d 'GCT 1/50,04 m % L46r"Il/
;) 641- colt err Z0,07
5-Lv O&E pjt vE v , SfN�I for l t owu
Reviewer/Inspector Name I NS. fs L_. I Phone: q*V Ih - 73 tr
ReviewerlInspector Signature: Date: I
n,,,.. i _r a 17/7R/llly (nnl3nuad
. --a - -1 -

Facility Number: —3 [19 Date of Inspection
�'Reguired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes O No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA P readily available? If yes, check Ll'Yes ❑ No ElNA ElNE
the appropirate box.
❑ WUP ❑Checklists Design ❑Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes[3/No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I"
Rain Inspections ❑
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
EdNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
o
❑ NA
El NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
YNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
Yes
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
Ek o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ENo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes WNo
6 o El NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document El Yes ❑ 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 ,L'^'N/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 No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did ee/sp s p o on -site pstoe El ❑
i Revi w r In ector fail to discus review/ins ecti n with an re re en tiv ? Yes [] No NA NE
�,
33. Does facility require a follow-up visit by same agency? El Yes LXzo ❑ NA ❑ NE
Additional Comments and/or Dirawin g s
T
Page 3 of 3 l z/28/04

0Division of Water Quality
Facility Number 3 � 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit Comp 'ance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: /6 /! [i Arrival Time: © Departure Time: County: f/iPLZ Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: / �,��J Title:
Onsite Representative: r T A rA P8/,�/✓ Y!� _zu 1
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
o
Latitude: =
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
❑ " Longitude: 0 0 0 ` =
Design Current Design -Current
Capacity Population Wet Poultry Capacity Population
❑ La er
Imo-- ❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
l
❑ Beef Feeder
❑ Beef Brood Co
I
Number of Structures-
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ENo ❑ NA ❑ NE
❑ Yes
❑ No ❑ NA
❑ NE
❑ Yes
❑ No ❑ NA
❑ NE
❑ N NA
❑ NE
❑ Yes
El Yes
❑ NA
❑ NE
ElYes
No ❑ NA
❑ NE
12128104 Continued

Date of Inspection
FaMity Number: 1 — z
i'
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: 4A 6-=A.) % l A 06AI -7,
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 s Z
Nc ElNA ❑ NE
M
LI No ❑ NA ❑ NE
❑ Yes C Nxo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
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 [INA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ElYes 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 JZNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
allo ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
fo ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
o ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
o ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Nw Ale4l G. r ¢- txan3T �U✓p - GAGS �✓ b fin(
I A/ap dr'ORjt_ �,,q(�n// BiEs-i(/ Aoa
LA60 peg on tkidCA/ Z 5&P6-E
Reviewer/Inspector Name r,[(j,J C[ t—, Phone /Q 11 — 73 X
Reviewer/Inspector Signature: Date: a 11 0
12/2VO4 Continued

, Facility Number: — Date of Inspection Lou
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA readily available? If yes, check es ❑ No ❑ NA ❑ NE
the appropriate box.
ElWUP ❑ Check lists Design El Maps ❑Other �
21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes 2 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ RainfalI ❑ 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? ElYes Er
No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Ej 'IS ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Comments and/or Drawings:
❑ Yes dyo
El NA El NE
❑ Y ❑ NA ❑ NE
Yes �No
N El NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes
2/No
❑ NA
❑ NE
❑ Yes
U 10
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
❑ Yes
[(No
❑ NA
❑ NE
❑ Yes
L N
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104

vision of Water Quality
Fae111ty ,Number 0 Division of Soil and Water Conservation
Other Agency
Type of Visit compliance Inspection Q Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: ! r A rival Time- �f [� Departure Time: County:
Farm Name: �' �� Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:(a
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Region:
Latitude: [= c [ = Longitude: 0 0 [= =."
Design 'Current: Design .. Current Design . Current -
Swine.. _ -Capacity Population ¢ Wet Poultry Capacity � Population Cattle Capacity Population ..
❑ Wean to Finish
❑ Wean to Feeder
eederto Finish
El Farrow to Wean
❑ Farrow to Feeder
ElFarrow to Finish
❑ Gilts
i=
❑ Boars
Other
❑ Other
JLJ Non -Layer j
Dry Poultry
❑ La ers
❑ Non -Lavers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl'
Number of Structures
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
12128104 Continued

Y�
: Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking PrCrop Yield,0120 Minute Inspections [:]Monthly and 1 °
Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes ❑ No ❑ NA ❑ NE
Additional Comments and/or Drawings:
�,ApAxAe101 o Yh t nL 1� r co cU
'
u y e�ol lilleldi
�3 �a
C�4 00 ee 6000V�_5
C 9 Z616��
Page 3 of 3 11/2&04

1 `:
Type of Visit A Compliance inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 10 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: / Arrival Time: cparture Time: ,� County: L Region:
Farm Name: %1�F Owner Email:
Owner Name: Phone:
Phone:
Mailing Address:
Physical Address:
Facility Contact: -Title.
a�
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 e = i 0 Longitude: = ° =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
I❑ Non -La et
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turke Poults
❑ Other
Discharp,es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifet
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ YesNo
❑ NA
❑ NE
❑ Yes No
❑ NA
❑ NE
12128104
Continued

Facility Number:" Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ 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: 0.1
Spillway?:
Designed Freeboard (in): 5
Observed Freeboard (in):
5
5. Are there any immediate threats to the integrity any of the structures observed?
❑ Yes
No ❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
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 ElNA ElNE
8. Do any of the stuctures lack adequate markers as required by the permit?
ElYes
�No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
�No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
'WfNo ❑ 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 Wiodow,, ❑ Lvidence of Wind,Drifl ❑ Application Or}tside of Area ti
Ir,
12. Crop type(s)
13. Soil type(s)
14, Do the receiv
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination' ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
No ❑ NA
❑ NE
No ❑ NA
❑ NE
No ❑ NA
❑ NE
No ❑ NA
❑ NE
No ❑ NA
❑ NE
ci11119
2-2
ReviewerlInspector Name Phone: D LG
ReviewerlInspector Signature: Date:
12128104 Continued

A . +
Facility Number; — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? Y(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 appropirate box.
❑ WUP Vf Checklists El Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
VfYes
❑ No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual
Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield 9 120 Minute Inspections ❑ Monthly and 1"
Rain Inspections
9Wcather
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
❑ No
❑ NA ZNE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
❑ Yes ❑ No
❑ NA ;Pl'�E
❑ Yes ZNo
❑ NA ❑ NE
❑ Yes No
❑ NA ❑ NE
❑ Yes ❑ No
❑ NA 'P NE
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 [INA ❑ NE
and report the mortality rates that were higher than normal? )n'
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes No ❑ NA ❑ NE
Additional Comments and/or Drawings:
44/11-7,f o 0y S �,,a AQ
ap
2aNQ �'zj-7zov ��G z,BR9>zo.�Eeol��Q.
12/28/04

iP
Type of Visit d ;Routine
liance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit O Complaint Q FolIow up Q Emergency Notification Q Other ❑ Denied Access
Facility Number 1 ZZ Mte of visit: t i o Time: 336
Q 'NotOperation2l Q Below Threshold
Permitted Certded E] Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
&AW) KaR.�E GAQ a-m County: Dom/
Farm Name. ___............... - - ---- - - ........._......-... tY-
Owner Name: _�- _ ... -... __. Phoae No:
Mailing Address:
Facility Contact: Title:._.. _ _. Phone No: _
f
Oesite Representative: �J OA N N? K(5 1�"� Integrator: - -V&AS-M.&6
Certified Operator:
Location of Farm:
Operator Certification Number-
[3 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude a " Longitude •
Discharges & Stream lmp cts
l _ 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?
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 i nnpacts 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 l Structure 2 Structure 3 Structure 4
Identifier: -- .. L.T --. 2 -- . .... _ _.
Freeboard (inches): 3
12112103
Structure 5
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes 0
❑ Yes o
Structure 6
Continued

Fa ' ity Number: 3 (— 3Z Date of inspection 191, Ito
v
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
o
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
o/
Wo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
[
9. Do any stuctures lack adequate, gauged markers with required maximum arid minimum liquid level
❑ Yes
o
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
o
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
21O
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type C69rJ i3 -Am wA (-a) SG6
— - -
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
-
6io
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
L�1Vo
b) Does the facility need a wettable acre determination?
[IYes
l�'No
rlo-
c) This facility is pended for a wettable acre determination?
❑ Yes
15. Does the receiving crop need improvement?
❑ Yes
Le2�'
16. Is there a lack of adequate waste application equipment?
❑ Yes
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes L] 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 �01 o
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 0
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional [] Yes o
Air Quality representative immediately.
(rri'er o�gasshon #) �F.�cpiam ���>.� andJor any, � -� � irr any�atb aatntts.'. -=
eCom
CTse dtrawm� offaci�'ity to better�txp#a�m stifxm�ns. (tese�aom�i'pages as rq? � Field Cop ❑ Futal Notes
3s, � uP�T� C 2.017 `k' tG-t b � o&J 6tt�ir
Reviewer/inector Name s} :.
sp
�� �� �
Reviewer/Inspector Signature: Date: [
12/12/03 V Continued

0
FRciiitq Number: 3 L —3 Date of Inspection S t
Reguired Records & Document,-.
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
© Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Samrpling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
27. Did Reviewer/iaspector fail to discuss reviewCmspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does retard keeping for DES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Farm drop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes No
❑ Yes 0<0
❑ Yes ! o
❑ Yes 3
❑ Yes C�'No
[I Yes No
El yes
❑ Yes ;;O--�
Yes
afes �7x�oo'
ElYes
❑ ;o;Yes
❑ Yes IO
❑ Ye o
es ❑ No
12112103

t
Type of Visit jJ Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Tune:
0 Not Operational O Below Threshold
0 Permitted 0 Certified =] Con ' 'onally Certified 0 Registered Date Last Operated�gr Ab�ove Threshold: .......„..........
Farm Name: ---- .Q 1.1' „ --� Qm.... County: ..�C/./J�l G iU...» .... ._. ...__ ...„.
tK
Owner Name: �fe f I� Phone No:
MailingAddress:..._ „ ......„_.......„....„..............„..._ ..._.„..„ W _ „.. „.„. „.
Facility Contact: „..„............„...............- ...„ _— ...... Title:..„.... „ .__..— -- - _ „.._._ Phone No:
Onsite Representative: ,(%Q,,�°(� ,�-� Integrator:
Certified Operator:.....„........................................_......_......„........„.....„.._.............. Operator Certification Number:.„...........................„.„.......
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑Horse
rDesignCttrrea
Latitude • 6 46 Longitude • 4 44
`� a;r Desaga s-, `Curreat �=
aPoultry onr.
Wean to Feeder
❑Layer
Feeder to Finish"
❑ Non -Layer
Farrow to Wean
y-- -
Farrow to Feeder
Other
Farrow to Finish
Gilts
Boars
Dtscbarees & 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)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes ❑ No
XYes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure b
Identifier:
Freeboard (inches):
12112103 Continued

cility Number: f I
11
FaDate of CKC.
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 D Yes ❑ No
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenancerimprovement? ❑ Yes ❑ 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 maintenancelimprovement?
❑ Yes
❑ No
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
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
I5. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor 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
❑ No
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.
�Comuuents (�i e#'er to gnestron'�#) Eaplam any YF..fi answers anid/ar any recommradatians o any other oou�_e�uts. =- --_
^Use drawrags of facility to better eacplarn srEaatrons: (use additranal pages as aery). � }_.❑��F�e—ld` Copy ❑Final Notes'��^I -
71? do
�n1- ADO
m P W45 Cr Rlv FD
Reviewer/Inspector Name L
Reviewer/Iuspector Signature:
Date:
12112103
Continued

Facility Number: — Z Date of Inspection Z p
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?
(iel WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ 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
❑ No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
JKNo
28. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
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
❑ 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
❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required foams need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After V Rain
❑ 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.
i3dition11 Cotiunents;andIdF'E, awrngs=
4k) 7-o Z,)Tocai /YOZKFA�'5
r7VNIGI��Gc �iS�C L,t�r7.� �Fc
NI /,Cl5 (r ETrzA)C
12112103

Type of Visit O Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 31 322 Date of Visit: 4/19/2002 Time: 10:20
NNot O erational O Below Threshold
® Permitted ® Certified 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: lRxar.Sl.K91;neI;tLI'.k:0.t'Jq4.......................................................... County: i _u4ft._......•--.._._..--•-
_....--•--.._.3UKQ--•---
Owner Name: ByArd_.-------- --- - - __----------------------- Phone No: ---
MailingAddress: ..7.7.6.[1".Yxy.49.Hut..................................................................... mX..AX...SIG......................................................... 65...............
FacilityContact: ........................................... ................Title:............................................... Phone No: ......................................
Onsite Representative: OIS1.�A��IDRAp� K4lA@gel_---------------------- Integrator:PJCfiAge FR[tiLT--_.-----_--_---_--.-----..
Certified Operator: Hyaxd... Gn............................. KohlLeDY........................................ Operator Certification Number: 1.72.43 ............................
Location of Farm:
Vortheast of Faison. On Southeast side of Hwy 403 just East of SR 1369, but before SR 1370. +
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 35 • 08 & 38 Longitude 78 ' 02 f 50 a
Design Current
Swine Ga' aci . _Po' ulation "
Poultry „ _(
❑ Wean to Feeder
® Feeder to Finish
6155
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons 2 a:' ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps - ❑ No Liquid Waste Management System
Discharp_es & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ 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: ------------ a------------- -------------2........._._ ................
Freeboard (inches): 41 23
ne ino inv r.. _..__...-s

u�iv�ivt
t.ununueu
Facility Number: 31-322 Date of Inspection 4/I9/2002
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?
❑ 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 ® Hydraulic Overload
® Yes
❑ No
12. Crop type Corn, Soybeans, Wheat Coastal Bermuda (Graze) Small Grain Overseed
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
® Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No
15. Does the receiving crop need improvement?
® Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
®No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
®No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
®No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
® Yes
❑ No
20.
Is facility not in compliance with ariy.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
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Coin eats (refer to questron #) Expla nrvany YES answers and/or any rec©mmendations or any other comiuents
_ _
Use d`rawmgs of fac�h#y to better expla n situatinons (useNaddrtronal pages as necessary) Field Copy❑ Final Notes
x r wW
11, and 25. Animal waste runoff has occurred from the sprayfield and has ran onto an adjoining property belonging to someone else.
Water quality samples and pictures were taken.
The minimum freeboard requirement for the lagoon 2 is 24 inches. The freeboard records show this lagoon at 19 inches of freeboard
on April 15, 2002; this is a violation. Mrs. Kornegay says that a farm worker had left the fresh water running and put this lagoon into
noncompliance. The high water mark on the lagoon gauge in lagoon 2 appears to be at about 17 inches in the recent past.
2. No notification was given to the DWQ regional office of the noncompliant lagoon level.
9. The`Kornegays need to ensure that a lagoon gauge is installed in both lagoons which accurately shows the start and stop pump levels.
If a lagoon gauge has to be installed to meet this part, then the new gauge also needs to show the top of the dam elevations.
+
r,
Reviewer/Inspector Name $tonewall.Mathrs
Reviewer/Inspector Signature: Date: Z D 7'

e
05103101 continued
N
Facility Number: 31-322 Date of Inspection 1 4/I9/2002
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ®No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ❑ No
32. Do the flush tanks lack a submerged'fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
_ a is an. or raver gs a - -
�' ti �ttotta ' :Yoram .
3 and 15. The northern field which is designated for bermuda is almost entirely fescue. This field is required to be in bermuda to
feet the minimum nitrogen requirements for the waste utilization plan. Fescue does not require as much nitrogen as bermuda and
iereby is limiting for this farm and in fact most likely results in the farm having a nitrogen surplus. I have been noting that this field
eeds the bermuda stand improved since I have been inspecting this farm during the past 3 years. The Kornegays need to take
nmediate action to ensure a well established stand of bermuda in accordance with the waste utilization plan by the end of the
immer 2002.
Also, the small grain needs to be removed by haying immediately from the southern bermuda field.
8. AnimaI waste appears to be leaking near the flush tank area at house 6. Animal waste has leaked onto the ground at the pumping
stations on both lagoons. Waste leaks need to be eliminated and prevented.
11. Animal waste is ponded and runoff has occurred on and from land application area where land application events recently
occurred on the southern bermuda pasture. Water quality samples and pictures were taken.
19. Mrs. Kornegay says she threw last year's freeboard records away; these records should not have been thrown away; freeboard
records are to be kept for at least 3 years while waste application records are to be kept for at least five years.
The Kornegays need to be sure to use a waste analysis dated within 60 days of application events to calculate on the IRR-2's the
nitrogen applied; a January 9, 2002 waste analysis has been used to calculate for application events which occurred in mid -March.
The Kornegays said that they applied waste yesterday and this event is not yet recorded. Application events need to be recorded
The Kornegays need to ensure that the correct beginning Plant Available Nitrogen allowance from the waste utilization plan is
used on the IRR-2's; 80 and 100 lbs PAN/acre was used as the beginning PAN allowance for hydrants 3 and 9 respectively while 9C
T p.
and 110 lbs PAN/acre respectively should have been used according to the waste utilization plan.
The Kornegays need to ensure that any applications made after March 15 are deducted from the iRR-2's for the corn crop. The
waste plan states that the wheat, if grazed as it was, must be removed by March 15. Some application events occurring after March
15, 2002 have been credited toward the wheat crop. These referenced events occurring after March 15 need to be deducted from the
nitrogen amount on the IRR-2's for the 2002 corn crop which is following the wheat.

j0f Bivision of Water Quality
Q Division of Soil and Water Conservation
Q Other Agency
Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 3 Z Dale of visit:
`4ermitted 13t'trtified © ConditionalyCistered
Fa{{{lllrm Name: ......GN �............ ........ ......................
/ 4-iene: /j% ! Printed on: 7/21/2000
Q Not Operational Q Below Threshold
Date Last Operate Above Threshold: .......................
County:............
Owner Name: Phone No
Facility Contact:........".!..`........6....... ...........Title:.... .................... Phone Na:...................................................
MailingAddress: ................. ... ......:........................................................................ ..........................
Onsite Representative: � Integrator: ,,,,, , , ,,,, ,S 'St°.r E-14....................... ......................_ .................. t ............................
Certified Operator:,,,,,, , ........... „ ........................ Operator Certification Number:
Location of Farm-
r14
Swine ❑ Poultry ❑ Cattle ❑ horse Latitude Longitude
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer ❑ Dairy
Feeder to Finish 10 Non -Layer ❑ Non Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Soars Total SSLW
Number of Lagoons JEJ Subsurface Drains Present ❑ Lagoon Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observer{, was the conveyance than -made?
b. If discharge is observed. did it reach Water of the State? (If yes, notify DWQ)
c. If dischar�.e is observed. what is the estimated flow in gallmin?
d. Dees discharge bypass a lagoon system? (If yes, notify DWQ)
Spray Field Area
❑ Yes Q(0
❑ Yes ❑ No
❑ Yes :f0 �❑ No
1 f
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes VIo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage less than adequate'? El Spillway El�N Yes ,o
St�ctttre I Struc ur 2 Structure 3 Structure 4 Structure 5 Structure 6
r
Identifier;
.............. "............_..................3..L....... ................................... ..................... ......................................................................................
.
Freeboard (inches):
5100
Continued on back

Facility Number: 31 — 3 Date of Inspection Z p Printed on: 7/21/2000
5.l�re there any immediate threats to the integrity of any of the structures obse ved? (ie/ trees, severe erosion, ❑yes j�No
seepage, etc.) K
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes 54 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 CNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes Q(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 ❑ Hydraulic Overload El Yes�No
12. Crop type
13. Do the receiving crops differ with ttfose designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
,QkNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
KNo
b) Does the facility need a wettable acre determination?
❑ Yes
VNo
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
4No
Reouired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes Q' 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 RLNo
19. Does record keeping need improvement? Oe/ 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 M No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes MNo
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 j 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
Rio •violaii6ris:or- &i Jcie.ndes were noted• d&irig t'his'visit' - Yoii ;will -i•&OW fid futth . .
corres orideince. about this visit.::::::::::.:::::.:: :: :::::::::: :
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessaary):
,Y11 S fh {� tAQ�1'
Ti Was -1 5 , A-C i l Love J 4 CGS Vl -tom `* -AAJ r �
W UP �- T"r, b -1-S -V, vw,,Ot�
f,1CWA 100L TVP W,41
Reviewer/Inspector Name 6� (Meer. 'A*. We -Le t 1 1W M/V ) 3 f 5 —
Reviewer/Inspector Signature ,(/ 1 a sue. %��� / %_ Date: 1,4//7 / I —Psi 5100

facility Number: — Date of Inspection Z Printed on: 7/21/2000
t Issue .
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge tit/or hrlow ❑ Yes RNo
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes JZNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 11Io
roads, building structure, and/or public property) \\
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes 'KNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or ��
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ;<No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes j�INo
32: Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes o
6CA (CL OCN____ If,4A "K&-
07f Mov-e kvk,.
o_C_. err;
:�,�e,�v��.��-
-- s
11
J
5100

Type of Visit Q 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 31 322
Date of Visit 21i6l1t1oQ Printed on: 3/232000
Not Operational 0 Below Threshold
0 Permitted E Certified 13 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: ...............
Farm Name: Byard.Kamegay.fAm[p.............................................................................. County: D PUM.............................
OwnerName: Byaxd................................ ..... KaMegaY ................ ........... .... ......... Phone No: b,58-36Q5............................ ................................................
FacilityContact: .............................................................................. Title................................................................. Phone No:...................................................
Mailing Address: 7.76.NCjdw _4Q3. W=t..................................................................... Mt-.0live-M ....................................................... 7.83.65 .............
Onsite Representative:.................................................................•......................................... Integrator. P.nests.ge.F s.....................................................
Certified Operator. Ayatd..................................... Koxmgay ........................................ Operator Certification Number- ..172.43.............................
Location of Farm:
® Swine ❑ Poultry ❑ Cattle Latitude 35 08 i 38 Longitude 78 02 50
❑ Wean to Feeder
® Feeder to Finish
6155
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
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) 0 Yes 0 No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes []No
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...................................................................................................................................................................................................................
Freeboard(inches):...............24...............................24..................................................

Facility Number. 31-3Z2 Date of Inspection 2/16/2000 printed on; 3/23/2000
5. Are there many immediate threats to the integrity of any of the structures observed? (iet 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?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10_ Are there any buffers that need maintenance./improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14_ a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit 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 reviewimspection 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 -X& V' Aiaii6ii tir:&&iericiei-were:uoieil:during This visit:: eau ZviY�:receive ao fiirtfier:
cnr-i-pertiripilt�ri�-ia ahri�it tRit,•vasii_
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
anal hydrants are being added and work should be completed within two weeks weather permitting (per NR Construction- ,
NC). r
CA
Reviewer/Inspector Name

;W xfr. [j Division of Soil and=Water'Conservation Operation Review
v. Division of Soil and:Water Conservation = Compliance` spectioit e
Division of Water Quality Compliance Inspection
13
Other Agency Qperahon-RWev�ewY-'
Jig Routine 0 Complaint 0 Follow-up of DWQ inspectionllow- up of DSWC review 0 Other
L - I Facility Number Date of Inspection
Time of Inspection 24 hr. (hh:mm)
® Permitted 13 Certified [3 Conditionally Certified 0 Registered JE3 Not Operational I Date Last Operated:
FarmName: ................ ya r!__..1 ,r t4c , .... ...... .....................County: ..... U r..............I...............- .......................
Owner Name: ................... C] A'�d )(-,.a r v{ [ A Phone No: .............
........ ........ ............................................. I.............
Facility Contact: ..................................... Tttle:................................................................Phone No:
......................................_...........
MailingAddress: ............................. ...•..................O!^ n G.............................................. .
Onsi€e Representative: ......
.f!!.1........................... a..... Intel rator......✓���...�� �...........................................
....
Certified Operator: ................................................... ....................... .................................... Operator Certification Number:..........................................
Location of Farm:
Latitude 0 C C�.; Longitude • �6 fl
Design Current' =; De sign ' Current' Design Current
Swine Capacity Population Poultry. Capacity Population Cattle Capacity Population"..
❑ Wean to Feeder ❑Layer ❑ Dairy
® Feeder to Finish f SS QQ ❑ Non -Layer I ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Tots! Design Capacity
❑ Gilts - _
❑ Boars
-.. Tata1 SSLW
µ -Number of Lagoons ❑ Subsurface Drains Present
❑ Lagoon Area
IDSpray Feld Area
HoldingPonds /. Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
❑ No
h. 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: 1
?S 241
Freeboard (inches): ................ I. ................................... .................................... ...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion,
❑ Yes
IN No
seepage, etc.)
3/23/99
Continued on back

Facility Number: 31 —32 . Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes 10 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 N No
8. Does any part of the waste management system other than waste structures require maintenarice/improvement? X Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes '® No
Waste ADDliCation
10.
Are there any buffers that need maintenance/improvement?
'M Yes
❑ No
11.
Is there evidence of over application? ❑ Excessivee Ponding ❑ PAN
❑ Yes
10 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?
JZ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
[:]Yes
JRj No
Re uired 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?
(ic/ WUP, checklists, design, maps, etc.)
❑ Yes
gj No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24-
Does facility require a follow-up visit by same agency?
❑ Yes
,� No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ff No
0: Rio O a .. tis or def ciencies 4Tre noted diWing 4bis:visit'. - You will 4receiye iiti furthe'r - : -
' correspoiide'nce: ab' this :visit:
Cotnments_(refer•ta question #) '; Ea plain any YES answers and/or aay recommendations'or any other. comments:
Us6A wings of factlrty tdrbettei�,explattri stftuations (use addttxonal pages as necessary) •`
8. �A�►Hcr w��� jrtJ< -P i pwider AaaA +o kmve c%GGBsS 0
t^_eas-a Field by 06+,6ey- 4-6;r year. C­es4al 4as rw
sPr&%ytA on 441%1 ye40 -
j�. Cows aced +o be -(en Led ou-t of d%-���br•tncGCam )eetve
-p iolc.e P6,r cows 4-o Gross,
l3, Wa14 T14 , 6LC+ +L1 ;s C;e-1.4 zeA so stLp1,ld
6e 'FP. IV 40 0 e'n 1-44es SLtou U 6e ad v-Acdl Aezv/,d ►ngl . -�
Reviewer/Inspector Name S (
.. rye h g
Reviewer/Inspector Signature: _ Date: O /g qq
3/23/99

Facility Number: —7 —322I)ate of Inspection /•t�+j j
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge.at/or below
10Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
2T
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
IN No
'Additional ' amo<►epts and/or
)J
�`Ar VviC,e j1A3 Sr► -re o 4r onr 6e re. CAn SG��O er"a+e 444 tier[
�
,nko Pqr4-s o-P 13N Ahd eP. 012 coulr1901"a-�c some
Ll; S Ade 1-1 eeklq) la ^x i Ih4-d ���✓� �o @�tsl>/e de rG/�'.
15. Cxis4cO on lov 0s 10 a-idnn IOA needs ieyrove ✓�cn+,
C�+tier 9r�gsseS Aa""�,na4e- geld . 4da i 1:,VtC aGCOr"d?
s a d 4 es+ i,,tf Pia +^�o rc 2 ' on C �a � t
�'l af'" -��� 4Gr e i n h
ve-"I) m^j 6,e1r ')--q eleve caps 1
F,vr vner ,says ra �d Coro a r17°e +3 w ees k
C
.f+'1 oW �Lle SG C �/�Yj�S, [,ODD d-� �i�ICr z � S L✓ �I''1, ?� CSG C l�l'Yl-�S
aid Se rjd - � Go 1'e's le me .44 :.
Soya �C.;r
tQ G Etii
-D
1 Z 7 Gated ;,1,i ] 'fir E-kl . s sue.^
k1 Z�1 R
Q;/M'. oh, Nc 2-940, '
' PA" A) on rot/ 7 1-3( Germ) n ae4s �o be CorreG�ed
110 4-, 7a.95
• Kee ��; CS o�' (5G4V1 D�eS)'aMS- V/ reed+-dr
3/23/99

{ ­ : ; 13 Division of Soil and Water Conservation ❑Other Agency
r Division of Water Quality
O Routine 0.Com faint O Follow-up of DW ins ection O Follow-ue of DSWC review O Other
Date of Inspection
Facility Number
Time of Inspection E= 24 hr. (hh:mm)
Registered 13 Certified 0 Applied for Permit Permitted 113 Not Operational 11 DateLastOperated:
Farm Name: �5. County.1.......................................... .
OwnerName: ........ .......... ........................................................................................................
Facility Contact:
.. Title:
Phone No:....
................. Phone No:
MailingAddress:................................................................................ .......... ....................... ..............
Onsite Representative:�•�!!Q�Q�,� L ...� .....-.- `-1... Integrator:...... V.
—''�j
Certified Operator:............................................................................................................... Operator Certification Number;.........................................
Location of Farm:
Latitude " Longitude �• �' �"
Design Current z :.N= Design Cui rent Design r_ FL Trent
Swine Capacity Population Poultry Capacity Population Cattle Capacity:Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
General
1. Are there any buffers that need maintenanceJimprovement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gaVmin?
d, Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No

it ffadW_�yNumber: -3t-
8. Are there lagoons or storage ponds on site which need to be property closed? 0 Yes [I No
Structures flLagoonsHoldino Ponds. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes 0 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Freeboard(ft): ........ ............. ............. rof.0 .......... ................................... .................................... ....................................
.......................
I ............
10.
Is seepage observed from any of the structures?
El Yes
[I No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
0 Yes
[] No
12.
Do any of the structures need maintenance/improvement?
El Yes
[I. No
(H 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?
0 Yes
[3 No
Waste , Application
14.
Is there physical evidence of over application?
0 Yes
0 No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type .................................................... 7 ................................................................. ........................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
0 Yes
0 No
17.
Does the facility have a lack of adequate acreage for land application?
0 Yes
0 No
18.
Does the receiving crop need improvement?
El Yes
0 No
19.
Is there a lack of available waste application equipment?
[I Yes
El No
20.
Does facility require a follow-up visit by same agency?
0 Yes
[] No
21.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
0 Yes
0 No
22,
Does record keeping need improvement?
0 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?
0 Yes
E] No
24.
Were any additional problems noted which cause noncompliance of the Certified AWNT?
0 Yes
[] No
25.
Were any additional problems noted which cause noncompliance of the Permit?
0 Yes
0 No
[3-N.o"vio'la'tioin's-ivideficieinc'ies'were 'n'otid-diiiiiig this'vislt, Yoiji,4ill iiceii'veii6flirtheri'.,
Ze-
L--A-, C� O
tH :
aTA
Ve" AVLO
oj�' �j
7125197
I Reviewer/Inspector Name
IReviewer/Inspector Signature:.
Date:

.
N.C. -DIVISION OF ENVIRONMENTAL MANAGEMENT
COMPLAINT/EMERGENCY REPORT FORM
WILMINGTON REGIONAL OFFICE
r
&eceiv�ed by: . �� j���_ _ Date,Tsme:
Eke_rgenqy:_Caapla3nt: ✓ sty:
Rjepor't Received From:
Agency: t Phone No. !EI I l _J�70 — 4r 35
Cdoplainant:
Address s Phone No _
Complaint or TnrideQt:
Time and Date Oc_=red:
Location of Area Affected:
Surface Waters Involved: Groundwater Involved: Other:
reri.8r her _-; oa /Conti rwna iV ti f�-; AA-
Investigator: `����� -- _ Date: 1
EPA Region 1V (4&)347-4M2 Pest .der 733-3556 Emergency Management 733-3867 R''iid'_-i Racurcc 733-7291_Y.
Solid and Hazardous waste 733-2178 Marine Fisheries 729-7021 Water SaMy Branch 733-2321 U.S. Cunt Gerard MSO 343-4881
127 Cardinal Drive Extension. Wilminpon. N.C. 28405.3845 • Telephone [phone] • Fax 91C-_50-2004
An Equal Opportunity Affirmative Action Employer

J
�� ��[� Division of Soil and Water Conservation ❑Other Agency � � x
`$ i�� Division of Water QuaEity � _ � '
O Routine O Complaint O Follour-uriof DWQ inspection O Follow-u of USWC review Other
Date of Inspection
Facility Number 32:L . ' Time of Inspection 24 hr. (hh:mm)
© Registered P Certified © Applied for Permit* 0$ Permitted 13 Not Operational I Date Last Operated:
FarmName: ............... 1IAr........!t�Atq�.........a]ran+.......................... ................. County; .......Ijt4r........................................ ... ..... ...............
Owner Name: ....................... a,r ...............� [acr �s.,q ... Phone No...... .....................................
Facility Contact: .................. Title:.......... f!n L,e Phone N°o:
..... ........................ ................... .......................
f
Mailing Address:.--" .{t......W.lS.....2u 4os...... west ........................:.. ... ....... mt.j ..... Nr........................... nz( ........
Onsite Representative: ........... gjA,rA...... ..................................................... Integrator.......... r.................. .......... .........................
Certified Operator;............................................................................................................... Operator Certification Number .........................................
Location of Farm:
.....a........��XQ•........................
.............I.... ........................................................... ................._ ...............I............ ...
Latitude �• �� ��� Longitude �• ��" o
Design Current Design Current Design Current
..
Swore Capacity Population:`'` Poultry Capacity Population Cattle v . ;Capacity =Population
-'" ❑ Wean to Feeder ❑Layer El Dairy,
Feeder to Finish ' S ❑ Non -Layer ❑ Non -Dairy
❑ Farrow. to Wean
❑ Other
ElFarrow to Feeder
El to Finish Total Design Capacity c
r
❑ Gilts &.:
❑ Boars Total LW
Number of Lagoons / Haldmg Ponds �0` ❑ Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area
ri
❑ No Liouid Waste Manasement Svstem
General
r
L Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
2. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon' ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) El 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
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) iequire ❑ Yes ❑ No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes ❑ No
7/25/97
Continued on back

Facility Nurnher:
8. Are there lagoons or storage ponds on site which need to be properly closed'
Structures (La-Zoons,llolding fonds, Flush Pits, et4Q
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3
Identifier:
Freeboard (ft): ....
10. Is seepage observed from any of the structures?
❑ Yes ❑ No
❑ Yes ❑ No
Structure 4 Structure 5 Structure 6
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?
(1f any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ............................. ......................................................................................... ...............................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste :Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit'?
No.violations or deficiencies were noted during this. visit. You mill receive no ftirther
eorrespondence ahoid this_visit..:
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
.....................
❑ Yes
......... I—-
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Comments (refer to: question #). _Explain any-Y 1✓:S answers and/or aria recorrunendattons or any other comment&, q
Use, drawings of f icihty to: etter ezplatn'situatitins '(ase additional pages as necessarv)
>�}
Of\ rtltA riv, A �vo�W C 14n y Hwo 0— �CIO.
`
L LDS
nu.
rurm,% A-6 m,I COrc�+\� ��K o� otVmtvn,
i�i,
)
faSsus vyojr 4Lt ►-OAJ/ ' .Igq/f�yoa Culvevf. �onaed w4tr—
'"
pr. W645�ae l� 4 iJCA LILXJ,� 5"6% Werf- -&,1, ' ' od,4 o.,c .
'.A
0
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:

❑ Division of Soil and Water Conservation ❑ Other Agency
® Division of Water Quality
10 Routine O Complaint O Follow-up of DWO inspection O Follow-up of DSWC review O Other
Date of Inspection 1I . j4 j�'
Facility Number `� 3�a Time of Inspection ® 24 hr. (hh:mm)
© Registered © Certified U Applied for Permit )dPer"tted 10 Not Operational Date Last Operated:
FarmName: ... .... ' !'` J....... ... ... County:.................................................................................
Owner Name:............. `...5` `�P..... Phone No: a (a S�...............................I........... ...............................~. S
Facility Contact: • .................................................. .. Title:..................... . Phone No:
Mailing Address: ..... -.. �- !...-4.3...W-. A .. ..:G V.,VOL k o�-$3E; 5
.... .............. .......................................................................................
(� [ ..... Inte rator•......1 Onsite Representative:. �'`'`Qy..:CSC! `rt` ............................................ g �?: .. ...............................
Certified Operator. ....................................- .. Operator Certification Number, .........................................
Locati n of Fa
Latitude • C76 " Longitude ' ' "
General
1. Are there any buffers that need maintenancelimprovement? ❑ Yes XNo
2. Is any discharge observed from any part of the operation? ❑ Yes X No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes 14 No
b. If discharge is observed, did it reach Surface Water? (if yes, notify DWQ) ❑ Yes 0 No
c. If discharge is observed, what is the estimated flow in ,aUmin? NA
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes DdNo
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
N�No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
N No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
lal 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
C,No
7125/97

.♦
rr`
Facility Number:
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
hA No
Structures (Lagoons] oldina Ponds, -Flush Pits, etc.)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
V No
Structure I Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: ................ .........................................................................................
......................................................................
Freeboard (ft): .3..:1 `a
................................................................................................................................................................
10.
Is seepage observed from any of the structures?
❑ Yes
tj�No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
M No
12.
Do any of the structures need maintenance/improvement?
,� Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
C4 No
Waste ADDlication
14. Is there physical evidence of over application? ❑ Yes KNo
(If in excess of WNW, or runoff entering waters of the State, notify DWQ)
15. Crop type. f F.� �.....5?''''...................................................................................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities_ Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0-No:violations4 deficiencies.werenoted•during this:visit.- You_:'ill rec_ eive�no' 1&iher
: orreSPOIA61 c dhout this;visit.• : ; :
❑ Yes NNo
❑ Yes Dj No
Yes ❑ No
❑ Yes NrNo
❑ Yes Wo
❑ Yes E) No
OYes ❑ No
❑ Yes %No
❑ Yes ONo
❑ Yes MI No
jj
` -Q P—' 7/25/97

State of North Carolina
Department of Environment
and Natural Resources
Wilmington Regional Office
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
Division of Water Quality
September 8, 1998
Mr. Byard Kornegay
Byard Kornegay Farm
776 west NC Hwy. 403
Mt. Olive, NC 28365
• •
NCDENR
NORTIi CAROLINA DEPARTMENT of
ENVIRONMENT AND NATURAL RESOURCES
Subject: Inspection Visit
Byard Kornegay Farm
Facility # 31-322
Duplin County
Dear Mr. Kornegay:
On July 8, 1998, staff from the Wilmington Regional Office of the Division of Water
Quality, based on a Notice of Referral from The Division of Soil and Water Conservation,
inspected your animal waste facility. It was observed that a temporary irrigation line has been
placed in a culvert running under NC Hwy. 403.
The Division of Water Quality has concerns regarding the integrity of this irrigation
system. Based on samples taken at the time of the inspection, there are elevated levels of fecal
coliform bacteria and nutrients in the water present in the ditch (see attached). Use of this
irrigation line should be discontinued, and a permanent irrigation line should be properly
installed under the road: We suggest that you contact your service company, local NRCS or
Soil and Water District office for any assistance they may be able to provide to correct the
situation.
Please notify this office in writing within fourteen (14) days of the receipt of this letter,
what actions will be taken to comply with your waste management plan. If you have any
questions concerning this matter, please contact Brian L. Wrenn at [phone] ext. 202.
Sincerely,
Brian L. Wrenn
Environmental Specialist
cc: Zack McCullen III, Prestage Farms, Inc.
Wilmngton Files
127 North Cardinal Dr., Wilmington, North Carolina 28405. Telephone 910.3_95-39_0_0 FAX [phone] _
An Equal Opportunity Affirmative Action Employer 50%Frecycled/10%post-consumer paper

envirochem
CONSULTING
CHEMISTS
Customer:
NCDEHNR-DWQ
127 N. Cardinal Drive Ext.
Wilmington, NC 28405
Attn: Rick Shiver
Brian Wrenn
Date Sampled:
Sampled By:
07/08/98
Brian Wrenn
STREAM: 31-322
Environmental Chemists, Inc.
MAILING ADDRESS: TELEPHONE: SHIPPING ADDRESS:
P.Q. Box 1037 [phone] (Office) 6602 Windmill Way
Wrightsville Beach, [phone] (Lab) Wilmington,
North Carolina 28480 [phone] (Fax) North Carolina 28405
NCDEHNR: DWQ CERTIFICATE #94, DLS CERTIFICATE #37729
REPORT OF ANALYSIS
Date of Report: July 24, 1998
Purchase Order #:
Report Number: 8-2079
Report To: Rick Shiver
Copy To: Brian Wrenn
PARAMETER
Sample ID
31-322
Lab ID
# 4750
Fecal Coliform, colonies/100m1
3600
Nitrate + Nitrite Nitrogen, NO3 + NO: - N mg/L
0.56
Ammonia Nitrogen, N113-N, mg/L
122
Total Kejeldahl Nitrogen, TKN mg/L
140
Total Phosphorus, P mg/L
25.8
Reviewed by 'j`t`(. GIN nd approved for release to the client.

p pw---
enviroch7eM j
6L� —.Mdgj®
Client:_ fit✓ �� W �,�-c.,— Qu�.�: �
ENWRONMENTAL CHEMISTS, INC
Sample Collection and Chain of Custody
6602 Windmill Way
. Wilmington, NC 28405
Phone: [phone]
FAX: [phone]
Collected BY:
.. .. ,
—,
Re ort No: 'S -aU—+G
_
Sam le T e: Inpuent Effluent Well Stream Soil. Other:
SAMPLE
IDENTIFICATION
COLLECTION
Camp
Gor
raf:
02
m IL
LAB
ID
PRESERVATION
ANALYSIS REQUESTED
DATE
TIME
I TEMP
none
110
n=so,
11NOs
nook
r1110
o'rtaFR
sec t-z"LZ
7�g,�s
q���
3a°C
��75UA
V
icc
reccl COl�ttrrv.
G
C
G
C
G
C
G
C
G
C
G
C
G
C
G
Maximum Holding Time Between Collection and Analysis: BOD 48 Hours, Coliform in Wastewater 6 Hours,
Coliform in Drinking Water 30 Hours,
Temperature when eceived: Accepted:
Delivered By: Received By
Comments:
iected: Resample Requested:
K. + Date• 8 Time: I',L.!

"7
Environmental Chemists, Inc.
® MAILING ADDRESS: TELEPHONE: SHIPPING ADDRESS:
P.O. Box 1037 [phone] (Office) 6602 Windmill Way
Wrightsville Beach, (9l0) 392-0223 (Lab) Wilmington,
CONSULTING North Carolina 28480 [phone] (Fax) North Carolina 28405
CHEMISTS NCDEHNR: DWQ CERTIFICATE #94, DLS CERTIFICATE #37729
Customer:
NCDEHNR DWQ
127 N. Cardinal Drive Ext,
Wilmington, NC 28405
Attn: Rick Shiver
Brian Wrenn
REPORT OF ANALYSIS
Date Sampled:
Sampled By:
07/08/98
Brian Wrenn
ST AM: 31-322
Date of Report : July 24, 1998
Purchase Order #:
Report Number: 8-2079
Report To: Rick Shiver
Copy To: Brian Wrenn
PARAMETER
Sample ID
31-322
Lab ID
# 4750
Fecal Coliform, coloniesh00m1
3600
Nitrate + Nitrite Nitrogen, NO3 + NOZ - N mg/L
0.56
Ammonia Nitrogen, NH3-N, mglL
122
Total Kejeldahl Nitrogen, TKN mg1L
140
Total Phosphorus, P mg/L
25.8
Reviewed by ee approved for release to the client.

POW'"*
envirochem
6L—
Client: w 01-�u� �.
Collected By:
ce.,.,.�e •rs,,,e. i..r,..e..* �....,,*VU
ENVIRONMENTAL CHEMISTS, INC
Sample Collection and Chain of Custody
SAMPLE COLLECTION Comp ' Cl,
or. mg/I.
IDENTIFICATION DATE TIME TEMP Grab
i`ec 1'i;zz 7�� qs 9.,Y? 3o°C
r
G_
C
G
C
G
C
G
C
G
C
c
c
G
w:
LAB PRESERVATION
ID NONE HC1 H=SO, HNO, NeOH THIO OTHER
Maximum Holding Time Between Collection and Analysis: BOD 48 Hours, Coliform in Wastewater 6 Hours,
Coliform in Drinking Water 30 Hours,
6602 Windmill Way
Wilmington, NC 28405
Phone: [phone]
FAX: [phone]
ANALYSIS REQUESTED
Temperature when eceived: Accepted: ✓ 'ected: Resample Requested:
Delivered By: Received By . K . Date: 0 Time: - l ' . t S .4 _
Comments:
{

IMPORTANT NOTICE
North Carolina Division of Water Quality (DWQ) is strictly enforcing EPA regulations
for sample collection and preservation.
Client Must Provide the Following Information
1. SAMPLE IDENTIFICATION (Container Associated with requested testing)
2. SAMPLE TYPE (Composite, Grab, Water, Soil, etc.)
3. DATE COLLECTED
4. TEME COLLECTED
5. SAMPLE COLLECTOR
6. DECHLORINATING samples to 0.2 ppm or less residual chlorine for Bacteria, BOD,
TKN, Ammonia, organics
7. PRESERVATION (Including Temperature and pH)
Temperature _Samples MUST be refrigerated or received on ice between
2 and 6° C. ' Samples received within two (2) hours of collection must show a
downward trend. Therefore, please record temperature at collection in space
provided on collection sheet.
pH : A two (2) hour limit to chemically preserve samples by pH adjustment is
allowed, except for metals samples reported to the Groundwater Section which
must be acidified at the time of collection.
The Laboratory will verify and document the above requested information.
ref NCAC 2H.0805 (a) (7) (M)
" At anytime a laboratory receives samples which do not meet sample collection, holding
time, or preservation requirements, the laboratory must notify the sample collector or
client and secure another sample if possible. If another sample cannot be secured, the
original sample may be analyzed, but the results reported'mustbe qualified -with the
nature of the infraction(s) . And the laboratory must notify the State Laboratory about the
inftction(s). The notification must include a statement indicating corrective actions
taken to prevent the problem for firm samples.
ref. NCA 2H.0805 a "

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
August 19, 1997
Byard Kornegay
Byard Kornegay Farm
776 NC Hwy 403 West
Mt. Olive NC 28365
A Ml."FA
I DEHNR
Im
AUG 21 1997
Subject: Farm No. 31-322
Additional Information Request
Byard Kornegay Farm
Animal Waste Operation
Duplin County
Dear Mr. Kornegay:
The Permits and Engineering Unit has completed a preliminary engineering review of the subject -
application. Additional information is required before we can continue our review. Please submit two
copies of the map showing field locations where the animal waste is disposed as required
in item 1(2) of the General Permit Application Form by September 19, 1997.
Please reference the subject farm number when providing the requested information. All
information should be signed and submitted to my attention at the address below. Please note that failure
to provide this additional information on or before the above requested date can result in your application
being returned as incomplete.
If you have any questions regarding this request, please call me at [phone], extension 363.
Sincerely,
gj:�
J.R. Joshi
Soil Scientist
State Engineering Review Group
cc: Wilmington Regional Office, Water Quality
Permit File
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

State of North Carolina gZECi VED
Department of Environment,
Health and Natural Resources - JUL 1 8 1997
Division of Water Quality
BY: - -
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
July 16, 1997
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Byard Kornegay
Byard Kornegay Farm
776 NC Hwy 403 West
Mt. Olive NC 28365
Farm Number: 31-322
Dear Byard Kornegay:
A4�jIL
E:>EHNFi
You are hereby notified that Byard Kornegay Farm, in accordance with G.S. 143-215.1OC, must
apply for coverage under an Animal Waste Operation General Permit. Upon receipt of this letter, your
farm has thirty. (30) days to submit the attached application and all supporting documentation. In
accordance with Chapter 626 of 1995 Session Laws (Regular Session 1996), Section
19(c)(2), any owner or operator who fails to submit an application by the date specified
by the Department SHALL NOT OPERATE the animal waste system after the specified
date. Your application must be returned within thirty (30) days of receipt of this letter. Failure to submit
the application as required may also subject your facility to a civil penalty and other enforcement actions
for each day the facility is operated following the due date of the application.
The attached application has been partially completed using information listed in your Animal
Waste Management Plan Certification Form. if any of the general or operation information listed is
incorrect please make corrections as noted on the application before returning the application package. The
signed original application, one copy of the signed application, two copies of a general location map, and
two copies of the Certified Animal Waste Management Plan must be returned to complete the application
package. The completed package should be sent to the following address:
North Carolina Division of Water Quality
Water Quality Section
Permits and Engineering Unit
Post Office Box 29535
Raleigh, NC 27626-0535
If you have any question concerning this letter, please call Mike Lewandowski' ai [phone]
extension 362 or Dave Holsinger with the Wilmington Regional Office at [phone].
Sincerely,
r A. Preston Howar , Jr., P.E.
cc: Permit File (w/o encl.)
Wilmington Regional Office (w/o encl.)
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

_.nD:SWGF� Alrrima! Feedlot Opera ion .Revi
Fadtlit r-
e E
3 3 Z
Farm Status:
Da :=; of , nspection E Tune of Inspectjon "
24 hr� Rime
Routine `O Complaint ❑ Follow-u
Farm Name:..,_..i44t" _ -_ - _ .. County:
Owner Name: 1 iZ . _ de 1J-f A &-(4. _ Phone No: �..�. fi s e
Mailing Address: ... �!. 7!t!,S.....�.. -. �` �.. .. 2 Y3(-
Onsite representatives Wr. _�..... _ Integrator: ��Z5
Certified Operator Name: -&4 - A-e.-t>� ....� _.
Location of Farm: -
Latitude 3 a '®° 3� Longitude t a t` C7Z ��
❑ Not O erational Date Last Operated: _ _ _
Type of Operation and Design Capacity
= ~�25�> a,{ - '��;,' _ 4��^� s .ors •..vr'p"a'>� �� ��e'� . �e
S,in►En_e K Poxa,p-Itr,
Nurrt3aer Y..Number a,t1e Number.:
Wean to Feeder I_a er Dairy
Rt
Feeder to Finish Non -La er Beef
Wean M_ _
f�
11 Farrow to Finish 0 Other Type of Livestock.
3x3 a _ x .
il MM.
g g ❑Subsurface Drains Present
w� � � Lagoon Area � Spray Feld Area
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes R No
2. Is any discharge observed from any part of the operation? ❑ Yes ® No
a. If discharge is observed, was the conveyance man-made? ❑ Yes ® No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWO) ❑ 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 DWO) ❑ Yes Q No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes No
4. Was 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 171 No
maintenance/improvement?
Continued on back
e E
Da :=; of , nspection E Tune of Inspectjon "
24 hr� Rime
Routine `O Complaint ❑ Follow-u
Farm Name:..,_..i44t" _ -_ - _ .. County:
Owner Name: 1 iZ . _ de 1J-f A &-(4. _ Phone No: �..�. fi s e
Mailing Address: ... �!. 7!t!,S.....�.. -. �` �.. .. 2 Y3(-
Onsite representatives Wr. _�..... _ Integrator: ��Z5
Certified Operator Name: -&4 - A-e.-t>� ....� _.
Location of Farm: -
Latitude 3 a '®° 3� Longitude t a t` C7Z ��
❑ Not O erational Date Last Operated: _ _ _
Type of Operation and Design Capacity
= ~�25�> a,{ - '��;,' _ 4��^� s .ors •..vr'p"a'>� �� ��e'� . �e
S,in►En_e K Poxa,p-Itr,
Nurrt3aer Y..Number a,t1e Number.:
Wean to Feeder I_a er Dairy
Rt
Feeder to Finish Non -La er Beef
Wean M_ _
f�
11 Farrow to Finish 0 Other Type of Livestock.
3x3 a _ x .
il MM.
g g ❑Subsurface Drains Present
w� � � Lagoon Area � Spray Feld Area
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes R No
2. Is any discharge observed from any part of the operation? ❑ Yes ® No
a. If discharge is observed, was the conveyance man-made? ❑ Yes ® No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWO) ❑ 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 DWO) ❑ Yes Q No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes No
4. Was 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 171 No
maintenance/improvement?
Continued on back

6. Is facility not in compliance with any applicable setback criteria? ❑ Yes ® No
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/1/97)? ❑ Yes ® No
• 8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes ❑ No
Structures (Lagoons and/or Holding Ponds
9. Is structural freeboard less than adequate?
Freeboard (ft): Lagoon 1 Lagoon 2 Lagoon 3
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 adquate markers to identify start and stop pumping levels?
Waste AV1211cation
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWO)
15. Crop type. . _.. ..._ -
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the cover crop need improvement?
❑ Yes 6d No
Lagoon 4
19. Is there a lack of available irrigation equipment?
For Certified Facilities Oniv
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal Waste Management Plan in any way?
22. Does record keeping need improvement?
23. Does facility require a follow-up visit by same agency?
24. Did Reviewer/inspector fail to discuss review/inspection with owner or operator in charge?
❑ Yes
(2 No
❑ Yes
pm
❑ Yes
® No
❑ Yes(]
No
❑ Yes
No-_
❑ Yes ® No
❑ Yes No
❑ Yes ( No
❑ Yes Ea No
❑ Yes E] No
❑ Yes jEl No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
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cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 11/14/96

//
State of North Carolina
Department of Environment,
Health and Natural Resources
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
November 13, 1996
Byard Komegay
Byard Kornegay Farm
776 NC Hwy 403 West
Mt. Olive NC 28365
SUBJECT: Operator In Charge Designation
Facility: Byard Kornegay Farm
Facility ID#: 31-322
Duplin County
Dear Mr. Kornegay:
Senate Bill 1217, An Act to Implement Recommendations of the Blue Ribbon Study
Commission on Agricultural Waste, enacted by the 1996 North Carolina General Assembly,
requires a certified operator for each animal waste management system that serves 250 or more
swine by January 1, 1997. The owner of each animal waste management system must submit a
designation form to the Technical Assistance and Certification Group which designates an
Operator in Charge and is countersigned by the certified operator. The enclosed form must be
submitted by January 1, 1997 for all facilities in operation as of that date. Failure to designate a
certified operator for your animal waste management system is a violation of 15A NCAC 2H
.0224 and may result in the assessment of a civil penalty.
If you have questions concerning operator training or examinations for certification, please
contact your local North Carolina Cooperative Extension Service agent or our office.
Examinations have been offered on an on -going basis in many counties throughout the state for
the past several months and will continue to be offered through December 31, 1996.
Thank you for your cooperation. If you have any questions concerning this requirement please
call Beth Buffington or Barry Huneycutt of our staff at 919/733-0026.
Sincerely,
A. Preston Howard, Jr., P. ., Director
Division of Water Quality
Enclosure
cc: Wilmington Regional Office
Water Quality Files
P.O. Box 27687, r-14Raleigh, North Carolina 27611-7687 r An Equal Opportunity/Affirmative Action Employer
Voice 919-715-4100 - 50% recycled/ 10% post -consumer paper

0
Site Requires Immediate Attention:
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: ��Z , 1995
Time:
Farm Name/Owner:
Mailing Address:
County:
Integrator:
On Site Representative: _
�0_ler R,101�_,
Phone:
Physical Address/Location: / •�vJii e2 j
Z
Type of Operation: Swin LL� Poultry Cattle
Design Capacity: Number of Animals on Site:
p//7/e /UC _2 034; � r
des / yzof-
A
DEM Certification N mber: 4CE DEM Certification Number: ACNEW
Latitude:Longitude: 70_°' . Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon hav ufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) e or No Actual Freeboard: year
Inches
Was any seepage observed from the lagoon(s)? Yes o&as any erosion observed? Yes o&
Is adequate land available for spray'?& or No Is the cover crop adequate? Yes or No
Crop(s) being utilized: S
Does the facility meet SCS mi imum setback criteria? 200 Feet from Dwelling or No
100 Feet from Wells? e or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes 06
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes 06
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes orOo If Yes, Please Explain_
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on
r
` r
Inspector Name
cc: Facility Assessment Unit
Use Attachments if Needed.

ly,

Y �a
s�
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