310398_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Quai

t 't
Type of Visit: 0 tompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: (3 / Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: - Departure Time: County:
Farm Name: A 160wner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative:
Certified Operator: YN Dyva� ®'prt"� 1sY %1Y-1.,
Region:
Integrator:
Certification Number: T^
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design
Swine Capacity
Wean to Finish
C►urrent
Pop.
Design Current
Wet Poultry Capacity Pop.
La er
Cattle
Da' Cow
Design Current
Capacity Pop.
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Farrow to Feeder
Design Current
D . Ploul_t_ry C_a aci P■o
D Cow
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turke s
Turke Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes L21'No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA 0 NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ZNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ETNo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

4
Facility Number: -?N 1 - ion Date of Inspection: 3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): LK
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
2jNo
❑ 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
0 No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
C2rNo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Z'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
WT No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
KNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
VrNo
❑ 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
KNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
rNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
;2rNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
V_No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[!fNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
fffNo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design 0 Maps [:]Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [!TNo
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes Q'No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

~
Facility Number: IDate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes [fNo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes [f No
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge
levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes [allo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes [7 "No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes E3"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 C2-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
ZNo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
0 No
❑ NA
[] NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[fj'No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�o
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
pq.' we•rV. 60 4'& tDo
Reviewer/Inspector Name: �p''7\�
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: 1
21412011

Facility Number I '
�-Division of Water Quality
0 Division of Soil and, Conservation.' .:
0 Other Agency,
Type of Visit �mpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for VisitG<outine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time:FOEENg-Mparture Time: L County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
';'Design
- - Swme Capacity..
m ❑ Wean to Finish
P ❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
9 ❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = i [= 6, Longitude: 0 ° =
Current Design,p Current ]
l'opulatitip Wet�Poulfry'. CapacityT Population: Cattle C
IlJ Non Layer f
r Dry Poultry
❑ Boars .
LJ Pullets
Turkeys
Other' , ;: ❑ Turkey Poults
FEI
Other P� ❑ 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
i
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 E '&o ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
jzrNo
❑ Yes
&
❑ NA
❑ NE
❑ Yes
dNo
❑ NA
❑ NE
Page I of 3
12128104 Continued

I
Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes JffNo ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 11-7
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes gNo ❑ 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 2f No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes . VrNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ff 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 2rNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need 0 Yes �o ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes PdNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
�No
❑ NA
❑ NE
[:]Yes
UfNo
❑ NA
❑ NE
❑ Yes
j2fNo
❑ NA
❑ NE
[:]Yes
&No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes [�No ❑ NA ❑ NE
❑ Yes dNo ❑ NA ❑ NE
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ,ZJ No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ZN
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
o ❑ NA ❑ NE
Page 2 of 3
21412011 Continued

Facili Number: IDate of Inspection: S
24. Did,the facility fail to calibrate waste application equipment as iequired by the perm/
w
❑ Yes
6 No
❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
No
❑ NA ❑ NE
the appropriate box(es) below.
TT
❑ 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
PNo
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
FefNo
❑ 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
)21 No
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
vNo
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? -
❑ Yes
EyNo
❑ NA ❑ NE
(Comments (refer to question #): Explain any YES answers and/or any additional recommendations or.,any other comme tts���'
Use: drawings of; facility to better explain situations (use additional pages as necessary).;
GS j2q M G-147rlC ar F/ /0 ItaLU 2 C' C7 C
liew GoC
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date: c
4/201

e
Division of Water Quality-'
�10
:Q Drv�sao of Soil and Water
Conservation ,, -' ,
0 0 er: Agen
Facihty4Number-
Type of Visit_,.(�r_Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit -Routine Q Complaint Q Follow up Q Referral Q Emergency Q Other El Denied Access _, �� /�h��
Date of Visit: L� Arrival Time: /,r �> C Departure Time: � County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Owner Email:
Phone:
Phone No:
Integrator: �h If &5
Operator Certification Number:
Back-up Certification Number:
Latitude: ° Longitude: °
Design C ru rent '� -- �Des�gn� Cuireri
ine�,_ __ Capac�ty�'Popttlahori Wet Poultry .Capacity Populatic
Wean to Finish �� ❑ Layer
Wean to Feeder❑Non-La er
Pullets
Turkeys
Feeder to Finish
Farrow to Wean"
h°Dry Poultry '•
Farrow to Feeder
Farrow to Finish � ❑ Layers wd
Gilts ❑Non -Layers
Boarsr
❑Turke s
El Turkey Points
Other ��.. ❑Other
&Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑Structure El Application Field El Other
a. Was the conveyance man-made?
❑ Dairy Cow
Discharges
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
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 -2110 ❑ NA .❑ NE
❑ Yes 48'No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes 61_I No
❑ NA
❑ NE
❑ Yes -E'No
❑ NA
❑ NE
❑ Yes p.ke
❑ NA
❑ NE
Page 1 of 3 12/28/04 Continued

Facility Dumber: 3 Date of Inspection �!
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes k No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ZNo ❑ NA ❑ NE
Strue 1 Struc e 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: G
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 12-No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes 2r-No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes �~No ❑ NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes IDNo ' ❑ 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 P-No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes -2 No ❑ NA ❑ NE
maintenanceJimprovement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes_J;'1Vo ❑ 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?
❑ Yesj:^No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes -M-No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes -P- No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes -23Qb
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes:-Q+io
❑ NA
❑ NE
Comments refer to question # .: Ex <.
( q } plain any YES answers any recommendations or any other comments
Use drawings of facility to better explain situations. (use additional page's as necessary •
g ty P P g )-
-
Reviewer/Inspector Name
Phone:
Reviewer/Inspector Signature:
Date:
Page 2 of 3 I21'28104 Continued

Facility Number:,3 I— Date of Inspection G G
-Recuaired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes P No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes jNo ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists El 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 ❑ 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
14 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
[I NA
El 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
l
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
}� No
ElNA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
Z No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
7No
❑ NA
❑ NE
Additional .Comments and/o"r Drawings: K=
/
AL
�C110,
Page 3 of 3 12128104

_-10—Division of Water Quality
m
Facility Number O Division of Soil and Water Conservation
Q Other Agency
Type of Visit p Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: ! Arrival Time: Departure Time: County: Region`//..AC
Farm Name: 3 �` D G Owner Email
Owner Name:
Mailing Address:
Phone:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: n Integrator: /—&
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
F
Gilts
Boars
Other
❑ Other _ _-
Back-up Certification Number:
Latitude: = o = i = Longitude: C
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
p =i = ar
Design Current !'
Cattle Capacity Population;
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
Beef Brood Co
Number.of Structures:,
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 ,0 No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
Cl Yes
J No
❑ Yes
;Xo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Facility Number: IE29Date of Inspection
4
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: _ J= _
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ❑ No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ❑ No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA ❑ 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? ; 1
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 [:IPAN > 10% or ] O lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
❑ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
❑ No
❑ NA
❑ NE
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):
y
Reviewerlinspector Name
Phone: 7-
Reviewer/inspector Signature:
Date: l
12128104 Continued

r
Facility Number: - Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ADNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ,E No [INA ❑ NF
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below, ❑ Yes J3-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 E]-No
❑ NA
❑ NE
23 selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes O-No
❑ NA
❑ NE
24 d the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes10
❑ NA
❑ NE
. 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 D-No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
/RNo
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes ❑.P�o
El NA
El 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
El NA
El NE
General Permit? (ie/ discharge, freeboard problems, over application)
//
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes 5'Ao
El NA
[I NE
33. Does facility require a follow-up visit by same agency?
❑ Yes b'1 "
❑ NA
❑ NE
Additional Comments and/or Drawings:
�y rf,< receti fv y/0-3S0 -a0�y
Aih�`-�
'A
Page 3 of 3 12128104

N
Fati(ity Number 3
,'Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit VC—ompliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit �Q'Routine 0 Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 6 Arrival Time: a Departure Time: County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsife Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
- Desi;
Swine Capa
n Wean to Finish
Owner Email:
Phone:
Phone No:
Integrator
Operator Certification Number:
Back-up Certification Number:
Latitude: ❑ c = I Longitude: 0 ° = g
x�
'urrefiV ` ,Design Current Design s Currei
pulatiori Wet -Poultry Capacity ;°•Population Cattle Capacity `r, illati
❑ Wean to Feeder
❑ Feeder to Finish
21 Farrow to Wean
a j/
❑ Farrow to Feeder
❑'Farrow to Finish
00
6
❑ Gilts
❑ Boars
❑ Other 1 1.
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Daia Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures
.M.
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 El No El NA El NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
12128104 Continued

Facility Number: Date of Inspection
ivaste 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 Sh-Wt re 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ❑ No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ❑ No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA ❑ 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 ❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate ManurelSludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) e, tl , S
13. Soil type(s)
In
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
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):
y
r� /J
Reviewer/Inspector Name CU[� 1 Phone: .G� 1 �Jl
��
Reviewer/Inspector Signature: Date: —� ��
Page 2 of 4 12hX104 Continued

Facility Number: 3 — Date of Inspection
.i
Required Records & Documents
l9. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1" Rain Inspections ❑ Weather Cade
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 CAW -MP?
❑ 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:
Page 3 of 3 12128104

r
IType of Visit .0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: / Q Arrival Time: 60 Departure Time: �ounty:
r
Farm Name: t d, m35�3Owner Email:
Owner Name: —�f �r�ewy' /Is& "W Phone: _
Mailing Address:
Physical Address:
�PL3� Region:
Facility Contact: ,y Title: Phone No:
�/f Q �,
Onsite Representative: / I'f �� co-Z& / VQ RerS integrator: / rM (tlRP'q-1 r JG��wAl
Certified Operator:
Back-up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = g = Longitude: = o = i
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean /
❑ Farrow to Feeder
10 Farrow to Finish
Gilts
❑ Boars
Other
❑ Other — - -
❑ Layer
❑ Non -La et
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at; ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifej
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes Ex No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes VNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

V - . , -
Facility Number:—�
Date of Inspection ! Q
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes to No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: L'.`.3 dCd
Spillway?: /i/0 M
Designed Freeboard (in): ZiO
Observed Freeboard (in): _ SD
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes XNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes No ElNA ❑ 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 A No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 21 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 V(No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes V No ❑ NA ❑ NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below, ❑ Yes X 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 Drifl ❑ Application Outside of Area
12. Crop type(s) 6"g v. W�f1/?i JfjE nlS
13. Soil type(s) WO�, ! D A /914 .
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 A No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination;❑
Yes 0 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
El NA
El NE
IS. Is there a lack of properly operating waste application equipment?
,(ZNo
❑ Yes yJ No
❑ NA
❑ NE
20) >,6 LO0' 3 ( "AY42elll
AM, Ir
20 9,4) �i?on, !�}�oo.J O,�s .cam.✓ Cc��rT.� �Q•�cv2,o s �IC-r�ca� �G `3 /��4 i
�i� � sy►�'�5
Reviewer/Inspector Name �, p. �:, 5 '. Phone:' ?d--7 ZW_
Reviewer/Inspector Signature: Date: / 47
12128104 Continued

1�• t�
Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ZfNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ yes ONo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ZNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
prNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
P No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
VfNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
VNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
;dNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
Other Issues
'ONE
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
0 No
❑ NA
Cl NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
1:1No
❑ 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
/[;Z No
❑ NA
❑ NE
Additional Comments and/or Drawings: t
20) AI'V/
F9eZ-60,94D, 2 SFr AT �� l�✓GI zS �QuzK6O %l1F/�iON2D
4
12128104

; ANIMAL FACILITY ANNUAL CE��R'�TIFICATIONFORM
CC
Certificate of Coverage or Permit Number NCA231398County DuUlinYear 2003 RECEIVED
Facility Name (as shown on Certificate of Coverage or Permit) BOC3503/3104 MAR 0 1 2004
Operator in Charge for this FaciIityAlton Mobley Certification # 25259 WATER GO;iL 11 f SECTION
Land application of animal waste as allowed by the above permit occurred during the pasty�t'aq'eTit `i Rg'-"0 Ent.
X Yes No. If NO, skip Part I and Part II and proceed to the certification. Also, if animal waste was
generated but not land applied, please attach an explanation on how the animal waste was handled.
Part I: Facility Information:
I . Total number of application Fields ❑or Pulls lease check the appropriate box) in the Certified Animal
Waste Management Plan (CAWMP): F-N/A/P-16Tota1 Useable Acres approved in the CAWMP
218.73
2. Total number of Fields ❑ or Pulls _ B (please check the.appropriate box) on which land application
occurred during the year: F-N/A/P-11Total Acres on which waste was applied 200.54
3. Total pounds of Plant Available Nitrogen (PAN) applied during the year for all application sites:
25,332.00
4. Total pounds of Plant Available Nitrogen (PAN) allowed to be land applied annually by the CAWMP and
the permit: 45.296.29
5. Estimated amount of total manure, litter and process wastewater sold or given to other persons and taken
off site during the year ❑ tons 0 or gallons T (please check the appropriate box)
6. Annual average number of animals by type at this facility during the previous year:
N/A Information provided by Mav 1 2004
7.Largest and smallest number of animals by type at this facility at any one time during the previous year:
Largest N/A
Smallest N/A
(These numbers are for informational purposes only since the only permit limit on the number of animals
at the facility is the annual average numbers)
8. Facility's Integrator if applicable: Murphy Bro-vvn. LLC
Part II: Facility Status:
IF THE ANSWER TO ANY STATEMENT BELOW IS "NO", PLEASE PROVIDE A WRITTEN
DESCRIPTION AS TO WHY THE FACILITY WAS NOT COMPLIANT, THE DATES OF ANY NON
COMPLIANCE, AND EXPLAIlV CORRECTIVE ACTION TAKEN OR PROPOSED TO BE TAKEN TO
BRING THIS FACILIT I- BACK INTO COMPLIANCE.
1. Only animal waste generated at this facility was applied to the permitted sites during"es ❑ No
the past calendar year"

2.
Thy facility was operated in such a way that there was no direct runoff of waste from
2Yes ❑ No
'
the facility (including the houses, lagoons/storage ponds and the application sites) during
the past calendar year.
3.
There was no discharge of waste to surface water from this facility during the past
©des No
calendar year.
4.
There was no freeboard violation in any lagoons or storage ponds at this facility during
C:I�es ❑ No
past calendar year.
5.
There was no PAN application to any fields or crops at this facility greater than the
9-1 es ❑ No
levels specified in -this facility's CAWMP during the past calendar year.
6.
All land application equipment was calibrated at least once during the past calendar year.
EYY//es ❑ No
7.
Sludge accumulation in all lagoons did not exceed the volume for which the lagoon
was designed or reduce the lagoon's minimum treatment volume to less than the volume
❑ Yes ❑ No
for which the lagoon was designed. . is
8.
*N/A Will be done and an file by April 24, 2004
A copy of the Annual Sludge Survey Form for this facility is attached to the Certification.
❑ Yes ❑ No
*N/A Will be done and on file by April 24, 2004
9.
Annual soils analysis were performed on each field receiving animal waste during the
Q-Yes ❑ No
past calendar year.
10.
Soil pH was maintained as specified in the permit during the past calendar Year:'
E�es ❑ No
11.
All required monitoring and reporting was performed in accordance with the facility's
Yes ❑ No
permit during the past calendar year.
12.
All operations and maintenance requirements in the permit were complied with during
" ' Yes No
the past calendar year or, in the case of a deviation, prior authorization was received
from the Division of Water Quality. Sew
13.
NJ
Crops as specified in the CAWMP were maintained during the past calendar year on all
Yes ❑ No
sites receiving animal waste and the crops grown were removed in accordance with
the facility's permit.
14.
All buffer requirements as specified on the permit and the CAWMP for this facility were
Eyes ❑ No
maintained during each application of animal waste during the past calendar year.
"I certify under penalty of law that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and
evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. 1 am aware that there are significant penalties for
submitting false information, including the possibility of fines and imprisonment for knowing violations."
NAY ti� r\ LLC,
Permit ee N4ne and Title Uype or print)
L �__�m _ •
ature rator in Charge Date
different from Permittee)

I F3 i COMMENT I
Facility Name
BOC3503/3I04 #12 Flush tank leak 5/8/03 & 11/18/03,flush pipe from tank
Ieak 5/12/03,field ponding 7/12/03.

e
ANI INIAL FACILITY ANNUAL CERTIFICATION FORM
AIIENDIIENT
Year:2003 M
Permit Number: NCA231398 3
c 7 lrJ�
County: Duplin
Facility #: 31-398
Facility Name: Farm #3 and Farm #4
6. Annual average number of animals by type at this facility during the
previous year:
Wean — Feeder:
Feeder — Finish:
Farrow — Wean:
Farrow — Feeder:
Boar Stud:
Wean - Finish:
Commercial Nursery_
Total Average: 3.383

Type of Visit O Compliance Inspection OrOperation Review Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: p Time:"_--^-+
G
Q Not Operational Q Below Threshold
[3"Permitted dCertifiied [3 Conditionally Certified © Registered Date Last Operated or Above Threshold: -.--._._ _.....
FarmName: ....A2W1 ..3.`l .�!.............................................................................. County:.....»'�•�UPiLW .......».. ... » ...._................
Owner Name: ......... .................................... Phone No:
Mailing Address: ... . ................. . ......... ....
Facility Contact; ............................... .................... _ Title:............................................... ........... Phone No:
Onsite Representative. �{
p •---� L�¢�--- �pr2�:�......._._...._...._ ..........................».... Integrator:.........��AJrt.�,:�.s..................................__._......
Certified Operator:_ _...._ ...._.. Operator Certification Number:.......... _. _.. .
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ horse Latitude * 4 " Longitude • ° «
- s Desega Current
Wean to Feeder
Rf
❑ Layer
Feeder to Finish
❑Non -Layer
Farrow to Wean
-
❑Other
Farrow to Feeder
6p
Farrow to Finish
I
(3M D�SI
El Gilts
El Boars
Cattle
Dairy
*Capacity;
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes /No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? 2/Yes ❑
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 phis storm storage) less than adequate? ❑ Spillway ❑ Yes /No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .... ,....... ... __ .... _.. �.... _....
Freeboard (inches)_ .33
12112103 Continued

Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ YesC�/No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ❑ No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify 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 maintenancelmprovement? ❑ 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 maintenance/improvement?
❑ Yes
❑ No
I l . 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
15. Does the receiving crop need improvement?
❑ Yes
' ❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge 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.
-Comuments (refer to question #) Ezplam any YES answers and/or any recommendatiops or apy other comrpents. s
:Use dirawrngs'of fatality to iietter explarn sttuab�(use addriianal pages as necessary) Field Coy ❑ Final Notes
Lehr— 3" rLUSA "rAt t 4' 4M ra4Wr 6F t40('
W6ose,5 SZn4 -towns Fox-sw '�jAT6r(_ LNm=*). AF*0y tMATGLY q06 To rc6
%0,Ll..0NS WAS 5AZD r0 4ZUO p6rJO, Z)MS T6 D L-rc.l4 . AvroJ u5E0
H L-6 VuyC'N E2. Oot,wr/ DXTCR BE f-69-e C-?J -tEe-VNGi
3AGr oOE. f3N D t)06 O
ryAXA fa'-61D iDZ7Tc q-. USED PUtAf TO fZc nAo"F D'TC- N WA-fC.n- AN o
Ar)q goG WgSfi(,. TOE? ALSO DAMPED. THE FRES4 wATCK'0"T
NOT", EfOTr6.0 Hoi-E (566 4 „^s;z.e' 5 -T!rAa
s rood A5 LEAk W13S
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8mP-r� 146L.t? ON 612516q A09 (olaylaq J05:r FOP, SAFE7J MEAS0ae
Reviewer/Inspector Name y�X N =< -` = -
�.�-__� . N m_ ...,... ,.�_�=.� .._ �_...
Reviewer/Inspeetor Signature: Date: (�o � O`)
12112103 Continued

Facility Number: 3 - 39 Date of Inspection
Required Records & Documents
2 L 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
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
N
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?
/
(iel discharge, freeboard problems, over application)
❑ Yes
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
�ZOO_'28.
Does facili re uire a follow-u visit b same agency?
rY q P y
❑ Yes
�f/o
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
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 forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
ddii�anal.Conuneats°andfor.-Draw:ngs• = -�-- -
..-;t�^�s=-_a"3s�-:r.-c;^{�:..:---c-cx.s•ti.^�... _. �_.._, �,_.._._..._.._.w._._ .-. _,n..-�e�-,. _.... ._ _ ___i._..i------- ��_.t. .., ...,_-._. .... ._,�._ _e,_. _...__��_i_._Y,_
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per, AN1 Fixx.THuz_ -vNSTAtiGE ?(AA* NO -Mr � AS O'Eu..
12112103

AA
�-
_».a� pe
Division w Water QRaYrty -. , 5 yr x r ', =c r r •z„
aaw� �?
'QXh_vrstasi'afSots"and.WaterConservat<an�
—a�tu '' �` wi+` t / ♦ y —' --�
.�-
-
Type of Visit AD Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit 22 outine O Complaint O Follow up Q Emergency Notffication Q Other © Denied Access
Facility Number Date of Visit:V-Not0perational
Time:
Q Below Threshold
Permitted Certified 0 Co�nlditionally Certified 13 Registered Date Last Operated or Above Threshold: _.___.-----_--
°t Farm Name:.. --. ... ..:............................................... .................. .. County: .......Q ` ?............ .....__._..
OwnerName: ... ...... ........ ....................... .......... ................. ............ ............... Phone No:
MailingAddress :....................................................... _ .................. _. _. ....... _ ..... _. .W.�.. - ,_.. �_
Facility Contact: W ......W-Title: ........... �.... ...... ......... __.. Phone No:
Onsite Representative: ..m .-GiaE L 1�... ............ .� .... Integrator: ,..-._..._._..... _........... ..... ......
..-..T....�.._............ - - ��_�-
Certified Operator: _, ................... ..........
Location of Farts:
Operator Certification Number:
❑ Swine ❑ poultry ❑ Cattle ❑ Horse Latitude ' 9 4 Longitude • 6 69
k. Crtrrent Desrgn , Cnrrent
y ,PoPtilation Poultry _ _Cpaeity,.Populaiio
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
a
Farrow to Finish
El Gilts
Boars
❑ Non -Layer
- OtherT
t= =
Desrgn Cn;rertl
Cattle _ _Ca aci ...'°Po 'ulatic
_-` ❑Dairy --
❑ Non -Dairy
wn
Number of LagoonGs4 - -
r
-- - - , - r= -
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes efN110,
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes 0
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? [ISpillway ❑ Yes No
Structure 1 tt Strructure Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...... D........... _ GPO .... ... ........................... ........ ... ...................... •......... ......................................................................
Freeboard (inches): 3 7- Z
12112103 Continued

Facility Number: 31 — ( Date of Inspection o
5. Are there any immediate threats to the integrity of any of the structures observed? Oe/ trees, severe erosion, ❑ Yes
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes��No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes ENo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yeso
elevation markings?
Waste ARPlicatiOn
10. Are there any buffers that need maintenance/improvement? ❑ Yes ZNc
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes Rio
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type C` Stj
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes0.60
14. a) Does the facility lack adequate acreage for land application? ❑ Yes
b) Does the facility need a wettable acre determination? ❑ Yes y
c) This facility is pended for a wettable acre determination? ❑ Yes No
15. Does the receiving crop need improvement? ❑ Yes ux
16. Is there a lack of adequate waste application equipment? ❑ Yes wo
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes 0<01
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes o
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.
'Conime`nts {refer_to question #) Fjxpla�n any>YES�an:�wers andlor �rmmerrda�tions or any�otli� �.
� .�coraments. ;_-�
Use drawl of fa`�ty to bettere�icplam�si3 ations. (ase:additional pages as iiecessary).� ❑ Field Copy Final Notes
0?DAtS 1 �91 Z FarL- COPLIJ OF 41,003
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: $�
12112103 8 Continued

Facility Number: JL _ Date of Inspection
L' -
23
Reauired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(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 Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection 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)
3I . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Farm ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes IJ No
❑ Yes
E No
❑ Yes
o
❑ Yes
❑ Yes
❑ Yes
o
;Noi
❑ Yes
❑ Yes
El Yes No
ErYes ❑ No
[I Yes
❑ Yes l'J N
❑ Yes No
❑ Yes ; o
❑ Yes ld O
121.12103

Type of Visit (I Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
I.
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit: O Time:
Not O erational 0 Below Threshold
Fd Permitted O Certified 0 Cenditionaily Certified #��[3/ Registered Date Last Operated for Above Threshold:
Farm Name: � /Yi W-3 �/ /17 T County:—19a'az l!_
Owner Name: / &xa��`.4ko A) Phone No:
Mailing Address:
Facility Contact: Title: Phone No:
Onsite Representative: �' I�L���L 1���,ri Integrator:
Certified Operator:
Location of Farm:
Operator Certification Number:
0 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 4 D u Longitude a 4
Wean to Feeder I JLJ Layer
Feeder to Finish ❑ Non -
Farrow to Wean
'arrow to Feeder , 000 ❑ Other
Gilts
Boars
lilVumber ofiLagoens L G J�JLI Subsurface Drains Present IlU Lagoon Area ILJ Spray Field Area 101
No Liquid Waste
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gai/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 C91lection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure
cture 2 Structure 3 Structure 4 Structure 5
Identifier: r��
Freeboard (inches): Q '4
05103101
❑ Yes 0 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
[--]Yes ,� No
El Yes 1CJ No
❑ Yes 0 No
Structure 6
Continued

Facility Number: —
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do anv of the structures need maintenance/improvement?
S. Does any pats of the waste management system other than waste structures require maintenance/improvement?
9. Do any stucrures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
'A'aste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
I2. Crop type (_ C/K,,/ VAg6/ 9 8�
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. is there a lack of adequate waste application equipment?
Reauired Records & Documents
17_ Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(it/ W'UP, 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?
(iel discharge. freeboard problems, over application)
23_ Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were. any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes )11No
❑ Yes 0 No
❑ Yes ZNo
❑ Yes ZNo
❑ Yes Qf No
❑ Yes ONo
❑ Yes 21No
❑ Yes ZNo
❑ Yes No
❑ Yes VNo
❑ Yes ❑ No
❑ Yes �fNo
❑ Yes 9No
❑ Yes XNo
�❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
(PfNo
VNo GcG
�N 1/��3
;2fNo
JeNo
PfNo
P�No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about tliis visit.
Cmmensto gaiWbz. i#)""- EE_-ps-n. .avyim
Yl$ i.ii-...•amr,a-nrdl�oir+b�.2ny.^- :rxie.4'c.;•omm»e.x.n'xd- atiLnisT
or.anv other�commenftt ,; "
lase drawrti s of facility to better ezphtm situations.juse addittttisl pages as necessary) ❑ Field Copv ❑ Final Notes_
,
- �n1$pECTzOtiJ �Dn10 T W� T f 6,vrj��E �O/y7 ep/�l
.. E✓6RyT47_fje_ APPE,gRFo a ,5-,C- 0.0 �.
Slop �°�n7p /ec/& C A&*CHeO G4-57- 1 �,� GR Z&>,Y
G11C-00AL
Reviewer/Inspector Name_, - �-,z
Reviewer/Inspector Signature: Date:
05103101 �/ r Continued

f k
Facility Dumber: — Date of Inspection
Odor Issues
25. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atior below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28, is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt.
roads. building structure, and/or public property)
29. is the land application spray system intake not located near the liquid surface of the lagoon?
30. N ere any major maintenance problems with the ventilation fan(s) noted? (i_c. broken fan belts. missing or
Or broken fan blade(s), inoperable shutters. etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
and/or
9'
❑ Yes 0 No
❑ Yes ON
❑ Yes VNo
❑ Yes VNo
❑ Yes XNo
❑ Yes ;" No
❑ Yes ❑ No
05103107

iiotSiOIE Of water Quafih'
,� QD don fSu�and'WaterConservat t
_ 4 Aft;
a -
KF
Type of Vlslt 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: Time:
Q Not erational O Below Threshold
0 Permitted 13 Certified © Conditionally Certified [3 Registered Date Last Opera r Above Threshold:
` .... County: . tG%�
Farm Name:....!!�Q.�r4J................
Owner Name: .......6k` J ...... CA i e Z-� p f.. LdCi.......... Phone No: .................... ........ . .................. .......... . .... ..
Facility Contact: .............................................................. I ....... ......... Title:............................ Phone No:
Mailing Address:
Onsite Representa
Certified Operator: ................................................... ............................................................. Operator Certification Number:
Location of Farm:
ASwine ❑ Poultry ❑ Cattle ❑ Horse Latitude A 44 Longitude • 4 0"
e ;Design , Current Design Current = =Di
ct;Ca acPopulation P.0a-PCattleoty -
Wean to Feeder
Feeder to Finish
Farrow to Wean
I
Farrow to Feeder
Farrow to Finish
❑ Gilts
❑ Boars
❑ Layer I 1 1. 10 Dairy
❑ Non -Layer I 1 10 Non -Dairy
❑ Other
Total'Design Capacity
Total'SSLW-
:Numbeir'of Lagoons ❑Subsurface Drains Present ❑ 1[,agooa Area . ❑Spray Field Area
Iiolduig Ponds /Solid Traps;; ` ❑ No Liquid Waste Management System
_?
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? )"Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑-No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .................................................................................
Freeboard (inches):
5100 Continued on back

s •�
Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes El No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste 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
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes ❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes ❑ No
20_ Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ❑ 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
r] No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Gooiinesnts (ireter..to question',#) .'Explain any YES answers andlor'any rero"maiendatsons ct"r ally other comments. T
_m.
_ _
Use drawutgs`of fact7ity to Better explain srttiattous: (use adci,tronaL`pages as-necessaty} = 4[] Field Copv El Final Notes
�i� �✓Fo ' L .e�,y,_ f�F Lr w s �' ..lei✓ 10 �
�' / ' ` �� r t'it��T�f .�.¢J,ev /'��2 �'.✓%fit✓ X .E''��-- (�/�57� E+E�, / ;erp
Reviewer/InspectorName
Reviewer/inspector Signature: Date: % 2 d Z�
O510310I Continued

Facility Number: 3 3 bate of Inspection /
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i-e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
[Additional Comments and/or Drawitr
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ iNo
❑ Yes ❑ No
❑ Yes ❑ \o
❑ Yes ❑ No
'(iLFq-�✓ �/P� ��-S (J'O�,tJG �/� �l/.��i� � /���i�L Y�O�, G,PFtt/5
7 �� r�FR L �G'.9-7 �✓S� c.��a
4*0
// Fib `f✓7® s���l_/R��S F� �•P�igc� ���
r
1,6� AO 430�YAZ /� /� 11 f i� �7 /p �Ti✓ Gfi✓�/f�/�7 �O
M
— 79d/< fed Gl % �i2FS/
05103101

Type of Visit 'Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visitb Routine Q Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 3 Date of Visit:
13 Permitted © Certified 0 Conditionally Certified 13 Registered
Farm Name: 13,-a 4 m s C -01 ���, ►.� 3 ��{
Owner Name:_ Or�-^�'--------------------
Mailing Address:
Zy Ez Time: S!
Q Not Operational O Below Threshold
Date Last Operated or Above Threshold:
County: -.z ,! . << �...- -- -.................
_.._. ----•--•--•--•---
PhoneNo: --------------------------------------- ---
Facility Contact: ...........................................................Title:....................: ..... Phone No:
Onsite Representative. _-- ° _ t-c^Goc Integrator:_ ''°i^" _-W !_a_ �_-L'�-.___.__.
Certified Operator: .......................................... ........ ................... ..... . ....... ........... . .. ... ....... Operator Certification Number:
Location of Farm:
❑ Swine ❑ poultry ❑ Cattle ❑ Horse Latitude �• �6 Du Longitude • 9
urgent -Deli
gn-
maifio` "Poultry-, Ca aci '
❑ Layer
= Design Current
i :Cattle Ca aci "Po ulatio
❑ Dairy
rl Non -Dairy
❑ Other -
- Total Design C
Total
LW
Discha 2es & Stream Impacts
1. Is any discharge observed from any part of the operation?
. ❑Yes 2140
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 gal1min?
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? OYes ❑ 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 2No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier: 3 -•----.._......-- -- - -- ----•----.......................... --•--•-----•-=•--------•--........................... ........................ •--...........................
Freeboard (inches): 36 '? 3
�:-, -- :f+•' ;ter;_., -- ���"��'_r:'•r.=.-,T"�";oyf���=�3:`�S•'.''�53���..•�\!�4.�:,�s•.lv-ti.;-<i"••.lv�4s'�9�.r�t<_i:,_.s�'�Yv,.c��-.rc;-< .- s _, ..:e:-•,r-•rv:�,::v;-

wiv�ivt
acility Number: 3 1
Date of Inspection iF 2 Y D z
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement?
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?
t,unitauea
❑ Yes ,!fNo
❑ Yes ,0 %
❑ Yes ,ONO
❑ Yes eNo
❑ Yes ffNo
❑ Yes XfNo
11. Is there evidence of over application? ❑ Excessive Ponding P"PAN ❑ Hydraulic Overload Iff Yes ElNo
12. Crop type C[� • n 1 tv'kz v 1 �O be A P%-J_ -
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ONO
14. a) Does the facility lack adequate acreage for land application? ❑ Yes P'No
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iet WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (icl 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 reviewlinspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes", -ONO
❑ Yes E]rNo
❑ Yes PNo
❑ Yes _;AO
❑ Yes �o
❑ YesjEfNo
)21'Y'es ❑ No
❑ Yes ZNo
❑ Yes �No
❑ Yes ❑ No
❑ Yes No
❑ Yes ,0 No
❑ Yes _121�o
[] No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Commen's� e[er to questron#) Explain-any'YES anew rsand orany°recommen!dationsIor any other commett
Us drawn s f faciI� tw ette lain situa ions u e�addi ion$ a es�as�necessary
moo' '`p ❑Field Cop ❑Final Notes
y
w
19 f 3,-- L&se p.p ,r 6e-in1--j llouC,hce '011 4e Tke-2'a-
-
e
6)
Dr /fE
7416 r l�tVc 7�il-ltOZ
U SeO� Bn ��� �►212� Z �S f'ar W � e A � off ZDO}
{�r �lys�,a�Hfs j-b2 sJhee t-✓ let9il /oljpj✓ed 4�,av�
Reviewer/Inspector Name;? ' r„�_r=i`ri,;
.'°'�
NKi
Reviewer/Inspector Signature: Date:

Facility Number: Date of inspection 2 Q2.- Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes _,ETNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes _,Pf&o
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 ;3No
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 ET -No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes J2'�To
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional Comments and/or rawtngs: = --
6^ehD +1 r 02 S)q[ is wj?i;r�, WaJ Used.
�l �4 dt�o�c- -�?,.� e'v 6Y"A o1 c'�,-�"0 f C & V r- - ed oy,
-ZOO Z "VLl1� ef� GrGr b� S, S� j bsI acreI�l
vn N I I a� z-4 4,7 azn evl aMd of N ydr ^,oi4 Z o-F
l bs %GC f r P Sep C��trrlel�-}I above
V►1d�� �� _ ��� - !; Wr AC,re 'Mr�O %D�-�`f �r �/e��'f� ��f Qp ICE
-la HVd r41-1-+ 1 Avd W ydr10?NT 2
z There G,Qs bee-1- G, e4;sckA1-9e ��' wa-54e ceri4o-v
r'VO4 ��d wr'S40- ; s fl-'Ad l eld ;"I4 lie �.a��✓way . ;�.. j-acae
s-'r-iy.s J'-%6i4 411e,re Uro,S of reC'FVV} yd,ran e Wl'c�,
�GJ 6een %,vRIe el-, . = + See ^tis a�a-� q le wr,4e r way iV\
-Ik; s rrec SII�^.o�rci Je
Nn4c New aY-5 kic,ve beep 1'r,s4ci (ad i\it ` ke I oane"r
w
S/00

eDivisiau of Water Qaalitp
�p a
OtheT.,Pl�gexic
a
Type of Visit _QJCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit �5 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of visit: 2 (o Time: 9 = 0
� 1 3
NNot Operational Q Below Threshold
Permitted [3 Certified 0 Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: .........B.v • . w r•...........3.��+...�.............................................................. Coantv:.. `. t'' 1
OwnerName: .......13.r a uv � s... ............................................ Phone No:.......................................................................................
Facility Contact:
Title: ................................................................ Phone No:
Mailing Address: .................................. ..........
Onsite Representative: �en �.�cd Integrator: Rr'aW Y-s `F CA-0
............................................................... ..
Certified Operator:
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • ° 64 Longitude • 4 «
Design Current Design Current' Design rrent-,4
Swine capacity population Poultry CapacityCipiiiity Population Cattle Ca aci Po ulatioii
❑ Wean to Feeder ❑ Layer ❑ Dairy
❑ Feeder to Finish 10Non-Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other -
❑ Farrow to Finish TotaH,0sign 'Capacity.
Gilts
❑Boars Total SSLW-
Number"of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
_.
Holding Ponds I Solid Traps ❑ No Liquid Waste Management System
Discharees & Stream ImBacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3- Structure 4 Structure 5
Identifier: .............7................................�.....................
Freeboard (inches): Ty
siao
❑ YesAfNo
❑ Yes JgNo
❑ Yes No
h /A
❑ Yes 9 No
❑ Yes RfNo
❑ Yes ;2[-No
❑ Yes JVNo
Structure 6
Continued on b"k

Facility Number: -3j Date of inspection 2 Qi
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste_A"lication
10. Are there any buffers that need maintenancelimprovement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type C D yr'''l I �'�.! hOq� A'S S
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ZNo
❑ Yes )2No
❑ Yes J' No
❑ Yes JdNo
.9Yes ❑ No
❑ Yes' No
❑ Yes ONO
❑ Yes EfNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes �No
❑ Yes �fNo
❑ Yes ONO
❑ Yes ,�dNo
❑ Yes 0 No
❑ Yes )ZNo
❑ Yes ;'No
❑ Yes 10 No
❑ Yes XNo
❑ Yes )&No
❑ Yes
)Z1No
�iq-*iol0tignis:er d0rid ndbg •wire h0fe(l jiotiiig Ois'Apit; • Your'yMI- reegi'ui-th tr.
ctiriespi deiice: abauti this visit:
Commeats (refer to-ggpSdon fit) Exglarn any YES answers and/or any recommeadati<ons or any other cone Ms. "" ,
Use di•awirigs of facility to better-eiiplain situations. {use additional pages as neccssgcy) -
9. LA oo� 3 �ct3 r¢ v;fed��'ce&oa,,p� a� 2.'7-ree� ate( � ao[•�
� t apt -fre e g &A.^A o� 2 . z �`e� . La oo► % hi qr- ke rs m eed Ao
A hcedS be bv,'1-f ceY-P-[e,,- Po of ¢V C419e,4et,h Rw
h ra v R. C -Fj v i' S 11 s .-Pvj.,� n eed S 4-o be .f'; xc d s� i 4Jon Y- leel K'r�dC
9" ut,,d needs o c cle�ncal v�rJ qs tiep�s�r1��1,ve Says rsplg��ed;
Reviewer/Inspector Name -lo=h t l:J a �!'t 1 4 t t Sg, - :: ,
.�
Reviewer/Inspector Signature: L,;` Date: 2 i 5/00

Facility Number: 3 /— 398 Date of InspectionZ jD J
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 ZNo
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 '+I0
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 UNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes'ONO
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? 0 Yes ❑ No
Additional -omments an
or_
trawtngs:
n oJe,,4 q b Eve e
-Ac 1 041J <k n A e Q O rd S
a1 rc h PG T� y k2pi .
�
S/DD

Facility Number ')ate of Visit: I dI 'fiine: 1 K30 1 Printed on: 10126/2000
Q Not O erational Q Below Threshold
© Permitted Q Certified © Conditionally Certified © Registered Date Last Operated or Above Threshold:
.........................
CJ C� -� �(
FarmName: ...............................�................................................................................ Countv:....I�.................................................
Owner Name:
Phone No:
FacilityContact: . Title:.......................................................... Phone No:...................................................
MailingAddress: ............................................ ...... r.................................................................................................................................................. ..........................
Onsite Representati<<e: � yJ { '—` ��15 inte rator
........................''1.........-.................. g 1• • ....; 4��F.......................
Certified Operator: ...... ­­­­ ........ I ......................... ............................................................. Operator Certification Number:..........................................
Location of Farm:
r•
[]Swine []Poultry []Cattle []Horse Uktitude * 0` ��� Longitude 0
Design Current
Swine CaDaCitV PODulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I ❑ Dairy
❑ Non -Layer I JE1 Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impact~
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon [I Spray Field Other
a. if discharge is observed, was the conveyance than -made?
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ)
c. If dischanx is observed. what is the estimated flow in galhnin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
IRfyes ❑ No
❑ Yes 9No
PTYes ❑ No
3--q
❑ Yes RNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
Identifier: .
Freeboard (inches):
5100 Continued on back

Facility Number:3 1 — 3 5 M Date of Inspection H Printed on: 7/21 /2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ❑ 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
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
I8. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes ❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ❑ No
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes ❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
Oe/ discharge, freeboard problems, over application) ❑ Yes ❑ No
23. Did ReviewerAnspector 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: io-viol'afioris'oi- ddicienc' *5* were noted• d(Whig ihis:visit; Yoii Will•feeeive Rio further • : .
....................... ......
-.�correspori�encea�autthisvtsit..�.-.�.-.-.-.�.-.-.•.�.�............. . . . .. ..... - - -
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):
V t3 �`-� ties c c �\ ►�-\ �G C 1:"LL
At
S
Svc X , 9-qQ G �
Reviewer/Inspector Name ove_ ,e
Reviewer/Inspector Signature: Date: ,'72Q 1 5100

C fity Number. ` — at Date of Inspection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge Wor 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
. itiona . Comments and/or rawtngs: _
1�-�-c t-�� h^� l�-U �t✓� . 1 '� � � � � CUP
c � � 0oo+
5100
J

V
x-
ap
t
<
41
'-7
Ai
X-
. 11 J -1 1
N
il;rAy �0,
10,
--- ---- ---
J
N, -2
D?3 7 7
ke,
7
nl—
"it
' ' \ �� 31 s `� 1955
000 FEET 2 30
57'30' �31 (CHARITY) 232
"53 IV sw 33 55' 234
SCALE 1:24 000
KILDMETEFIS 12
100[ ------
0 luou —2WO
1000 0 1wo 30M MILES 50005000 7000 BODO IDOOD
�FEET����
CONTOUP UqTERVA- 2 METERS
NATIONAL GEODETIC VERTICAL DATUM OF 1929
rn%-m.r)i rir,—nvc __. _,, _,,..

Type of Visit 0 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: 1-17-200i ,q'ime; 1530
0 'Not Operational O Below Threshold
Permitted [3 Certified M Conditionally Certified © Registered Date Las{Operated or Above Threshold: ...................
Farm Name: County: Dupliu----------------------- YErIIiQ- --
Owner Name: ........................................ . .... . .. Rru)e 1.'.a.of.CAraUj>t,.Im................... Phone No: 2. 0A,2fi:18DO..........................
Facility Contact- Title: ............................................... Phone No: .......................................
Mailing Address: �QBou�4�Z-----------------_w...----------------------aria A1C--------------•-------------- 2839---._..
Onsite Representative: Czar ��ratfk,.Oletaaliaxi........_................................ Integrator: Briatixn'.s..of.GAtjutta'krp.................................
Certified Operator. A�xid....._........_...—..._.._ It ...................... ..__._..__.__._. „Operator Certification Number- ..$.7.95......................
Location of Farm:
South of Keuansville. At the end of SR 1981 oft of SR 1959. +
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 53 ' 14 " Longitude 77 • 58 41 u
s
..:Aesig>t Ctlltkcut _. -
Sw,ne .................. a acx €Pa ullattvtiE...:..:' :1
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
® Farrow to Feeder
2000
® Farrow to Finish
1200
❑ Gilts
❑ Boars
ihmber o l.agnotts 2 ® Subsurface Drains Present ❑ Lagoon Area 119 Spray Field Area
... -
Holding Ponda 1 Solid Traga ❑ No Li uid Waste Management System -.
.ey
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ® Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in galhnin?.
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?
® Yes ❑ No
❑ Yes ® No
® Yes ❑ No
3.5
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
Mm1m1

f L
r
Facility Number: 31-398
Date of Inspection
1'
i-17-2001-!
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
n
Identifier: .. _................. ..... __ _.......................................... _.. _........:'... _ _.._ ..... _...... _.._.. . _.. _.. _........... _.. _...
Freeboard(inches): -- -- -- -- -- -- -- -- -- - -- -- - -- -- -- -- ...... -- -- -- -- -- -- -- -- -- -- -- -- -- -- - - -- -- -- -- -- -- - --
5. Are there any immediate threats to the integrity of any of the structures observed? (le/ 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 runprovement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenancehmprovement? ❑ 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,Ovcrload ❑ Yes ❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre deternnation? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
17. Are rock outcrops present?
❑ Yes
❑ No
18. Is there a water supply well within 250 feet of the sprayfield boundary? ❑ Unknown
❑ Yes
❑ No
❑ On -site ❑ Off --site
Required Records & Documents
19. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
20. Does the facility fail to have ail components of the Certified Animal Waste Management Plan_ readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
21. Does record keeping need improvement? (iet irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
22. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
23. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
24. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ict discharge, freeboard problems, over application)
Yes
❑ No
25. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
[] Yes
❑ No
26. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
27. Were any additional problems noted which cause noncompliance of the Certified AWMP? .
❑ Yes
❑ No
Odor Issues
28. 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?
29. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
0 No

r
u:�liut
Facility Number: 31-398
Date of inspection 1-17-2001
Continued
Printed on: 1/232001
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
32. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
33. Do the animals feed storage bins fail to have appropriate cover?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
34. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Field Copy N Final Notes
in response to call from Brown's of Carolina about release of waste from flush tank overflow.
mington office notified at approx. 2:30pm on 1-17-2001. Problem discovered at approx. 7:30am by BOG personnel.
Baste entered stormwater diversion into ditch that enters into Stockinghead Creek. Worst case is a release of approx. 2,400
allons based on information provided by BOC. Amount is more likely approx. 1,000-1,500 gallons. BOC blocked ditch and
umped waste back into lagoon. BOG personnel already at nearby farm (31-766) dealing with another problem.
: BOC informed to make notification for 1000{ gallon release. BOC should attempt to make notification in a more timely
ner in future.
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:

Division of Water Quality
-O Division of Soil and Water Conservation
Q OtherAgency
Type of Visit _'Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ):� Routine O Complaini O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit:
Facility, Number 3 39�
firPermitted [] Ci�e--r`-tified ©Conditionally Certified j�[] Registered
FarmName: ........t^u!...............................................................'` ..... ..................I..............
Owner Name: �5r'OW ✓t S �7 . �rD 1 �L►Z C
'riine: � Printed on: 7/21/2000
0 Not Operational Q Below Threshold
Date Last Operated or Above Threshold: .........................
County:.. ...Ltta.-.- 2 1...L.—..........
Phone No:
Facility- Contact:..............................................................................'I itle:...... .......................................................... Phone No:...................................................
MailingAddress: ................................... ....................................................................... ....................................................... ......... I ...... ..-...........
J�ev art 1-,/eS-�a� �,J KDW� �jr ! ..........................
Onsite Representative: ........................... ......f. �1. ...........-.. Integrator: 6...✓'t S T ....i
Certified Operator: .................... Operator Certification Number:
Location of Farm:
F1
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
Z df�(1
J t7
Farrow to Finish
112,00
1 1115,0
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number Of Lagoons Z ❑ Subsurface Drains Present ❑ Lag�n Area ❑Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. V discharge is ohserved. did it reach Water of the State? (If yes, notify DWQ)
c. if dischart,,e is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate'? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: .....�r- "`\ 3 � P', 4
..............I......................-...........................................................................................................
Freeboard (inches): Z6 q 3
5100
❑ Yes thio
❑ Yes KNo
❑ Yes ONo
❑ Yes PNo
[--]Yes PNo
❑ Yes F'No
❑ Yes ff No
Structure 6
Continued on back

k
acilit?Number: j J — 3 Date of Inspection UWZRIPrinted on.• 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ONo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes M No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
T Do any of the structures need maintenancelimprovement?
❑ Yes
0 No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
`RI No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
KNo
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
�fNo
It. Is there evidence of over application? ❑ Excessive Ponding OPAN 0 Hydraulic Overload
Yes
❑ No
12. Crop type t-,i �,�1 , So 6ect+'�.f
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
gNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
UNo
b) Does the facility need a wettable acre determination?
❑ Yes
V] No
c) This facility is pended for a wettable acre determination?
❑ Yes
k4 No
15. Does the receiving crop need improvement?
❑ Yes
®No
16. Is there a lack of adequate waste application equipment?
❑ Yes
A No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available'?
❑ Yes
�No
18- Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
0 No
19, Does record keeping need improvement'? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
)3 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
V No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
'SNo
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
❑ Yes
0 No
24. Does facility require a follow-up visit by same agency?
❑ Yes
t[No'
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
19No
:: �Vo V44i tiotis:or• iieftciencies v�ere hated. during fhis:visit: Yoif will r'eceiye Rio: further:
comes oiideizee:ab0' UAthisvisit.::::::•::::::•.-.-.-.-:•............:...:.:..................
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):
�! . 14 ydrau);f aver load in3 an4 pfiAf hq-,& oc�ur✓ed.
►V ok o Cure_.- pica}-A-•aveis over ��-�c1�25/wa- �Y�va�s gtnd ek
A S► 'I Vdd1C 0,1 wit 4e- 'V',5 DbSev C'A lh 4zrrt, f 7h Use C&LA)',Itn
L4 Ine 11 Spr�� ;ti,oy rtie�,' -��� Se grvrtr . ! -
ao t ✓er►�ved
deed
f-�ti /S� la9c 6� jes
speGi �. lly-lhdse-- QbdcrlGdv
Reviewer/Inspector Name S4,0h e tJ A 1) ti )1); ,.S
Reviewer/Inspector Signature: Date: Z 0p 5/00

Facility Number: Date of Inspection 9 2 ad
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 allo
31 _ Do the animals feed storage bins fail to have appropriate cover? ❑ Yes O No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ®"No
3/23/99

0 Division of Soil and Water,Conservation.-Operati
on] Review
_ .Division of Soil and;Water Conservation Compliance -Inspection
y Qualr on of Water Com Rance3ns ection_
t _ ty p - . p r:
DOther_ Agency Operation Review_
LR Routine O Complaint 0 Follow-up of DWQ inspection 0 Fallow -up of DSWC review 0 Other
Facility Number a Date of Inspection
Time of Inspection �G 24 hr. (hh:mm)
Permitted I] Certified (3 Conditionally Certified 0 Registered 113 Not O erational Date Last Operated:
Farm Name: 4 �...... #.q..........................................................................
County: ....... .Dvoita...................................... .......................
Owner Name:............... k
t!DkX1S.....4....... Q�lfCl lt!. Phone No: _..CgLoQ ..Z:1. -Iwo..........
FacilityContact: ...........�.�9C........ ..................... Title: ...................................... .......................... Phone No: ...................................................
Mailing Address 'T ........................ ............1 lyrsafd.T... tir. ...... ........ _....... __....... ....
Onsite Representative: .....�.�.....n .......... ..�.`.�Cr ................................................... Integrator: ...... &.WXJ.S..........................................................
Certified Operator: ...................................................
Location of Farm:
.................................................. Operator Certification Number:..........................................
E.......... .................. ........-............................................................... ........ ................. ........................................
Latitude ���� �• Longitude
Design Current Desi Current _ Design Xuirent
Swine atte tPyy Capacity _Po Capacity onCapacity Population':
❑ Wean to Feeder ❑Layer ❑ Dairy
❑ Feeder to Finish ❑Non -Layer ❑Non -Dairy
❑ Farrow to Wean -
Farrow to Feeder ❑ Other
Farrow to Finish
Total Design Capacity 3�p
Gilts
❑Boars = - . Total SSLW
�Nttmber of:Lagoons = Z ❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area -
1101ding.-Ponds I. S61id Traps 10 No Liquid Waste Management System
Discharge- & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated ,w ❑ Lagoon ❑ Spray Field []Other
a. If discharge is observed, was the conveyance man-made`? ❑ Yes 0 No
b. If discharge is observed, did it reach Water of the State'? (If ycs, notify DWQ) ❑ Yes P No
c. If discharge is observed, what is the estimated flow in gal/min? NIX
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) []Yes M No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes [9 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [P No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes W No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 3 4
Freeboard(inches): Z1.. 44...........................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes M No
seepage, etc.}
3/23/99 Continued on back

1 iteilityANumber: Date of inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11, Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
I RHD
❑ Yes
® No
M Yes
❑ No
91 Yes
❑ No
❑ Yes
® No
❑ Yes
[M No
❑ Yes
0 No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15_ Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes tg No
❑ Yes ❑ No
❑ Yes ❑ No
Oyes ❑ No
❑ Yes No
❑ Yes ® No
❑ Yes 0 No
❑ Yes W No
Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes [J No
❑ Yes No
❑ Yes No
0: Ito ....s.......... were noted iiur ig �1�is;visit: Your will receive to .further
. . ;comes oncence. ab'OU
f this .visit. ..
Comments (refer 'to;.question #),.. Explatt:any;YESMansweis and/ot.'any recommendations or,any other continents g
T
Use.drawings of facility -to better explain.sttuatioitts (uk. additional_pages as -necessary) -'
�• Cori ntx "A-, ft2fjVk- 6,-'- Cum 0, O\A,e. r )11(1 F1
"kV0 be— &)Z�d
e Yc� p i " Ny,\O f J La's
�� � P b� �. tam i R -2 �orvns .
tq. C.t�rrcc� �� N 4\OLAj �tx�o �t t�
_.
Reviewer/inspector Name
Reviewer/Inspector Signature: - Date
3/23/99

Facility Number: Date of Inspection -`--�
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below 0 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 ONo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes OA 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 5No
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 [R No
3I . Do the animals feed storage bins fail to have appropriate cover? ❑ Yes q No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ® No
Additional -Comments - and/or Drawm
3123/99

Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 31 398 Date of Visit $-9-z000 Printed on: 5/16/2000
0 Not Operational O Below Threshold
Permitted E3 Certified M Conditionally Certified E3 Registered Date Last Operated or Above Threshold: .........................
Farm Name: f au'.not.#1.atpd.EArm#4................................................ .......................... County: D.upUn................................................ N..IT�tI.........
Owner Name:. .................................................. .................... Phone No: 9.1.0.-29.b.48.0Q............................
...............................
Facility Contact:
Title:..........
......... Phone No:
MailingAddress: PQ.Box.48.7............................................................................................. W!a>t'saw.NC.......................................................... 18398 .............
Onsite Representative:........................................................................................................... Integrator: Br.awn!.&.of.jCarohxx3,.1nC .................................
Certified Operator: Rarid...................................... Im .................................................... Operator Certifcation Number. .X8.725.............................
Location of Farm:
.......................................................................................................................................................................................................................................................................
ia>xt�. o��enatx�rill�....�.t. t!a><.��asi.Q�:�Ii,.1Q$3._Qft.at'.S.Ii..I9.�13�..................................................................�---�---..._.._........_.............._......................................
....................................................................................................................................................................................................................................................................... .
® Swine ❑ Poultry [3 Cattle ❑ Horse Latitude 34 - S3 6 14 " Longitude 77 ° S$ 41 L[
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
® Farrow to Feeder
2000
1950
® Farrow to Finish
1200
1150
❑ Gilts
❑ Boars
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: © Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
❑ Yes 9 No
Yes 0 No
❑ Yes X No
❑ Yes N No
❑ Yes No
❑ Yes No
4. Is storage capacity (freeboard plus storm storage) less than adequate'? ❑ Spillway ❑ Yes X No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ........... fatm.3 ...................... fam4........... ........ ......... .......... ......... ................................... ......................................................................
Freeboard(inches):................29............... ................ aa ............... ................................... .................................... .................................... ....................................

M cility Number: 31-398 Date of Inspection 5-9-2000 printed on: 5/16/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes N 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 N 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? N Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes N No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes N No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes N No
11. Is there evidence of over application? ❑ Excessive Ponding N PAN N Yes ❑ No
12. Crop type Soybeans, Wheat
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes J No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes N No
b) Does the facility need a wettable acre determination? ❑ Yes N No
c) This facility is pended for a wettable acre determination? ❑ Yes N 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 review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
4-NO',vi;olaiions'tar'&ftciencies'ivere:cioied'du'riing iiiis'visii;' V-iri �vi11'ri! :eive.no hift ier .'
rarrPeririwNPricw ahriiit'*Ri�.vatii.-'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
...................................
7 - Vegatation on lagoons needs some improvment. (East side of farm 3) (West side of farm 4)
I I & 19 - Field # 4 - Hydrant # 6 has over application PAN = 17.69 lbs/ac
Field ## 3 - Hydrant # 08a has over application PAN = 17.19 Ibs/ac
Field # 3 - Hydrant # 08b has over application PAN = 31.14 Ibs/ac
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
N Yes ❑ No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
AL
IV
Reviewer/Inspector Name John C[►p�g.:` ......::.

Facility Number: 31-398 Date of Inspection 5-9-2000 Printed on: 5/16/2000
Odor Issues
26, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes H 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 1@ No
28. Is there any evidence of wind drift during land application? (i.e, residue on neighboring vegetation, asphalt, E} Yes CR 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 CK No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, mussing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes H No
31. Do the animals feed storage bins fail to have appropriate cover? 0 Yes X No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? 0 Yes X No

Division of Soil and Water Conservation 0 Other Agency
Division of Water Quality
110k Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review Q Other
Date of Inspection g I
Facility Number I Time of Inspection :3 24 hr. (hh:mm)
[3 Registered yP Certified © Applied for Permit
f� 01 Permitted E3 Not Operational 1 Date Last Operated:
Farm Name: .................... ikXt!s ............ .3......A.......#A. E ......... .. County: .....l.. upl.i.......................................
Owner Name:................... .... �' .5....6 ......... �.b! �.�.............................. Phone No:....... ` (.4.. 2a .:...ti....................................
Facility Contact: ................. S t+m.......1.. .............. Title: ..... Phone No:
Mailing Address: ..............:. &. ` s ..-- ......NC .................................... .4nik........
Onsite Representative: ............. "K.......... bY.L'z ................................................. Integrator: ....... &_CCJA.S............................................................
Certified Operator:............................................................................................................... Operator Certification Number:....................
Location of Farm:
..we .......s.� a....... ►i. �.....Sty.. ............................................................................................................................................._...........
..................................................................................................... r7V
Latitude =•='" Longitude • ' "
Ds�gn Current �,
Design Currertt Design ' Current
She Capacity `Population
Poultry q:
Capacity..,Populathon : Cattle Capacity Population
�.
❑ Wean to Feeder
❑Layer
❑Dairy
❑ Feeder to Finish
?
❑Non -Layer
❑Non -Dairy
❑ Farrow to Wean
AEI Other
x� -�z �
Farrow to Feeder
Zdpp
F
Farrow to Finish
12.00
ILW
Total Design Capactty.A
Gilts
❑ Boars
se Total' SSLW
Number f ag Loons /Holding Ponds 0
Subsurface Drains Present
❑ Lagoon Area
Spray Feld Area
PQ
❑ No
Liquid Waste Management System
u
General
1. Are there any buffers that need maintenancelimprovement? ❑ Yes EA No
2. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes (] No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes No
c. If discharge is observed, what is the estimated flow in gal/min? nF A
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes No
3.
Is there evidence of past discharge from any part of the operation?
❑ Yes
® No
4.
Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
No
5.
Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
21 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
[4 No
7/25/97

Facility Number: 31 --
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
Act No
Structures (Lacoons.11olding Ponds Flush Pits etc.
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
M No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: 3
Freeboard(ft): ..4_1............ ................................... .................................... .................................... ....................................
10.
Is seepage observed from any of the structures'?
❑ Yes
® No
It.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
jN No
12.
Do any of the structures need maintenancelimprovement?
Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
( No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ................. t........_....W...R.........5(I..b........................ . ...............................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
® No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
�ZNo
18.
Does the receiving crop need improvement?
❑ Yes
No
19.
Is there a lack of available waste application equipment?
❑ Yes
R)No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
EVNo
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
[A No
22.
Does record keeping need improvement?
Yes
❑ No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
CdNo
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Permit?
59Yes
❑ No
❑-No.vioIatioiLio' d6rciencie's.weren6tedduring this,'AA :� :You.will re-cei�eno,ftirth�er:
Off pkldeaat about fbis: visit.
12. i5 olaWe- cJ�% ak- Jvrriyk�b, Vwt.a 0V\ invtitrr d;{_e- WC,Ik o� I C., 3. E,vasian Luis aw
�h Ar oak,- m_, V?,Ak r01 {al�oor `r"tSet cx�eas s�.n�� beI �`r�ec w�-jj_ of
60 0.+tGS oh C� i ►tiply, . �e-S�-e� eta.
Z2-• lr-r,c�o,�itlr i►ti�rm��sfsn s���� ion- r�J�� �rn.. +rt�o�s.
7�(•�; M"�.r a,r��,p�1: co..�-t a►— of r.�►�-vogev�, , < Z�`I�s�a.c.
ov" COV►n.
7/25/97
Reviewer/Inspeetor Name r' n > ; ��"
a� e3 ,
Reviewer/Inspector Signature: _ l ,t,�_� Date:

Ps Form 3800. AQril 1995
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':coet.Items 1 mWor 2 for ad NorW SON-M. I also wish to reoelve the
m .complete Items s, 4a, and 4b. following services (for an .�
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•Print your name and address on the reverse of this form so that we can retum Shia extra fee):
card to you. 8I
■Attach this form to the from of the mailpiew, or on the bads if space does not 1. ❑Addressee's Address
m ■wri e'Aatum Raaerpt Requasrad•on the maitPiece below the amide number. 2. ❑ Restricted Delivery
■The Ratum Receipt wtp show to whom the ar ide was delivered and the date
delivered. Consult postmaster for fee.
o $
de Addressed to: 4a. de Number ¢
C�1�lGn S� �Zf _E
E 4b. Service Type ml
0
it �.�"� ❑ Registered Certified S�
❑Express Mail ❑Insured
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❑ RetumReceiptfor MedlardSe ❑ COD
O 7. Date of DeIN f
0
5. By: fqrfnt Name) 8. Addr 's Address my ff requested
Lp and lee is paid)
+ 6.5igna
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PS Form 3811, December 102595-97•e-0179 Domestic; Retum Receipt

❑ DSWC Animal Feedlot Operation Review
® DWQ Animal Feedlot Operation Site Inspection
Q Routine O Complaint O Follow-ue of MV0 ins ertion O Follow-up of DSWC review ® Other
Date of Inspection
EFacility Number 348 Time of Inspection 3=S�24 hr. (hh:mm)
© Registered 0 Certified [3 Applied for Permit © Permitted [3 Not Operational I Date Last Operated: .
FarmName: .........3..'.. Countv: .............................................................. .......................
OurnerName:...................-. ... Phone No: 110)...29%..... �FAd ......
Facility Contact: ....,.�-i `
A mk^'��...........�n.5an........................... Title:.............................................:................. Phone 1Sa•
MailingAddress: ...... ..... lC?X'...... .?............................................................................... a!'ST~t,t..r..h%..........................................................
On i#c Representative :....�z.t��n►�......%�R li'........................... . ... •-------- Integrator:..... i�..]....................... ........................................
Certified Operator,........ ........................ __ ............ .................... ......................... .............. Operator Certification Number:....`'. ..r!�S .....
Location of Farm:
r>........Qrr....S.........�.�M............... .......Daw...'.......SPI. .GiS........].Rr............................................ #
.......................... ............................... ........... ............................................................................................................................... ......................................
Latitude ' " Longitude 0 ` «
Design Current
Design Current
Design: Current
Swine Capacity Population
Poultry
Capacity Population Cattle
Capacity Population
❑ Wean to Feeder
❑ Layer
❑ Dairy
❑ Feeder to Finish
❑ Non -Layer
❑ Non -Dairy
❑ Farrow to Wean
Farrow to Feeder
9
❑ Other
❑ Farrow to Finish
Total Design Capacity ,
3 'Lvb
❑ Gilts
Total SSLW
a L�
❑ Boars
^Numbe' of Lagoons / Holding Ponds 1E1 Subsurface Drains Present In Lagoon Area 10 Spray field Area
❑ No Liquid Waste iVtanagement System
General
-
1. Are there any buffers that need maintenance/improvement'?
❑ Yes
[].No
i
2. is any discharge observed from any part of the operation?
❑ Yes
❑ No
Dischariae originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a- If discharge is observed, waz the conveyance man-made?
El Yes
El No
b. If discharge is observed. dill it reach Surface Water? (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
3. Is there evidence of past discharge from any part of the operation'?
❑ Yes.
❑ No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
❑ No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
Yes
❑ No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
7. Did the facility fail to have a certified operator in responsible charge!
❑ Yes
.E1 No
7/25/97
Continued on back

Facility Number: J — 3�
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (LaQoons.Holding Ponds, Flush fits, etcj-
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes ❑ No
❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (ft):................................
10. Is seepage observed from any of the structures? Yes ❑ No
I I. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes ❑ No
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15, Crop type............................................................................
h
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.violatioiis-ordeftcieneies.werenotedduringthis:visit.-You'w'illreceive-rto-ftirtlieir-:
•�-correspot�det><ceab"oul�t�is;visit.•:•;-:�:-:�:•�'- •:•.:; ;-:••:-;•:�;:::�:�:•:•:•'•,-:::�:-;�:•
"R Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
1b. QoStiibll scelaari 4 La,aa�. Wi�l �+e tt�Slty� wp�ai� ot� c-+n+zUc.( ihy�e�on
.Cnr Phev'e. `Ohc,�UiiV� d2t��s;on.
i�.. C>u.KSi�e ,�i Ca-1 wt�t� c NAv� 1aP- t-LNnI� �T°F.�. �a.qo�+1• �G�d �j+ q �.t,'� Sin_Oc�� ��
7/25/97
Reviewer/Inspector Namel t txk �+yn.,,n
Sifvc . Reviewer/Inspector Signature:— Date: l/[�

State of North Carolina
Department of Environment, Health, and Natural Resources
Wilmington Regional Office
James B. Hunt, Jr. Division of Water Quality Jonathan B. Howes
Governor Secretary
May 19, 1997
Brown's of Carolina, Inc.
Farah #4
PO Box 487
Warsaw, NC 28398
Dear Brown's of Carolina, Inc.:
Subject: NOTICE OF DEFICIENCY
Farm #4
Facility Number: 31-398
Duplin County
On May 14, 1997, staff from the Wilmington Regional Office of the Division of Water Quality
inspected your animal operation and the lagoon(s) serving this operation. It was observed that erosion cuts
and other bare areas on the lagoon wall could threaten the integrity of the structure. A significant quantity
of medical waste was also observed in the lagoon at the time of inspection.
As we discussed, the erosion cuts in the lagoon wall should be filled and revegetated. Other bare
areas on the lagoon wall should also be revegetated. In addition, actions should be taken to remove medical
waste from the lagoon. We suggest that you contact your local MRCS, or Soil and Water District office for
any assistance they may be able to provide to correct these problems.
To remain a deemed permitted facility, you must notify this office in writing within fourteen (14) days
of the receipt of this notice, what actions will be taken to comply with your waste management plan. Failure
to do so may result in the facility losing it's deemed permitted status, requiring it to obtain an individual non
discharge permit.
127 Cardinal Drive Extension, Wilmington, N.C. 2MS-3845 • Telephone [phone] • Fax [phone]
An Equal Opportunity Affirmative Action Employer

rr+
Brown's of Carolina, Inc.
May 19, 1997
Page 2
Please be aware it is a violation of North Carolina General Statutes to discharge wastewater to the
surface waters of the State without a permit. The Division of Environmental Management has the authority
to levy a civil penalty of not more than $10,000 per day per violation.
If you have any questions concerning this matter, please call Andy Hehninger, David Holsinger, or
Brian Wrenn at 910-395-3900.
Sincerely,
Andrew G. Helminger
Environmental Specialist
cc: Harold Jones, County Soil and Water Conservation
Sandra Weitzel, NC Division of Soil and Water Conservation
Operations Branch
Wilmington Files
S:1 WQS I IAD YA 131-398. DF.F

� .........
-0pi�rafion'ReV'ieW',,.'.
.[3DSWC- iiidia'I F�edlof
o'tion MW 0' a er"
•J&Routine 0 Complaint 0 Follow-up of DW2 inspection 0 Follow-uD of DSWC review 0 Other
Date of Inspection sb9/411
Facility Number I . j
J Time of Inspection 1 S-0 J Use 24 hr. time
Farm Status: Total Time (in hours) Spent onReview
or Inspection (includes travel and processing)
Farm Name: -S-�2t-a ---- --- --- County: JXV-4-2
Owner Name: W yk C,2,= it SI-96 Phone No: ( q 10 q
Mailing Address: E0 go,( 491 - - 0 C, n %& W, t-� C- Z-9 ? 2 R
OnsiteRepresentarive: Soi�'N, :J-L,muo. �--- Integrator: Jsx_-�O,( C I— I r vL-a ...
CerdfiedOp Operator Operator Certification Number- j-9.17d
Location of Farm:
I P d ho 6 is -Zd.-12
Flu,
Latitude = Longitude
❑ Not Operational Date Last Operated:
Type of Operation and Design Car)-aciti,
-j
1Niftnber-2;Poultry mbe Ndihbii
El Wean to Feeder
Laver ❑ Dairy
El Feeder to Finish
Non -Laver Beef
J D Farrow to Wean
A T
Farrow to Feeder
Zoo r3
Farrow to Finish
stock 0 OtherType of Live
gSubsurface Drains Present
ID Lagoon Eea:]Aiy Field Area �RLSpra
4,im,
General
1. ke there ary buffers that need maintenance/improvement?
2. Is any dischi3x2e obsen-red from any part of the operation?
a- If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DNVQ)
c. If discharge is observed, what is the estimated flow in purnin?
d. Does discharge bypass a Iagoon system? (If yes, notify DWQ)
Is there evidence of past discharge from any part of the operation?
4. Was there any adverse impacts to the waters of the State other than from a discharge?
5. Does any pan of the waste management system (other than lagoons/hoiding ponds) require
rnaintenancetirnproverncm?
0 Yes 49 NO
El Yes ENO
El Yes RN-o
11 Yes P NO
OJA
13 Yes aNa
E] Yes RNco
Ej Yes CR\o
E❑I Yes U.Nia
Continued on 1-ack

6. Is facilitynot in compliance with any applicable setback criteria? ❑ Yes KNo f '
7. Did the facility fail to have a certified operator in responsible charge (if inspection after l/1/97)?_ ❑ Yes ®No
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes E-No
Structures (Lagoons and/or lloldina Pondsl
9. Is structural freeboard less than adequate? ❑ Yes IgNo
Freeboard (ft): Lagoon 1 La_oon 2 Lagoon 3 Lagoon 4
10. Is seepage observed from any of the structures?
I L 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 A plication
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 " ---ca rr.L_ _—t n— '�4 --:
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?
19. Is there a lack of available irrieation equipment?
For Certified Facilities Only.
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 PIan in any way?
22. Does record keeping need improvement?
23. Does facility require a follow-up visit by same agency?
24. Did Reviewer/InVector fail to discuss reviewlinspection with owner or operator in charge?
yl•'12. Erasio,-, cuts ov" loose
�k10 l�v,)a.Lk- Tti.
�_-t l 1 e �, a --j- rev e-q e � a. .
j0 V- e, V 0- is a. { e dL . J
C'I .t Q,_ L �-t o v i
1
❑ Yes 1 No
0 Yes ❑ No
® Yes ❑ No
❑ Yes allo
❑ Yes O'No
❑ Yes P.No
❑ Yes RNo
❑ Yes 1&No
❑ Yes
® No
❑ Yes
®.No
❑ Yes
BNO
® Yes
❑ No
❑ Yes ELNO
ca Vera { w &v--e_ a b t e.,r v +� : K vK a y p t a �e-s
e t -a s E o c.✓ E-s s k4 v 1 d b P s
I aitke„r- bare a,r -Qs 5L­�,au41 also
4 ( aR o d L-► -
Reviewer/Inspector Name `
Revi.ver/Inspector Signature: Date:
cc: Division of Water Oualirr_ lG'rrrer Oiralitt, Section. Facility• Assessmen Unit t i/Ed/Q,5

H•
DSWC=Animal Feeyd'16f0p et-ation Revrew
a �DWQ An>EmaI FeedloiOperanon Site Inspection
�. _ x
.� Routine O Complaint O Follow-up of DWQ inspection O FollOW-uo of BSA}'C review O Other
Date of inspection
Facility Number 3 S
Time of Inspection Use 24 hr. time
Farm Status: b2A Total Time (in hours) Spent onRevieiv
or Inspection (includes travel and processing)
Farm Name: E a County: ..-u4 xa._.�....
Owner Name:. W in (&:2=„ sa,.. Phone No: .�,g.► Q�L �.. 2
Mailing Address: E 0 E 9 K Li 91
Onsite Representative: t ____ integrator: a km W !2 t r� Qa.Q= r ; e%—a.
Certified Operator- Da.y t d Operator Certification'Number.
Location of Farm:
Latitude • 53 a �R�" Longitude• �r1
❑ Not Operariona! Date Last Operated:
- -•- rype of Operation and Design Capacity
"ti
Swsne
K =Number Poultry-%F _ `szmher Cattle a ,Nti�ber
_
❑ Wean to Feeder
Y= ❑ Laver . ❑ Dairy
ElFeeder to Finish
El Non -Laver ❑Beef , ,
Farrow to Wean
_
A s
Farrow to Feeder.
T -
a �s k
Farrow to Finish
_ _ ..
- n �
e of Livestock
ZO ❑ Other Type
,r_
T number of La�oaas f HoldmgYPonds i Subsurface Drains Present
a =
:_ ab0 Spray Field Area
❑ L oa Area
General
1. Are there any buffets that need maintenance/improvement? ❑-Yes Wo
2. Is any disc7�p observed from any part of the operation? ❑ Yes El No
a. If discharge is observed, was the conveyance man-made? ❑ Yes 'Est No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWG El Yes Fq 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 Eq No
Is there evidence of past discharge from any pan of the operation? [:]Yes P9 No
~ 4. Was there anv adverse impacts to the waters of the State other than from a discharge? ❑ Yes [21 No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ®\o
maintenaneelimp rovemen t?
Comiuued on hack

6. Is facility aot in compliance with any applicable setback criteria?
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 111/97)?
8: Are there lagoons or storage ponds an site which need to be properly closed?
Structures (Lartooas and/or 11olding 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 maintenancelimprovement?
(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 adquatemarkers to identify start and stop pumping levels?
«'aste A lication
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 - s itti.• S a 1, e A
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?
19.. Is there a lack of available irrigation equipment?
Fnr Certified Facilities On1y-
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 folIow-up visit by same agency?
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
►r
❑ Yes ® N'o
❑ Yes J No .
❑ Yes NNo
❑ Yes E No
Lagoon 4
12-• F i 11 e +r o z i d ti. c v E k o v% 1 a 0 0 vL W a. C 1 ►•r, e_4 — .1-, O J S err a v�
r 4e �I e C a E£ tL, , S a 'r e-<L t� �l n w i h ,. e-r uJ (X{ I o cL do -t •
fee t+ d a.n c1 b a K.
�C.4- r.Jo.L)
Reviewer/Inspector Name
Reviwer/Inspector Signature: Date: 5 I
❑ Yes RNa
❑ Yes ONO
Q Yes ❑ No
❑ Yes QNo
❑ Yes 2L o
❑ Yes ® No
❑ Yes 15Na
❑ Yes El No
❑ Yes KNo
❑ Yes IR No
❑ Yes ® No
❑ Yes ®No
❑ Yes ® No
❑ Yes E�No
cc. Division of Water_Oualh , if ater Ouality Section, facility Assessment Unit . 11/14/96

State of North Carolina= -
Department of Environment, -
Health and Natural Resources rE P V _ p
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Brown's of Carolina Inc
Farm #3
PO Box 487
Warsaw NC 28398
Ale
IDEHNR
November 12, 1996
SUBJECT: Operator In Charge Designation
Facility: Brown's of Carolina Farm #3
Facility ID#: 31-513
Duplin County
Dear Farm Owner:
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 fonn 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 919n33-0026.
Sincerely,
A. Preston Howard, Jr., ector
Division of Water Quality
Enclosure
cc: Wilmington Regional Office
Water Quality Files
P.O. Box 27687, 4. FAX [phone]
Raleigh, North Carolina 27611-7687 fC An Equal Opportunity/Affirmative Action Employer
Voice 919-715-4100 - 50% recycled/109% post -consumer paper

•
r_1
•
Site Requires Immediate Attention: �G J
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATION SITE VISITATION RECORD
DATE: .1995
Time:
Fame No
Mailing
County:
Integrate
On Site .
Physical
Type of
Design Capacity: �O1P
Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
` Latitude: t" ° rg ' Longitude: 77 Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) es or No Actual Freeboardo -9 Ft_ Inches
Was any seepage observed from the laon(s}? Yes No Was any erosion observed
a No
Is adequate land available for pray Ye o No Is the cover crop adequatel Ye r No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwelling Yes No
100 Feet from Wells
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters o the state by man-made ditch, flushing system, or other
similar man-made devices? Yes r' N If Yes, Please Explain_
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific
Additional Comments:
)0
with cover crop)? Yes or No
I
n
N A-/
41
cc. Facility Assessment Unit
Use Attachments if Needed.

Site Requires Immediate Attention:
' Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
• ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
Time: t 3 3v
Farm Name/Owner:; .s5_
Mailing Address: S ° ��x Y �' l 6,* 5"+ . I A. C
County: I r
_Integrator. _ e Phone: 9iv D 93
On Site Representative: 1141- Phone: 9 ° i 3 3 u
Physical Address/Location: 1 �s,� ; s _ �o cam- � _ wf �,� �/k.r S i y_�
_vn Le ivy"\ 4::� c° I e r ZEE
Type of Operation: Swine Poultry Cattle a u so
Design Capacity: r�- �`' Number of Animals on Site:
u &w
DEM Certification'
UU Number: ACE DEM Certification Number: ACNEW
Latitude: 3LI_° ' Imo" Longitude: 7? ° 5-? ' ,_. 9 Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes No Actual Freeboard: �Ft. Inches
• Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observedz�5 No
Is adequate land available for spray. Ye or No Is the cover crop adequate? Yes or No'�
Crop(s) being utilized: So��
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings"(foe or No
100 Feet from Wells? 66 No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? -Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man -trade ditch, flushing system, or other
similar man-made devices? Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No
Additional Comments: _-t�a+�� 5 �fi -T%- _P
Inspector Name
�IW AMA
1 rt :1+
S iture
cc: Facility Assessment Unit Use Attachments if Needed.

UFLKHI WN5 EKHNI-H — lau i dX yly—(15—b1J4�3
Jul 1�s 'yt) 12:05 P.02/23
Site Requires mediate Attention
0
is
Facility Number. 3 1 3 5 g
SITE VISITATION RECORD
DATE: � — 17 �.1995
Owner: „' eyj s - -- Farm Name:
county: , J� n� .
Aeye at Visiting Sits: ` '^ Phone: ql0 --- 9 L - QLi -- t
Operator: -_ --- - Phone:
On Site Representative: t/ a h- Phone; 9 ! -- 3 3 Gv "0
Physics? Address: +- gtl d"- S
Mailing Address:
Type of Operation: Swine Poultry Cattle
Design Capacity:., o d Number of Animals on Site: A OQ 0
Latitude: u Lengitude: o "
Type of Inspection: Ground Aerial
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) G or No Actual Freeboard: ! Feet -7 Inches
For facilities with mom than one lagoon, please address the other lagoons' freeboard under the
conunents section.
Was any seepage observed from the lagoon(s)? r No Was there erosion of the dam.?: Yes c No
Is adequate land available for land application? Yes or No Is the cover crop adequate? Yes or No
Additional Comments:. j!nf!� �{,,. 'Io o h ,Sd -d .5� 56 m �.
S r
i
Fax tc [phone] Sicnawru - of Agent

. .,
0
Site Requires Immediate Attention: Al
Facility No. FZ
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIO SITE VISITATION RECORD
DATE: ) , 1995
Time: 3 �'
Farm Naznel0wne
Mailing Addr
County: ddwld
Integrator -
On Site Representative:
Physical Address/Location:
Type of Operation: Swine V Poultry Cattle
Design Capacity: 2-dV Number of Animals on Site:
DEM Certification umber: ACE DEMggrtification Number: ACNEW.
Latitude: Longitude: �° S Jam" Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inche es r No Actual Freeboard Ft. -6-1 Inches
• Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or No
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No
Crop(s) being utilized: O � , - f) lC
Does the facility meet SCS minimum setback criteria?. 200 Feet from DweZ§R
No
100 Feet from Well
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Lime? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No
cc: Facility Assessment Unit Use Attachments if Needed.

y
1-1
•
Site Requires Immediate. Attention -
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 17 , 1995
Time: - 36-
Farm Name/Owns
Mailing Address:
County:
-3elk
Integrator: C� Phone:
�(/d - 3,-0 /a 0
On Site Representative: ���`l� �a S b r _ Phone: la S`
Physical Address/Location: f �Gc J t c
,4o4%YZ l 4�22-2'� F.e�rn /uc'r/F 2.5 -
Type of Operation: Swine Poultry Cattle 1 -7U -0 0 U
fz o v 5G � 5 err. -ram-- .
Design Capacity: �' Number of Animals on Site: t 3 Gv 0 ..tot41 A N, eAK
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: - 3 4_° 5-q ' a-k " Longitude: —lj—° 5- S Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes or No Actual Freeboard: _Ft. Inches
Was any seepage observed from the lagoon(s)? Yes oiCNo Was any erosion observed? Yes o l0
Is adequate land available for spray? A or No Is the cover crop adequate? Yes or No
Crop(s) being utilized: CAf_", f 0-�-1wVk
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? G or No
100 Feet from Wells? es or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet, of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar matt -made devices? Yes or�34 If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No
Additional Comments: %2�
Inspector Name
Si
cc: Facility Assessment Unit
Use Attachments if Needed.