310418_INSPECTIONS_20171231

NORTH CAROLINA ..�
Department of Environmental Qual

Type of Visit:
ompliance Inspection 0
Operation Review ❑ Structure Evaluation
0 Technical Assistance
Reason for Visit:
outine Q Complaint
Q Follow-up 0 Referral 0 EmergencyEinergmy
Q Other Q Denied Access
Date of Visit: NArrival
Time: ®
Departure Time: ® County: (
Region:
Farm Name: I . W I
I !14L4
(91
E2AOwner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: L�Ll[AC Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number:
Certification Number -
Longitude:
Design Current Design Current
Swine Capaclty Pop. Wet Poultry Capacity Pnp.
Wean to Finish er
Design Current
Cattle Capacity Pop.
DairyCow
Wean to Feeder
LQLa
Non -La er
DairyEl Calf
Feder to Finish 4C�
GOD
DairyHeifer
Farrow to Wean
Farrow to Feeder
Design Current
Dr. Poult . Ca acit POP.
Layers
D Cow
Non -Dairy
Farrow to Finish
Beef Stocker
Gilts
ir
Non -Layers
Beef Feeder
Boars
W.22le
Pullets
Beef Brood Cow
Turke s
Turke Poults
11 ether I I Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes N❑ ❑ NA ❑ NE
❑ Yes ❑ Na ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (if yes, notify DWR) ❑ Yes ❑ [DNA ❑ NE
2. is there evidence of a past discharge from any part of the operation? ❑ Yesqlo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ❑ No ❑ NA ❑ NE
of the State other than from a discharge?
Page l of 3 21412015 Continued

Faelli Number: - Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes F7Ko ❑ NA ❑ NE
a. Ifyes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):_
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes [:.No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes ; j Ida ❑ NA ❑ NE
❑ Yes ,Q�No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an Immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes 12 "° ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ''No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes L3<o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA ❑ NE
maintenance or improvement?
1 1. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes [2 o. ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 2 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? [:]Yes 2fNo ❑ NA ❑ NE
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?
I
20. Does the facility fail toIliave all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP 3 ❑Checklists []Design ❑ Maps ❑ Lease Agreements
❑ Yes ;],Ko [] NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑Yes ❑NA ❑NE
❑ Yes J� "o
❑ Yes P10
[]Other:
❑NA ❑NE
❑ NA ❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes jI No ❑ NA ❑ NE
❑ Waste Application 0 Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to iristall and maintain a rain gauge? ❑ Yes No . ❑ NA ❑ NE
23. If selected, did the facility, fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 F► 21412015 Continued
q

Facili Number: - date of Ins eetiun:
24. Did the facility fail to calibrate waste application equipment as required by the permit ❑ Yes o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes DVo ❑ NA ❑ NE
the appropriate box(es) below, 7
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? [:]Yes o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No n ❑ NE
Other Issues 7
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes o ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes [?'No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the E] Yes ; 'No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application) T
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
o ❑ NA ❑ NE
❑ Application Field ElLagoon/5torage Pond ❑ Other:
32, Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes�o [] NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes '12 No ❑ NA ❑ NE
Reviewer/Inspector Name: r l Q ri[''�one:
q Z3
Reviewer/Inspector Signature: U Date:
Page 3 of 3 21412015

V Division of Water Resources
Facility Number - Q Division of Soil and Water Conservation
❑ Other Agency
Type of Visit: 7Routine
fiance Inspection Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Q Complaint Q Follow-up 0 Referral Q Emergency d Other Q Denied Access
Date of Visit: Arrival Time: f = Departure Time: ® County:% Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
T
Onsite Representative: `1 ot`+AT A1.{ LLintegrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Certification Number: 1-07
Certification Number:
Design Current
Wet Poultry Capacity Pop.
BIa cr
Design Current
ury rounry %.apacuy ro
Non -Layers
Pullets �-
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Dues thedischarge bypass the waste management system? (if yes, notify DWR)
2. is there evidence of a past discharge from any part of the operation'?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dai Calf
Dair Heiicr
Dry Cow
Non-Dair
Beei'Stocker
Beef Feeder
Beef Brood Cow
❑ Yes al,140 ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[] Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA [] NE
❑ Yes 21tiiio ❑ NA [] NE
❑ YesEJ'No ❑ NA ❑ NE
Page I of 3 21412015 Continued

Facili Number: - Date of Ins ection: }.
'Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 2 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: 6roao-)
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes YNo ❑ 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 [2/No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes [2/No [ ] NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes dNo ❑ 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 [AINo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [] Yes Z/No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application'! If yes, check the appropriate box below. ❑ Yes L21/No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
7] No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
0No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
FNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
jrN o
ON A
❑ NE
Required Records & Documents
No
19. Did the facility fail to have the Certificate of Coverage & Permit readily available'?
❑ Yes
❑
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
114
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
2 1. 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 0 Weather Code:
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute inspections ❑ Monthly and I" Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes o ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes FZ/No ❑ NA ❑ NE
Page 2 of 3 21412015 Conti►ueed

Facifi Number: r - Bate of Inspection: a
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
6No, ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
io ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
❑ o❑ NA ❑ NE
27, Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
E3'9'o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
❑rgo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
C],K° ❑ 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
E31qo ❑ NA ❑ NE
❑ Application field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Q.No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with an on -site representative?
❑ Yes
Nv ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Q No ❑ NA ❑ NE
omments re cr, to: quest.on c, xp a n any anMers an or any: a, t ono recommendat ons' or any other.:coin�rients::
Ilse draw in s�of fucill tn.liefte'r'cii lain sRuidons use ttddittonai a e`s as9necessar ; }�? ; k �14
�i �`
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
JaHpd FA a-N(:,
Phone.
Date:
2112015

Type of Visit: 0 7Routine
'[lance Inspection Q Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit: ❑ Complaint Q Follow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: Arrival Time: ® Departure Time: ® County: 1 Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
Onsite Representative: JJp A%l!y Mlu P�_' Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number: ZZ7
Certification Number:
Longitude:
Design Current
Swine Capacity Pvp.
Design Current Design Current
Wet Poultry Capacity Pop. Cattle Capacity Pop.
Finish
La er
Dai Cow
Feeder
Non -La er
Dai Calf
Finish
rj
Dai Heifer
Wean
Feeder
U
Design Current D Cow
D P,ault Ca aei F'v Non -Dairy
Finish
La ers
Beef Stocker
Non -La ers
Beef Feeder
Boars
Other
Pullets
Beef Brood Cow
Turke s
Turkey Puults
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other;
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes No
❑NA ❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[] No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes Or" ❑ NA ❑ NE
❑ Yes �No ❑ NA [] NE
Page I of 3 21412014 Continued

Facility Number: j - Date of Inspection: 23
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 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
21No
❑ NA
❑ NI?
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmenta threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes E!fNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below, ❑ Yes Z/No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
C3 ❑
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
I__I No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
E!fNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[3"'No
❑ NA
❑ NE
Required Records &_ Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
F2r 'No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes <o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers [] Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �f ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes LJ No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facifi Number: - hate of Ins eetion:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ NA ❑ NE
25� Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes L No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [f No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
040
❑ 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
[2 o
❑ 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
Q 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
Ej 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 E5No ❑ 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 ❑ NA [] NE
G.6mmbnts.(refer. to question #}: Explain any YES answers and/or any additional recommendations or any other, comments..
Ilse.diruwingstuf:f'acility to better explain situations (use addifldnal palzes as necessary),
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
C_zNlJ
M
J
Phone 73 ;L
Date:
Id/Z015

Type of Visit: p Compliance Inspection Q Operation Review Q Structure Evaluation a Technical Assistance
Reason for Visit: a Routine ❑ Complaint Q Follow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: Arrival Timer Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: L]hk�ffl hj�) ft-X_u.g0- Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Latitude:
Poults
Phone:
Certification Number: i5103
Certification Number:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State`? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Dairy Cow
Dairy Calf
Dairy heifer T^
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Yes © No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes FNo
❑ NA ❑ NE
Yes❑ NA ❑ NE
Yes❑ NA ❑ NE
page I of J 21412011 Continued

Facilit Number; -IR Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
2No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: [�
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
Wo
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ YesVNo ❑ 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, setbac'ks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11, Is there evidence of incorrect land application? Ifyes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window [] Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
m
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
!� °
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�rNNo
❑ NA
❑ NE
Reouired Records & Documents
wtio
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
�j`No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. r] Yes Na 0 NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No [] NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: ID2te of Inspection: 319�'f jig
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes e o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes WNo
NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 2No [] NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
Ifyes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes Z"No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility? If yes, check the appropriate box below. ❑ Yes O/N o ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes u No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes E�o
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes ❑ NA [] NE
Comments° reFer:ti%: ueat on; x a nan ;answers an or an a ono �recommen at otis:or ari vt er eomrnents;=�; � <;.� _ fig.
UseAraw[nas'af facilitY:to:lietter<explain situations:fuse,sdditianal:pa�eslas. necessary] �.; � .. ,;� _ �, _..; �_:..; ..a 7 .t .x , < _ . a1.
Reviewer/Inspector Name:
ReviewerlInspector Signature:
Page 3 of 3
Phonc:( Z?l 1
Date: ��"q 1)4
V]

Type of Visit: QQCo fiance Inspection U Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit; Routine Q Complaint Q Follow-ue Q Referral Q Emergency 0 Other D Denied Access
❑ate of Visit: Arrival Time: 23sa departure Time: County:` Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: �S oN AlfliAo - nqT Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Wean to Finish
La er
Wean to Feeder
Nun-L
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
ra'No
Gilts
Boars
Other
Latitude:
Poults
Phone:
Certification Number:
Certification Number:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge7
Longitude:
Dairy Cow
Dairy_Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stucker
Beef Feeder
Beef Brood Cow
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes [] No ❑ NA ❑ NE
❑ Yes Vo
❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Tellity Number: - Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
S� ;'�/
Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
o ❑ NA ❑ NE
❑ No ❑ NA 0 NE
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes dNo ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc,)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes �No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmenta threat, notify DWQ
7. Do any of the structures need maintenance or improvement? [] Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes j�jlffo ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) TT
9. Does any part of the waste management system other than the waste structures require ❑ Yes trio ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �No ❑ NA ❑ NE
maintenance or improvement.'
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [[ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? Yes ❑Zo
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reauired 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 2Io
❑ Yes ❑N6'
❑ NA ❑ NE
❑ NA ❑ NE
[:]Yes
10
❑ NA
❑ NE
❑ Yes�o
❑ NA
❑ NE
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, cheek the appropriate box below. ❑ Yes 12<0 ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yesi o ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes3LX""
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

acilit Number: -21-91 jDate of Ins ection. f
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑Yes WNo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge'? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
2r<o
❑ NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
❑
[] NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
C;�11
❑ 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
ONo
❑ NA
❑ NE
permit? (i,c,, discharge, freeboard problems, over -application)
3 1. Do subsurface tale drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
❑.t o
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
P41>'u
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
34, Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use -additional pages as necessary),
1' lj L"(_ 4EVCP. 15'_1G lv W Ue
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
"OJL�
Phone: I U--'
Date: 1z� J
2/4 011

Type of Visit: (Y7Routine
pliance Inspection Q Operation Review p Structure Evaluation Q Technical Assistance
Reason for Visit: Q Complaint Q Follow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: Arrival Time: Departure Time: County: ❑t,P(, Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
Onsite Representative: JO"AT14Ad iL�1( Integrator:
Certified Operator:
Back-up Operator:
Phone:
Certification Number: 2-40 9-7
Certification Number:
Location of Farm: Latitude: Longitude:
11 Mill!Design Current Design Current
Swine Capacity jrap. Wet Poultry Capacity Pop.
Design10,11 Current
Cattle Capacity Pap.
Wean to Finish
Layer
DairyCow
Wean to Feeder
Nan -La er
DairyCalf
DairyHeifer
Feeder to Finish
Farrow to Wean
llesign Current
D I'vult . Ea aeI P,o
Layers
D Cow
Farrow to Feeder
Farrow to Finish
Non -Dairy
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars Pullets
Turkeys
Uther Turkey Puuets
OtherIN 10ther
Beef Brood Cow
Discharees and Stream lmnacts
1. Is any discharge observed from any part of the operation?
[:]Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ o
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ YesVNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Condnued

Facility Number: - t Date of Inspection:
Waste Collection & Treatment
4, Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure 1 Structure 2
/AGO
Structure 3 Structure 4
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
Structure 5 Structure 6
❑ Yes N❑ ❑ NA ❑ NE
❑ Yes /No [DNA NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental neat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 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 ❑ ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [] Yes No ❑ NA ❑ NE
❑ Excessive P❑nding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
NA
❑ NE
15. Does the receiving crap and/or land application site need improvement?
❑ Yes
rNgo❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
�Ko ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
L_.IX'Ng❑NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 2No [DNA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections []Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

F cili Number: - L Date of Inspection:
24, Did the facility fail to calibrate waste application equipment as required by the permit, ❑ Yes ❑NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes ;Og�o
o ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non --compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes 0
[] 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 Zf No [DNA ❑ 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 ZfNol ❑ 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 the drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
[:]Yes No ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
❑ NA ❑ NE
VNoNA
NA ❑ NE
[] NE
:omments.(refer to question #): Explain any YES answers and/or any additional recommendations or any other comments:':-.:. ; ;•;
1de'dra vin s of facili to better ex lain,situatiins: use'additiorial a e§'as necessary)
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: L-I(O " �' �4
Date: I
21412011

V Division of Water Quality
Facility Number - I�iLJ ❑ Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 0 Co pl€ance Inspection Operation Review p Structure Evaluation Q Technical Assistance
Reason for Visit: Routine a Complaint Q Follow-up Q Referral Q Emergency O Other Q Denied Access
Date of Visit: '7 Arrival Time:® Departure Time: rU County: G Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title: Phone:
Onsite Representative: '-'0re mgw ALL Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Design Current
Cattle Capacity Pop.
DaiEX Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Page 1 of 3 4 21412011 Continued

Facili Number: -qj Date of ins ection: Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 2 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:6�
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 16 No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a [:]Yes dNo ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment I threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes rN'o ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes O/No ❑ NA ❑ NE
maintenance or improvement'?
_Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 6 No ❑ NA ❑ NE
maintenance or improvement?
1 l . Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Z j No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes ❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes rj/No
NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes YNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
�No
[] NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes 2
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other-
2 1. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain" gauge?
❑ Yes (N
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes F2/No
❑ NA
❑ NE
Page 2 of 3 21412011 Continued

Facili Number: I Date of Inspection: ? 17,7 h I
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ NA ❑ NE
25 js the facility out of compliance with permit conditions related to sludge? If yes, check [:]Yes u No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No [] NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ENo ❑ NA ❑ NE
Other Issues
28, Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29, At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes Cj"No
❑ Yes 2No
❑ Yes []"No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
[:]Yes E�f/No ❑ NA ❑ NE
❑ Yes [TIo
[:]Yes filio
[:]Yes
❑ NA ❑ NE
[DNA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or. anyother comments. '` P
Use. drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name: joqj j i1�JJ�L� _ Phone: iR
Reviewer/Inspector Signature: Date: A74
Page 3 of 3 V4120 1

U Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit ,om
C.,ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit C9 Routine Q Complaint Q Follow up Q Referral Q Emergency Q Other ❑ Denied Access
Bate of Visit: Arrival Time: 1��1 Departure Time: County: _JDUJ?'�] h) Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: Jo#JA7'Y►4+-� muj_ k_&u-
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = s ss Longitude: 0 ° =1
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
El Layer
r�T�l Non -La er
Other
❑ Other
Dry Poultry
LJ Layers
El Non -Layers
❑ Pullets
Ej Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part ol'the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Co
Numbor 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'?
❑ Yes No ❑ NA ❑ NE
❑Yes
❑No
❑NA
❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑NA
❑NE
❑Yes
❑N
El Yes
No
[]NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
El Yes L'1No El NA El NE
12129104 Continued

Facility Number:3 I— Date of Inspection•
Waste Collection & Treatment
4.' Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Stu l Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ' S
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes E I No ❑ NA ❑ NE
❑ Yes M No Cl NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? eyes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes [} o ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes [�`No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes L3 No ❑ NA ❑ NE
maintenance/i mpro vcmcnt?
11. Is there evidence of incorrect application? If yes, check the appropriate box below, ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13, Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
eVNo
El NA
El NE
15. Does the receiving crop and/or land application site need improvement?
El Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
EjAo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
04o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
a�o
❑ NA
❑ NE
;Co�nrrtents: [refer#v,question; N):; Explain: any; YFSeanswers atid/or;any;rccnmmenrtationsAvr any. other comments::., . .
�. c ., i•4 i 3f. $E�• a+ebi��`4$� .�
,Us�,drawtngs of facility to better explain,sititations� (use additional pagesas,necessary'j: 1 &$;; ° �,,, ,, ,fik
a:v�....7p.,. •;. �.:; . F: a:.y.: •,s,^. •a,�:.�.,s S.. ' z: xr:w:�:s.::s sdi�,:'-s' lt;. rK. isz. r'W. .C' ����.aa �3.��;. ist
EReviewer/Inspector Name ,°,K;s.a r` ; 4` f Phone- y
Reviewerlinspecttrr Signature: Date:•
Page 2 of 3 12128104 Continued

Facility, Number: 3 — Date of Inspection
Renuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ w u r ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check [lie 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 ❑ MonthIy and €" Rain Inspections"
❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ElYes LJ No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbrcakers on irrigation equipment? ❑ Yes C Flo ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes L, rNo ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes LrJ No ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ENo ❑ NA ❑ NE
❑ Yes E3 No ❑ NA ❑ NE
❑ Yes 2 No ❑ NA ❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
N❑
❑ NA
❑ NE
Other Issues
28,
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ NA
❑NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Zo
El 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?
ElYes
No
❑ NA
❑ NE
31.
If yes, contact a regional Air Quality representative immediately
Did facility fail by
the to notify the regional office of emergency situations as required
❑ Yes
LEI/N.
❑ 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
ElNA
ElNE
33.
Does facility require a follow-up visit by same agency?
Yes
El Yes
❑ NA
❑ NE
.. .. ... .. ... .
Adilitionat:'Commcnts andloi
i
Page 3 of 3 12128104

Type of Visit [j Co pliance Inspection Q Operation Review Q Structure Evaluatlon Q Technical Assistance
Reason for Visit Routine Q Complaint Q Follow up Q Referral Q Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: ® Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
�o ��N`
Onsite Representative: M-.S LL-�(Z--
Certified Operator:
Back-up Operator:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: 0 e = I = Longitude: 0 ° = ' 0 "
Design C nt
Ueslgn Current
Design Current
Swine
Capacity.
Population
Wet Poultry
Capacity
Population Cattle
@opacity lopulation
❑ Wean to Finish
JE3 Layer
❑
Dairy Cow
Wean to Feeder
❑ Non -La er
❑
Dairy Calf
Feeder to Finish
TIFET
Ro o o
❑
Dairy I Ieifer
❑ Farrow to Wean
Ur-y Poultry
❑
Dry Cow
❑ Farrow to Feeder
❑
Non -Dairy
❑ Farrow to Finish
ElLa Layers
El
Stocker
❑ Gilts
El Non-LayNetsers
El
El
Beef Feeder
❑ Boars
❑Pullets
❑Beef
Broad Cow
❑ Turkeys
Other
❑ Turk e Points
❑ Other I
Numbef!Structures: ;E:J
❑ Other
Discharges & Stream Imparts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a, Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
ElNA
[INE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
2 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
No
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

F'acfiity Number: — Date of inspection
Waste Collection & Treatment
4. Is'storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes dNo ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LA C"O-^j
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
❑ NA ElNE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
% ❑ NA ❑ NE
through a waste management or closure plan?
ental threat, notify DWQ
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or envi7yes
7. Do any of the structures need maintenance or improvement?
❑ No ❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
ENo ❑ 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
L,d No El NA El NE
maintenance or improvement?
Waste Application
ld. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
E No ❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application'? If yes, check the appropriate box below. ❑ Yes
No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or iU lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drill ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
NNo El NA
El NE
15. Does the receiving crop and/or land application site need improvement?
El Yes
,L��,J
L��,'/No ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
Id No ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
ElNA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No ❑ NA
❑ NE
eoS 64,-A S 5 -t..aVe YL D" 'ro P Ad D n►trucp
00 6AucS2!w(6,
Reviewer/Ins pector Name t '` Phone: c1
,:. : i .
L.
Reviewer/Inspector Signature: Date:
rage a Of 3 wvY t.vr+«.,Kru

Facility Number: 3 Date of Inspection o�
Rewtiked Records & Documents
f
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20, Does the facility fail to have all components of the CAWMP readily available? [['yes, check
the appropirate box. ❑ WUP 0 Checklists ❑ Design ❑ Maps ❑ Other
❑ Yes 6o ❑ NA ❑ NE
❑ Yes -EfN❑ ❑ NA ❑ NE
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
❑ AnnuaI
Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ MonthIy and I"
Rain Inspections❑
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
Ll N
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ILJ o
❑ NA
❑ NE
24,
Did the facility fail to calibrate waste application equipment as required by the permit"
❑ Yes
7
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
LrNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge'?
❑ Yes
C?<o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
C?5 o
❑ NA
❑ NE
Other issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Q No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Ld 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?
El Yes
,,
LI 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
i J No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
1 .:i (. s..�.:i'i
Additional'Cammt.nts and/or'.i)rawin s: N�= �� ''.���':1�::r.. :; •�.`.
.. �.. ... ... _ S .. .. .��':LL :�di'.. ... ...a ... .� }� ..K .. ...i c r;�'�.. C. •.. k'? ..4:i". �i .'... ... .. .. . ',Pi.: .... .. .. ... ..•
Page 3 of 3 12/28/04

q1
Type of Visit Crpliance Inspection O Operation Review ❑ Structure Evaluation O Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other . ❑ Denied Access
t_l
Date of Visit: O$ Arrival Time: ® Departure Time: County: bUR + Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Phone:
Onsite Representative: _stN atu Ap� I'1�I � 1-�- frJL -- - - - I ntegrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 ' Q Longitude: 0 ° = . = «
Design
Current
Design Gurrerit
Design Current
Swine Capacity
Population
Wet Poultry Capacity Population
Cattle Capacity
Populatlott
to Finish
❑ La er
❑Dai Cow
Vean
ean to Feeder
❑Non -La er
❑Dai Calf
eder to Finish
S
❑ DairyHeifer
❑ Farrow to Wean
pry Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
La ers
❑ Stocker
-La ersPullets
❑ Beef Feeder
EOGilts
Boars
El Pullets
ElBeef Brood Co
❑ Turkeys
Other
❑ Other
❑ Turkey Poults
10 other
I
umber of Structures:
Discharges & Stream Imparts
1. Is any discharge observed from any part of the operation?
❑ Yes
6No
❑ NA
❑ NE
Discharge originated at; ❑ structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c, What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
El No
ElNA
ElNE
2. Is there evidence of a past discharge from any part of the operation?
Ell Yes
Z N
El NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
LJ No
❑ NA
❑ NE
other than from a discharge?
Page 1 of 3
12128104
Continued

FaclCty Number: 3 — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: LACen
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): Li 9
Are there any immediate threats to the integrity of any of the structures observed'?
❑ Yes
No
E No ❑ NA ❑ NE
El"
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
ONo ❑ 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
Id N ❑ NA ❑ Ng
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
t N ❑ 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
ON ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
ErNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E5"NNo
❑ NA
❑ NE
"No
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
El
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
G?<o
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
fffN
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Reviewer/Inspector Name 1 ai. Phone: d - 73era
Reviewer/Inspector Signature: Date: a
Page 2 of 3 t 12128104 Continued

Faeility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ffNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes E14o ❑ NA ❑ NE
the appropirate box. ❑ WIIP ❑ Checklists ❑ Design El Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
0 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?
El Yes
N
ElNA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
ElYes
L'J No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
EfNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
6'No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified.operator in charge?
❑ Yes
ONo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
0-<<o
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
0 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
LEI 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
Cl/No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 l .
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
Q 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
d No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
PNo
❑ NA
❑ NE
Page 3 of 3 12128104

Division of Water Quality
Facility Number j Division of Soil and Water Conservation
'Q Other Agency
iType of Visit Co Hance Inspection ❑ Operation Review ❑ Structure Evaluation ❑ Technical Assistance
ReasonforVisit ❑ Routine ❑ Complaint ❑ Follow up ❑ Referral ❑ Emergency ❑ Other ❑ Denied Access
(late of Visit: Arrival Time: ® Departure Time: County: PViL>A.! Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: 'Title:
Phone:
Onsite Representative: _jufin-' Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
Operator Certification Number:
Back-up Certification Number:
Latitude: = e ❑ L Longitude: ❑ ° = 6
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
® Feeder to Finish f i 6 d JIM
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non -La et
Dry Poultry
Non-L
Pullets
Poults
Discharges & Stream ImRacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-madc7
Design Current
Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
DaiEy Heifej
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were thcre any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes E14o ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
LrNo
❑ NA
❑ NE
❑ Yes ENo ❑ NA ❑ NE
12128104 Continued

Facility Number:' g Date of Inspection
'Waste Collection & Treatment
4• is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier; ''
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): ,.,/
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ICJ 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 LEI 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? [I Yes DhrNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes �,d No El NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require 0 Yes 94 ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ZNo ❑ NA [:IN E
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below, ❑ Yes r_ N❑ ❑ NA ❑ NE
❑ l;xcessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
E] No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
D NNoo
El NA
❑ NE
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑
Yes
E5 o
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA
❑ NE
18, Is there a lack of properly operating waste application equipment?
❑ Yes
Zco
❑ 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):
F.rjvb C#V"
Reviewer/Inspector Name 7►7 Phone: 6 f 3
Reviewer/Inspector Signature: Date:
12128104 Continued

F aci[ity Number: Date of inspection Id
Re uired Records & Documents
19. Did the facility tail 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 appropirate box. ❑ WUP ❑ Checklists ❑ Design
g ❑ Maps ❑ other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
❑ NE
❑ Waste Application [:]Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste 'Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V
Rain Inspections
❑
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
lJ Yes
❑ No
❑ NA
❑ NE's
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
DIN o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
Ck�o
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
YNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
L No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
Q NA
❑ NE
Other issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Ek,fgg�o ❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
E1 o ❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
D<o ❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
El Yes
�J�
LNo ❑ NA
❑ NE
General Permit`? (ie/ discharge, freeboard problems, over application)
32.
Did ReviewerAnspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No ❑ NA
❑ NE
Comments and/or
12128104

"Division of Water Quality
Facility3 Number Division of5oil and Water Conservation
Q Other Agency
Type of Visit O Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
0
lRoasonforVisit O Routine O Complaint O Follow up O Referral O Emergency O Other []Denied Access
Date of Visit: Arrival Time: Departure Time: County:
Farm Name -
Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: i't d
Certified Operator:
Back-up Operator:
Phone:
Phnfio No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Region."
Location of Farm: Latitude: [= e = 4 = Longitude: ❑ n = 4 0
Design Curren#
Swine Capacity Population
Design Current
Wet Poultry Capacity Population
Design
Cattle Capacity
Current
Populalion
❑ Wean to Finish
❑ Layer
I
I
❑ Dairy Cow
❑ Wean to Feeder
❑ Nan -La cr
El Dairy Calf
Feeder to Finishhoo
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
llry Poultry
❑ Layers ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
❑Dai Heifer
❑ D Cow
❑ Non -Dairy
❑ Beef Stocker
ElBeef Feeder
El Beef Brood Cow
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
❑ No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'!
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
❑ Yes
❑ No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
❑ No
❑ NA
❑ NE
other than from a discharge?
Page I of'3
12128/04
Continued

Facility Number: - Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes ❑ No ❑ NA ❑ NE
❑Yes El No ❑NA ❑NE
Structure 5 Structure 6
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ 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 > 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) 6 , !�,
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination 7
❑ 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):
Reviewer/Inspector Name �yj �tf-� Phone: [!�•- �T--� a
- -- --
Reviewer/inspector Signature: _ - Date: yt a C,-"
Page 2 of-3 1V.Z61U4 C.nntinuea

Facility Number.3Z Date of Inspection
Required Records & Documents
19, Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box.
❑ WllP ❑Checklists ❑Design ❑Maps ❑ Other
21. Does record keeping need improvement'? If yes, check the appropriate box below. JEFYes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections I�Konthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
❑ NE
Other issues
28,
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
❑ NA
❑ NE
33,
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
3-
0-A5 o6 9-7
-- pa�� 6r � llell5
Page 3 of 3 I2/2&04

Type of Visit Q5 Co plianco Inspection ❑ Operation Review Q Structure Evaluation ❑ Technical Assistance
Reason for Visit CJ Routine ❑ Complaint ❑ Follow up ❑ Referral ❑ Emergency ❑ Other ❑ Denied Access
Date of Visit: t G S Arrival Time: 1 [ Departure Time: 1 S� 3` County: QLRLII , - Region:
Farm Name: (SaA00rn1'l 5 . Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator: owk677S _2VAWQ
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Phone:
Title: Phone No:
Latitude: n D
Integrator:
Operator Certification Number:
Back-up Certification Number:
= « Longitude: = a 0 6 �s
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
iiI El Layer
INan -La er 1.-- ...._.. -.-
Dry Poultry
11 Layers
Non -La ers
❑ Pullets
Turkeys
❑ Turkey Poults
Other
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation`?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Caif
❑
Dairy Heifei
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beel'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)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑Ycs L7No ❑NA ONE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes L_�,J, NNoo ❑ NA ❑ NE
El Yes LI�IV0 ❑ NA ❑ NE
12128104 Continued

Facility Number: — Date of Inspection o
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
2fNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: LA Er0�)�J I
Spillway?:
Designed Freeboard (in): q
Observed Freeboard (in): y'V
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
3No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
dNo
❑ 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
S. Do any of the.stuctures lack adequate markers as required by the permit? ❑ Yes ENo ❑ 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 [54o ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes &No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) q W
13. Soil type(s) OoA
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
3 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�o
❑ NA
El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,
❑ Yes
Zo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
E No
❑ NA
El NE
18. Is there a lack of properly operating waste application equipment?
Cl Yes
[ No
❑ NA
❑ NE
I�G-up—hgnts {refer 4to;quuestian#)i�EpV-zlsiin°any YlrS.iangwersananyirecommendatiuns`or any other comments.
Use drawing. oftfyayc�Wtystii better yexplain-situations (use additional pages;as_neC sary)};
ir�uF,T
Reviewer/Inspector Name 4 R. f7.t l.. ' r::.:: t -r S" — L
Ir.[ ,�. � ..:::>:.::, .,. Phone:(4i M 3°� o x, e
Reviewer/Inspector Signature: Date:
12/28/U4 Condnued

Facility Number: 3, — Date of Inspection
Required Records & Dncuments
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
iyes ❑ No ❑ NA ❑ NE
❑ Yes [XNo ❑ NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
Yes
❑ No
❑ NA
❑ NE
❑,/Waste Application [I Weekly Freeboard El Waste Analysis ❑ Soil Analysis El Waste Transfers
❑ Annual Certification
L� 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?
L� Yes
❑ No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
�o❑_
NA
ElNE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
ElYes
12 N
LiCJ NA
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
70
dNA
❑ NE
26,
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
ElYes
7N.
ETA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
EfNo
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ff No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[2(No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
dNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
o
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
El Yes
WNo
❑ NA
❑ NE
Y [onA- -
AdditUEoiutireent's`andlorwllrawinnnb`s ',�:'_'!: �:` �;: �, �t � 1 �•�,,'
8 � �.F. ��:r �;.d. !JY.V'.. 1iT. � �',',.,y?,�-v'�.•: ° F5. S•eA:•..53AF �H�+v.'r�:� e'. .. �•... b... �. �
•.�ti... .:. �$'� its .ae :.,i�_�.:.i �;��..
12128104
12128104

j�
Facility Number date of Visit: % Time:
f
© Permitted 0 Certified �[/C/ondition lly Certified' 0 Registered Date Last Operated or Above Threshold:
Farm Name: _ ►�t !A` /l: 5� �'��� _ r� r/n _ . County:
Owner Name:
MaiIing Address:
Facility Contact: Title:
Onsite Representative: Cry t c/
Certified Operator:
Location of Farm:
Phone No:
Phone No:
Integrator: �r
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 6 �6 Longitude
Design Current Design Current Design Current
Swine CaVRCitV Pu ulation Poultry capacitv Population Cattle CavacitV Pa ulation
Wean to Feeder ❑ Layer ❑ Dairy
Feeder to Finish ❑ Non -La er ❑ Non-Dai
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts j ❑ Boars Total SSLW
Number. of Lagtiuns ❑ Subsurface Drains Present ❑ La von Area • 5 ra Field Area
Holding Ponds'1'Suiid iritps`..Liquid
..
:. ❑ No Li uid Waste Mana ement S stem is ;:` :.:':.: ; '-., :,-;';; ":;
Discharges & &Vam Im sd ct9
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 UWQ)
c. If discharge is observed, what is the estimated now 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 1Co Iection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ spillway
Structure I Structure 2 Structure 3 Stnucture 4 Structure 5
Identifier:
Freeboard (inches):
05103101
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
Continued

Facility Number: —
Date of Inspection
S. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
{If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Wage Agplication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of Dyer application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type O>!ft -C A f�'nt -c 2's X
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
I4. 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?
Reguired rd & D cum nts
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?
Oe/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative"
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ Yes
❑ No
❑ No
❑ No
❑ No
❑ No
❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #): Explain say Yl"S answers >xitdlor anyr`eeornmendations or any atht;r. comtittents: __ r�;•"`.:'' ti ;�
Use drawings of faclllty to better explain situations Euse. additional pages- as necess ryj: 't❑Field Conv Final, Notes
C-
r/
14jiA G444
— 5;�Ay eZ .0 a 074 Ael
IReviewer/Inspector ]Name
Reviewer/Inspector Signature: Date:ZAP
05103101 Continued

• Facility Number: — Date of b1spection
Odor Issues
25. 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 Can 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
Additional omments and/or Drawings:
., .
3/23/99

Type of Visit f5i-Compliance Inspection Q Operation Review 4 Lagoon Evaluation
Reason for Visit JDRoutine O Complaint ❑ Follow up Q Emergency Notification
Q Other ❑ Denied Access
Facility Number Date' ufVisit: `_-�- lime:
Not O rathi ai QBtlowThreshold
0 Permitted ® Certified 0 Conditionaliv Certified [3 Registered Date Lust OperatedorAbove Threshold:
Farm name: County:
Owner Name: _ i�r r��� -• _ _ Phone No:
Mailing; Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 ' Longitude C 0 •
Design *, Current
Swlne' . , runiseity .Pnnnintinn
❑Wean to Feeder
t
❑ Feeder to Finish
[.� Farrow to can
❑ Farrow to Feeder
17'!tEl
Farrow to Finish
TA
❑ Gilts
❑ roars
Design Current Design ' . Current
"Pouit M 'Cattle r
Ca ac is 'Pn uiatiou 'Ca aci •: Po uia on
" ❑ La er . 1 1.r,FQ Dairy I
❑ Non -Laver ID Non -Dairy
J2.
.•k rt.� 11
i � •.'..• �. • �. • .. *� ...!'.. fir ' .. .. r' �i., ... �9. 1.`Ar-n
other
# - r , _ .�, „?'� m• �; � "'F"'Total;Desigin; Ca aci � '-�
;r
Tafa1; SSL�' L ..,
�Numlier•ofLa sons "3,+ ❑ Subsurface Drains Present ❑ La ann Area S .y Field Area r
i' ;Huidingvs ondSolidsTapWaste Management Stem
Dlschar& Stream jMVRCtj _
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)
z. 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?
Wig Co;iection & TreatMeqt
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure ? Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
❑ Yes qNo
❑ Yes -❑ Nn
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
tB No
❑ Yes
E,No
❑ Yes
ERNo
Structure 5
Continued
i

Facility Number: n7V— hate of inspection
5. Are there any immediate threats to the integrity of any of the structures observed?` (sic/` trees, severc erosion, ❑ Yes FI No
seepage. etc.) �!
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ;
closure plan? El Yes No
(if an►' of questions 4-6 was answered yes, sod 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? El Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Anplication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ®No
11. 1s there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes [5�No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 1�rAIo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes Z No
b) Does the facility need a wettable acre determination? ❑ Yes 4 No
c) This facility is pended for a wettable acre determination? ❑ Yes SNo
15. Does the receiving crop need improvement? ❑ Yes MNo
16, is there a lack of adequate waste application equipment? ❑ Yes 2�No
1tguir_ed_Records _& Dngu rents
17, Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ErNo
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 RNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) .0 Yes ❑ No
20. 1s 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
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
_.Y
_���}�ii�nrr i•rfl��.]�n..�� 1.�:��� 5• .`�.�r _aL �.i�: r� '�f�l�:te2 ''���.�.I si_��:Z._.� �:�' i'i. ....... _. _... _ __
' � G SB:I f.F//7�'G. 71e. 54"I'G A41 i,t 000 rll V' h o�- &,/ -i-e. 4el4e Iz;;;,n 1/,9,
—
Reviewer/Inspector Name V�
Reviewergnspector Signature:
Date: .rh /02-
05103101 eL__1_ Continued

Facility Number: Bate of Inspection
QAU 11MM
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)
24. 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 rail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanentltemporary cover?
❑ Yes ® No
❑ Yes Z� No
❑ Yes &No
❑ Yes allo
❑ Yes ONo
❑ Yes ZNc
❑ Yes ® No
,Addidotml Comments and/or Drawiny,
ralalith
ralalith

Facility Number Date of Visit: ® Time:
rO Not Operational 0 Below Threshold
Wennitted 0 Certified 0 Conditi wally Certified [3 Registered Date Last Operated or Above Threshold : .........................
�-�j_,�.
Farm Name: ��.t!''t """`1.,. � Coun • ...... ..... ..... ................
OwnerName:..............................................,..................................................,......................... Phone No:
FacilityContact:.....................:........................................................ Title:................................................................ Phone No:
MailingAddress:.... ............................... ....................................................,....,......................................... ......................... ..........................
Onsite Representative: .!~ ............................... Integrator:... ....................................................
Certified Operator:................................................................................................................ Operator Certification Number:.........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 6 fig Longitude ' 4 44
Design _ Current Design Current Design Curt+ t
Swine Capacity Population Poultry
Clipacity Population Cattle :.Caps. ci Pa ation
Wean to Feeder ❑Layer ❑Dairy
Feeder to Finish ❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder JE3Other
❑ Farrow to Finish Total Desip Capacity
❑ Gilts €
❑ Boars 'Total SSL W
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds 1 Solid Traps; ❑ No Liquid Waste Management System ?
Discharges & Stream Im acts
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. Dues 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 9No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:.......................................................................................................................................................................................................................
Freeboard (inches):
510a Continued on back

Facility Number: —qW Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
0 Yes
Q(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
*v
(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 maintenancetimprovement?
❑ Yes
No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid. level
elevation markings?
XYes
❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
RNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
;KNu
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
A No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
gNo
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
RNo
16. Is there a lack of adequate waste application equipment?
❑ Yes
XNo
Rectuired Records &_Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
)Vo
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
XNo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
JYes
❑ No
20, Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
P No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
XNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes XNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes 4No
24. Does facility require a follow-up visit by same agency? ❑ Yes RNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes O•No
P. isQ•Ykk-19— R's -oi' k1epexi ►►ire 00fed• 0064g 41hisAsit; • ;Y;oU ."i-tOO �'� 40 fo#tho
canes• o deike; abottt� this visit:
Comments [refer to question #):. Explain grty YES answers and/ any irecotaameadatlons orany otlisr, cnmien{tai '' , l"`' :?
q p .... _ ...
`r t.. H '1 ..I •ii Il :I.'i{ {":$ {i. �F ?�:'ff':
Use drawings of facility to better explain situations. (use addiitianal pttgeg es necessary) ., Itii, {.;u; E, ;i,
a.CT)
C�- - A Sew d
It 7 r
) c"►�--t +�- 0- �=c �� si? nib
�S
ram. ����-. 1►J� C � rxe j�
Reviewer/Inspector Name _.' rv' ' 'y
Reviewer/Inspector Signature: Date: — .--Q t 5/00

Facility Number: Date of Inspection r 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 o
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes N0
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 111( 10
32, Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes 'XNa
Additional Comments an or Drawings;
AL
1
5100

j' ©Division of Soil and Water Conscirwatipn.- Dperation:Re'�ie►v
s [j Division of Soil -and V.ater Conser~vation'-;Compliance Inspection
division of Water. Quality Compliance Inspection
0 Other Agency - Operation Review',7e; `
r
19 Routine 0 Complaint 0 Follow-up of DW 'ins ection ❑ Follow-up of DSWC review ..❑ Other
Facility Number Date of Inspection
Time or Inspection 24 hr. (hh:mm)
Permitted 0 Ce ified [j Conditionally Certified 0 Registered [] Not O erational 1 Date Last Operated:
Count
Farm Name: ......... 7r...............1....,.1�/...:.................................. y= ..,...........,.1.. ..:......
OwnerName:.........,1��...............................�1!t�.��.�.�.. Phone No: ............,. .........................................................................
..............................
�'l J� .'l'itle:. (erM 1��'1 !'R� {s.. Phone No: Facility Contact: ��.�,......,,�. .......................................,..,,.......................
MailingAddress:................................................................................................................................................................
{?nsite Representative: ... ......... ,l if7...................................... Integrator:....................... r�.............................I.................
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location of Farm:
.. ............. ........
Latitude Longitude �• �' 0�s
Design Current Design Current ` 1 Design Current
Swine Ca acit Pa ulataon Poultry Ca acit Po ulation CattleL. ;CapacityzCapacity Population'
[3Wean to Feeder JEJ Layer ❑Dairy `
Feeder to Finish ❑ Non -Layer ❑Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
J.
❑ Farrow to Finish Total Design Capacity `
❑ Gilts
[I Boars Total SSLW'
Number of Lagoons 10 Subsurface Drains Present ❑ [,agnnri Area ❑ Spray Field Area
Holding Ponds 1 Solid Traps ❑ No Liquid Waste Management System ..i
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated ;it: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance Irian -made''
h. If discharge is observed, did it reach Water oi'the State? (If ycs, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Docs discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: 1
Freeboard (inches):...................................................................................................................... ..
............................... .. ........ ...............
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion,
seepage, etc.)
❑ Yes 0 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 'Z No
❑ Yes [kNo
❑ Yes J[ No
Structure 5
❑ Ycs ANo
Continued on back
3/23/99

Facility Number: 3 Date oll Inspection E
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
,closure plan? ❑ Yes qNo
(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
ANo
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 A lication
10. Are there any buffers that need maintenance/improvement?
❑ Yes
R5No
11. Is there evidence of [1 r application? ❑ Excessive Ponding ❑ PAN
❑ Yes
.XNo
12. Crop type
13. Do [lie receiving crops differ with those designated in the Certified Animal Wastc Management Plan (CAWMP)?
❑ Yes
MNo
14. a) Does the facility lack adequate acreage for [and application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) 'Phis facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
XNo
16. Is there a lack of adequate waste application equipment?
❑ Yes
K No .
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
MNo
18, Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?•
Yes
No
(ie/ WUP, checklists, design, maps, etc.)
❑
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
XNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
XNo
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes .
DkNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
;9No
(ie/ discharge, freeboard problems, over application)
23..Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
RNo
24• Does facility require a follow-up visit by same agency?
❑ Yes
SNo
25, Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ENo
1o•yiola60tis'ojr, d g r •V►r� ppte�3 dilr tng �hs'vis�tr Ynjr wi�� reeive tr�n /Fur tgr
co rt s• azidence: ab"f this'isit. • . . ... .. .. . ..... .
Comments (refer to question ft Explain any VUS answers -and/or any recomritendatians or ariy other coinments.:;,
Use awings of facility to better explain situations. (fuse additional pag6" s necessary)., .. ' j f Ig: r
&,4
1
I C. GGrrAG� ��{ th�.�-� s/`^`� `r CY�w. G-� . w►-�a .� C .
Reviewer/Inspector Name
Rey iewerlInspector Signatu �� �� d �t Date• _4—_ J 7
3/23/99

Facility Number: Date ref lnspection
Odor Issues
26. `Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes XNO
liquid level of lagoon or storage pond with no agitation'?
27, Are there any dead animals not disposed of properly within 24 hours? ❑ Yes j
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes '
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 'N r+
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 1046
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 25No
32, Do the flush tanks lack a submerged fill pipe or a pennanenUtemporary cover? 0 X Yes ❑ No
Additional omments and/or Drawin s: + u
J
3123/99

.,. , , �. W--w VWW NUN VIL YlAKW-_ BK PAGE e4/e8
Inacti4e Lagoon Field Data Sheetrr-11
FacjUty,Number: -©
Latitude F;_;�• ❑ `�� y 1 A x I n
4. Waste Last Added (mm/yy) J
5. Estimate of lagoon surface area (acres)
5. Effective height'of embankment (feet)
Inactive Lagoon Number:
Longitude E-) . k�- ❑Map
❑ Owner ❑ Estimated
7. Distance to Blue Line or Intermittent Stream (feet)
❑ Determined From Field Measurement ❑ Map
8. Down Gradient Well
❑ < 250 250 - 1000 ❑ > loon
r
a. Is there a down gradient well located within 250 feet? P Yes No
b. Is an intervening stream not located between any part of the lagoon and the nearest well? Yes ❑ 7io
9. Distance to WS waters or HQW (mi.) 10<5 ❑ 5 - 10 ❑ > l0
10. Does the representative know of overtopping from outside waters? ❑ Yes KNo ❑ Unknown
I I. Appearance of Lagoon Liquid
a. Sludge Near Surface
b. Lagoon Liquid Dark, Discolored ❑
c. Lagoon Liquid Clear ❑
12. Embankment Condition
a. Poorly Built, Large Trees, Erosion, Burrows, Slumping, Seepage, Tile Drains, etc. (]
b. Construction Specification Ual sown But Dam Appears in Good Condition
c. Constructed and Maintained to Current MRCS Standards
13. Outside Drainage Area
L Poorly Maintained Diversions or Large Drainage Area not Addressed in Design
b. Has Drainage Area Which is Addressed in Lagoon Design
No Drainage Area or Diversions Well Maintained k—
c.
14. Liner Status
a. High Potential for Leaking, No Liner, Saady Soil, Rock Outcrops Present, etc. ..- _ ❑
b. No Liner, Soil Appears to Have Lo, Pe eability ❑
c. Meets MRCS Liner Requirements
15. Application Equipment and/or Sprayfield Not Available ❑ Yes No ❑ Unknown
15. Contact could not be made with on -site representative
M■ 17
ILFD5
11121DO

ILFDS
V1J0D Z

Water Quality Active Lagoon Ranking 1. C/
- Draft s 1,7 /�
Central Office Criteria
1. Was facility constructed before 1993 MRCS Standards or there is no verification of standard?ye S
2. Plant Available Nitrogen (PAN) Deficit < 500 4 per year or F 1. F3 or F4 Wettable Acre Determination
Flags
F 1 Lack of Acreage resulted in over application in last two years
F3 Obvious field limitations ditches. buffers irregular shape
F4 Application acreage in excess of 75% of total acreage �r
3, Lagoon Capacity greater than 1,000,000 cubic feet
AID
4. Was there a discharge from waste system in last five years? .ND
Central Office Criteria available after new verified GIS data is gathered from field GPS Units
i, Distance from Lagoon to Water of the State (WOS) > 300'?
6. Is lagoon in 100 year flood plain? 0
Field Inspector Criteria
7. Modify Questio ,44 from current inspection- add choice box: Is high freeboard due to storm water or
management? r- �j �A �� S Ala
8. Modify Question 9 5 from current insp ction form (take immediate out) and define in form instructions:
Current question: Are there immediate threats to the integrity of any of the structures observed? (trees,
erosion) hA
9. Add question on effective embankment Height > 10' a
213/00

r
0 Division of Soil and Water Conservation --Operation Review
D.Division of Soil and Water Conservation - Compliance Inspection
Division of Water Quality - Compliance Inspection s
0 Other Agency - Operation Review
h Routine Q_C'omplaint a Follow-up of DWQ inspection 0 Follow-up of DMVC review O Other j
Facility Number Date of lnspt-clion �
'fine of Inspection :pp 24 hr. (hh:mm)
[3 Permitted Certified © Conditionally` Certified 0 Registered 113 Not [) er•ational Date Last Operated:
Farm Name: J{.�.�.t+rt►..................... I ttu......Lr.
nt4: ��r .1�.......................................
OwnerName: ............................. .......................................... Phone No:.....��5� 1..��R�`.trO��Z...................................
Facility Contact:.....p.......................................................................'Title:
Mailing Address:...... 1.Q.VA..............3.....
Onsite Representative: ......... bucJ.j..... � Y!s :! 4i1.........................
CertifiedOperator:.....................................................................................
Location of Farrn:
Phone No:
P.+. u......1-.� .1.�.�.1 ..............................z z.....
... I...... 1 n t egra tor:........cur-.0,11`5............................
Operator Certification Number:
..... �n.....�cttr. .i......et...............�......... A :.�4....�-sa. .....cc .... a........... 94:.11..l..........................I.............
.........
. . ....... ... T
Latitude ' 6 �• Longitude �' �° �°°
Design Current
Swine Capacity Population
❑ Wean to Feeder
ts Feeder to Finish
1Q00
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 1 $'ao
Total SSLW
Number of Lagoons ❑Subsurface Drains Present ❑ I,agcrnn Area I0 Spray Field Area
Holding Ponds 1 Solid Traps ❑ No Liquid Waste Management System
DischaEg c& Stream Im�aacts
1. Is any discharge observed from any part of the ❑peralion {If yes, notify DWQ)'?
Discharge originated al: []Lagoon ❑ Spray Field ❑ Olhcr
a. It' discharge is observed, was the conveyance man-made''
h. II'dischargc is ohrcrved, diet it reach: ❑ Surface Waters ❑ Waters of the State
c. lF dischatgc is observed. what is the estimaicd Ilow in gullmin7
d. Does discharge hypass a lagoon system'?
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts to the waters of the State other than From a discharge?
wa%te collectinn & 'Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I
Identi Fier:
Freeboard {inches): ........... Z
..................
1161y9
Structure 2 Structure 3 Structure 4
❑ Yes 5 No
❑ Yes N No
❑ Yes j0 No
tj
❑ Yes
No
❑ Yes
No
❑ Yes
No
❑ Yes
No
Structure 5 Structure 6
.................................................................
Continued on
hack '

Facility Number: 31 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, K�+ Yes ® No
seepage, etc.)
6. Are there structures on -site which arc not properly addressed anchor 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 niaintenancelimpt•ovement'? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenancelirnprovcmcni? ❑ Yes j No
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings? ❑ Yes tM No
Waste Application
10. Are there any buffers that need maintenancelimprovenienI? ❑ Yes P No
1 1 • Is there evidence of over application'? ❑ Pondingi ❑ Nitrogen ❑ Yes ® No
12. Crop type CO? Y�.......... ............... Q1t]A4'4tr---.......... ....... ................ ............... ............................. ..........................................................
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14.
Does the facility lack wettable acreage for land application? (loutprint)
M Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
[R No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
�d No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Pcrmit readily available?
Cl Yes
No
18.
Does the facility fail to have ail components of the Certified Animal Waste Management Plan readily available?
(icl WUP, checklists, design, maps, etc.)
❑ Yes
No
19.
Does record keeping need improvement? (iel 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
ONo
21.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
(P No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(icl discharge, freeboard problems, over application)
❑ Yes
DP No
23,
Did Reviewer/Inspector fail to discuss rev iewlinspcction with on -site representative?
❑ Yes
EP No
24.
Does facility require a fallow -up visit by same agency?
ElYes
V No
h1:n.vitalitions:ar. defieiericaes .were rioted dtirin'.tfii' - ' isit.' You-vWfrerceive no further . ;
ec}rresparide>rrce. . .... .vt.:: ... . .. :.:.:.:.
Comments (refer to question #): Explain any YES answers anchor any recommendations or any, other Comm_ men _ i i;
Use drawings of facilit to better explain situations.' use additional a es.as necessary).r F ' 4_ $.
S. � �5 hRulr7 � roe sLrvhb OS
I . row,w:ll (� c+J der Iti1lt yip ,�►vi rw. a- unL�s, �'a [or3i+v, core be PvtvViOec� h1r 4/t Z4I,
J ]
IV
Reviewer/inspector Name
i
Reviewer/Inspector Signature: _ le:� - Date; __ qa'n 1/6/99

NF
0 Division of Soil and Water Conservation ❑ Other Agency p ;
Division f W Quality
e4? 3's
g
Routine 0 Complaint 0 Follow-ue of DWQ ins action 0 Follow-ug of DSWC review 0 Other
Date of Inspection
Facility Number
Time of Inspection ® 24 hr. (hh:mm)
0 Registered ® Certified © Applied for Permit U Permitted hot O erational Date Last Operated:
FarmName:............ '7M......G i� .. Ii��...... �.c w.... k..j.......................................... County:.... �It It n........... ,.............................. .......................
Owner Name:............ o.�..................... ........ �!�?�:1,.ki4.1i1........................................ Phone No:...���°i�..�t�.'.����.........................................
Facility Contact :........... ..tiles..............'ti'Y1i ....r .f4............ Title:..............................,,................................ Phone No . .............,.....,,..............................
MailingAddress: ...... 7,ft ....... ...... ................ .I ............... .. ........................................... I,...........
Onsite representative:....... .inb� ............ � 4t!ti............................................ Integrator:.......... Car.v.4L[K.................................. I..................
Certified Operator;................................................................................... . Operator Certification Number:
Location of Farm:
Latitude Longitude
Msigri Current Design Current esegn Current'';
i
Swine' Capacity Population Poultry Cs acit Po elation "Cattle; . •.. Ciapa�tt zPa elation'
y. p y' p y p
❑ Wean to Feeder JE1 La er 1 ❑ Dairy
Feeder to Finish I0 Non -Layer 1 ❑ Nan-Dairy
El Farrow to Wean
❑Other . 33
❑ Farrow to Feeder "' "'` "
❑ Farrow to Finish Total:DeSign Capacity:,'
Gilts
[I�,'.
Boars ''iE3 , ill, ,; ii Total' 5SL W„ i
Number of Lagoons Molding! 10 Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
❑ No Liquid Waste Management S stem
5•
1
is
----
Geneol
1. Are there any buffers that need maintenance/improvement?
❑ Yes
® No
2. Is any discharge observed from any part of the operation?
❑ Yes
® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
❑ Yes
No
b. if discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
❑ No
c. If discharge is observed, what is the estimated flow in 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
f� No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
PNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require
CA Yes
❑ No
maintenance/improvement?
b. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
EANo
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
09 No
7125197
Continued on back

Facility N umN-r: 3
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
No
Structures (Lagootis,lfoldiiip Pon(ls. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
No
Structure l Structure 2 Structure 3 Structure 4
Structure 5 Structure
6
ldentifier:
Freeboard tft}: ..............1. P ...............
10. Is seepage observed from any of the structures?
❑ Yes
[N No
It. Is erosion, or any otlie r threats to the integrity of any of the structures observed?
❑ Yes
® No
12. Do any of the structures need ntaintenancelinif+rovement?
Yeti
❑ No
(If any of questions 4.12 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
i9 No
Waste Annlication
14.
is there physical evidence of over application'?
❑ Yes
09 No
(If in excess of WMP, orrunuf'f'e11nter++ing waters ofthe State, notify DWQ)
15.
Crap type rrfYF.r1............. WT �i...r.lXl.....................................................,....,..,....,....,...,,.....,...........,............,..............-.....-............
16,
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMI')?
M Yes
❑ No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yeti
No
18.
Does the receiving crop need improvement?
❑ Yes
No
19.
is there a lack of available waste application equipment?
❑ Yes
P No
20.
Does facility require a follow-up visit by same agency?
Cl Yes
;KNo
21.
Did ReviewerlInspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
22.
Does record keeping need improvement?
tA Yes
❑ No
For
Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
l� No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
159 No
0 No.viblatioils or deficiencies were noted during this visit.- No'U411l re,cei've no ftirther
Correspondence ahoid this visit.
Coe ' m" 'e' lts.(refer to question*)- Explain any ..YES answers and/or any recommendations`or: any''ather: comments:' .
r
Ilse drxwtngs of fu ihty.to;better explain situatirms juse�addltional pagF'5'a5 necessary ;
�sFs .;tia,
Low
...c kt&,, be '( �-lii.�i � y�t��c� 4- rr-5eer}c.ea . A,
��• � � �i t4. W�,�l o�- ��-hoar.
I(,. SfN&jk �lr 001% i&'W in �hll oP C!`7 ire (tto jejiv 4C- C-OCK+J1Q.�,I6ea %n... 1�•ll CVn�
` �
J$ D t. e�[rn i r. A E6,- S 64 �&e t; 5 , r, W L.
"z- Z�,SQr nvm6tr- 5hadl4e ILA Om !M& i pvro,
7/25/97
Reviewer/Inspector Name r: , .,, . 5. :? > �,.: �S
.. ... ...::: !. i..: it e• :. �.::.',.1' '�4;•j
.. .' .... .:i: .'.� .eve.
Reviewer/Inspector Signature: p� _�.. �,� Date: 1r1„dqX

.................................... ..... .................. ..
.. �. .. ..<� ❑ DSWC Animal Feedlot Operation Review
is s'�itiii: `v:
4:
;' °_
`•.'
Sv, 'i'•,l it'
.... 1
DWQ Animal Feedlot Operation Site Inspection
lifr?ji a
.. jib;`:.. '
„!,;
s.¢; x.. .
10 Routine ❑ Complaint 0 Fallow -up of DWO inspection 0 Follow-up of DSkVC review 0 Other
Date of Inspection [I
Facility Number
Time of Inspection b 24 hr. (hh:mm)
0 Registered I Certified © Applied For Permit 0 Permitted 0 Not Operational Date Last Operated.....
Farm Name. .Toft.... Ail -Ad 6111,............................. county :.....Dutlie►.........................................
Owner Name:........ rQIt'...... 1&zf. tl j......... .. Phone No:..00.1.6-0.. 20..................
Facility Contact: ....wtiltlG l...••1 t ara ........................... Title: ......... I!'tkI�ii�&............................ Phone No:... ......
Mailing Address: ...... P.t ... ..... 2m.5.4........ lly...'aW4... .......... A16r+5 It..lj-C ..I........ ......
❑nstte Represetlt:tttve.:.............. .......{7.L1X1................................... ........... Integrator: ......... ..AV%Q.�,i, s...............................................,....
Certified Operatot..................................................... ........... ................................. ................ Operator Certification Number, ...... I.-TI 1...
Location of Farm:
c:,....4 ., . ...... ,n....
1Ci� orx... ...... K...IS��ti..... �
Gti.C'4?.... tS........}:.r..1+e►..5....:..GIl1.......5..5�L..,., r1............................................................................................................................
Latitude • ` " Longitude ' ` "
Design Current Design Currant Design - Current. ,
Swine Capacity Population Poultry Capacity Population Cattle Capacity :Population.
❑ Wean to Feeder JEJ Layer rEl
Dairy
14 Feeder to Finish j ❑ Non -Layer Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑utter
❑ Farrow to Finish I Total Design Capacity
❑ Gilts
❑ Boars "Total SSI.W Zr{ azyt7
Number of Lagoons l Holding Ponds JOSubsurfaceDrainsPreient Lagnrtn Areu ❑Spray Field Area
❑ No Liquid Waste Manarcluent System
General
1. Are there any buffers that need ttr:tiutenancelimprovettiettt'?
❑ Yes
® No
2. Is any discharge observed from any part of the operation'?
❑ Yes
W No
I)ischargc originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge it observed, was the Conveyancr. rnan-made?
❑ Yes
IJ No
b. It•discharge it observed. did it retch Surface Water' (11' yes, notify DWQ)
❑ Yes
No
c. [f discharge is observed, what is the estimated flow in gal ntin?
d. Does discharge bypass a lagoon systettt'y flf yes, nntit'y I)WQ)
❑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 frotn a discharge?
❑ Yes
® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
(Z Yes
❑ No
mai ntenancelimproventent'y
6. is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7, l)id the facility tail to have a certified operator in responsible charge?
❑ Yes
PNo
7/25/97
Continued on buck

Facility Number: 31 —
8.
Are there lagoons or storage ponds on site which need to be properly closed'?
❑ Yes
® No
Structures (Lagoons.11olding Ponds Flush Pits etc.
9.
Is storage capacity (freeboard plus storm storage) less than adequate'?
❑ Yes
® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Freeboard(tt): ......:<.......................................................................................................
10.
Is seepage observed from any of the structures?
❑ Yes
W No
11.
Is erosion, or any other threat~ to the integrity of any of the structures observed?
[J Yes
❑ No
12.
Do any of the structures need maintenance/improvement?
Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
W No
%Waste Application
14.
Is there physical evidence of over application?
❑ Yes
JO No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type G.I? rt`...............................................................................................................................................................................................................
15.
Do the receiving crops differ with these designated in the Animal Waste Management flan (AWMP)?
❑ Yes
® No
17.
Does the facility have a lack of adequate acreage for lane] application'?
❑ Yes
91 No
18. Does the receiving crop need improvement? ❑ Yes I© No
19. Is there a lack of available waste application equipment? [:]Yes E] No
20. Does facility require a follow-up visit by same agency? $1 Yes ❑ No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'? ❑ Yes 10 No
22. Does record keeping need improvement? ip Yes ❑ No
For -Certified or_Perinitted Facilitie5_Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes 91 No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? %Yes ❑ No
25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes M No
0 No,violations or deficiencies were noted during this:visit. You.wiII receive no further
correspb6dence about this'visit:
Comments (refer to question #): Explain any. YES answers an. any recortimendations,nr any other;cpixtas tints'
Use drawings of facility to k►ctter explain situationsi (use additional. pages as necessary}:
e .. .. .. ...
'F?55�i13Fssl�.
�Pnrls �koc+� k3e 60i o-rout �1� �cca ed rt o r n I t F A
II •r12. Cro5ion Wks an 'K F (o' ti'[.r WAO 04- Ia5opon 5kiui� I. LA [ t�.� 04, C-6 &4 resQeat' d ip
1 r'ees �6016 1 e, etmOdcU 'f'rOm 6JW (, ,O of �t�OC1+�• C[3h`IQ SO' � `-WAIT Dr-s,t-icf' At-
A.T51S6L�e,
22. Ut4&k d w]os� t. camp wjjysi s s kouj) 6P_ o n 5; k. flwaalor\s
5� riu orris shouj j be KPr by
f" tiser Er+vg ev�f OXVVI an �w OLIJ i,fir�gc�a� OA 5y st4jr` S� C: h6v(} � e t n �OA .
14. 5reO * 1 ska O yl» Aadp�P +o k-A-, e v`1 Itxa+o; , o , . 'rr�1j * I h,& s beer. I rH'aitJ- d s
sv1U ht' �aCU +o 6,•. 7y
nn25//97
Reviewer/Inspector Name
L.
Reviewer/Inspector Signature:
Date:
t 1

-�..p: .; Ff �.;F€r. ,SSS{ is
°`
'•.ix:i;i}i:;a:
DSWC Animal Feedlot Operation Review
`€. :�ii� n:•:: �''
x:f }� ��I:� �:ii
i"t5 �S: ii' h.86i':v.:e� 5:. �..
'P.. ;':}€t'Cip;Fisy:.""y).:`:..'.:r
..�e�'.
;'=:e:;
El DWQ Animal Feedlot Operation Site Inspection
p p
S ;:
SiIF.,,�'.e:�: `
.
a
yk°`
s.
10 Routine Q Complaint Q Fallow -up or mvo inspection 0 1' allow•-ut) of DSWC: review D Other 1
Date or Inspection € l
Facility Number +
Time of Inspection Ih 1G 24 hr. (hh:mm)
Registered Q Certified 0 Applied for Permit © Permitted 0 Not Operational I Date Last Operated . •,
Farm Itiumc; ......`i i€.1�.....1 .�.s .�t�f�. ...... 1 .......................... Count►•:.....�:��1lt.t�.........I.............
Owner ��'ame: {i1 �. r� I'honc tin: „.`.?.` 1 Grp - G .f�l�
,.,........ I�l.Sll.......Jcx.A �i..... .�.Y. .......................................................................... if.l..........'Y................ ,..,.................-
F'acility Contact:...,l:u.!al�a�....... ........................... Title: -....... Phone NW ..,r`�°:!�...::'." a.: fc:....`� .......
SlailingAddress* ...... ... `....... N�....lhulj....U.l..... lolvt�..,Ai ................L14. F:f.?,5.t;+Xt..!I.�.............. ?.':`!a....,...
f ' 4
❑ttsite Represfntativc: ...... i�s�i.t^L2..I......... �AQ P..'%Gti............... lntrl;ratrir;............Y.::.��................................ ,...... .... ...........
Certified Operator. ............................. ................................................... .,............................. Operator Certification Number ...........................
Location of Farm:
..............................................`.
Latitude Longitude • �' "
Design ° =.Current Design 4Current Design,. Currents .
.
Capacity.F Population Poultry";Capacity Population Cattle' Capacity, Population .; ;'
❑ Wean to Feeder
® Feeder to Finish
l$
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Layer ❑ Dairy
❑ Non -Layer JE1 Non -Dairy
❑ Other
''Total Design Capacity
Total SSLW
:Numliex of I:agouris 1"Huldirig Ponds' ❑Subsurface Drains Present ❑Lagoon Area 10 spray Field Area
❑ No Liquid Waste Management System '
t er l
I, Are there any buffers that need maintenance/improvement? ❑ Yes ONO
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 dischargc 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'?
�j-
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
[2) ,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 lagoonslho[ding ponds) require
Q-Yes
❑ No
main ten an ce/i mprovemcnt?
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
[9 No
7/25/97
Continued on back

µ e ; r .. ... .: ., y,•nf' •i+ v ^!r}�i7..:... n .rr ..I •ur , -.n L. ..
umber:gi7; ,i i 'i ;� • a.'== Y:r, �.,; ?;fA14 F., Tt 1 i , ,,
Y there lagoana orlstorage potids'on'site which need to be properly dlosed? : - , ; , '? t� ❑ Yes ti �j No
r i t
pp t"A.
a OOtl5 Y id h Plt
Is'storage capacity.(freehoard plus'stormfstorage) lcss'than adequate,,:.'
'. ,❑ Yes No .
F•
Structure 1•.., Structure 2 Structure 3' Structure 4 Structure 5 Structure,fi
i'= 'Id
fier:'..,....,.,......................... ........................:...,.....,;,,:............`......:........,......,.P...... ...... u.................,,..,:..........:.:.`.............,...,.,
�, y •5 f•:, r :y ,,
.....�. .... �� .. .... .......... .. ."
T trlx••
•,�.. .. �•;
I't
Q %Is seepage observed from any of the structures? d ;.
❑ Yes S No
t 11 :iIs'ervsion,'or any, other threats_ to"the integrity of any of the str'uctures observed?
{� Yes . ❑ No•
-
'tnaintenancelirriprovement?
i 2:; Do any of the structures need N.; {, . „ •
Yes ❑ No
;• (If ariy of questions 9-12 was answered yes, and the situation' poses
W.1'4'n ihiitiedtate public health'oi'erivir`on,''mental,threat, noti€y'DWQ)
,
'.13--:Do any<of the structures lack adequate minimum or maximum liquid level markers?
❑Yes . �tj Na
�aF«'a5te4rApplk t10ri.
there physical evidence of over application?
e:i i•
❑Yes : No .'
rt:•rdf! jrtrs .t;•'�'.,1' aE.. . • .. ,
`�'' = w ;; • (If in excess of WMP, or runoff entering waters of the State, notify DWQ]
'
15.` Crop type C 8 r?`............................................................................. ........ .. ......... .................................:.............
r
...., .. ..
...: .....
16. Po the receiving crops'differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes �] No
',yi•i '. ..yam. 1•.-y .',wl� , .r
;17.; the facility hove a lack of adequate acreage far land application?
• _
❑Yes ',� No
,Does
''''
❑ M'No '
i8; Does the receiving crop need improvement?
Yes
Is, Cheri*"& ack'of.avaiiable wasteequipment?''
❑ Yes ] No
,19`.,"application Y
,
r 24 `Does facility require afollow-up visit by same agency?
® Yes ❑ No
'21 'I}id ReviewciA spector fail to discuss review/inspection with'on-site representative?
Yes: No,
:''t22- Does record keeping need improvement?'
fl�acilitirQriiy:
®Yes [] No .
Fnr_�grtiiiedorrniitte -
fail to have.a the Animal Waste Management Plari available?
• ❑Yes No
�a23.�EDocs the,facility copy:of reailiiy , .
Were any additional problems noted which.cause noncompliance of the Certified AWMP? �. '. .
,
[Yes ;,❑ No ,
2S.' Were anyadditional problems noted which cause noncompliance of the Permit?
„-
❑+Yes ~ No'',"' ,-- t
Na:vialatioins or deficiencies. were' noted•during this:visit...Yait;wili recei:ve'no'ftirttier
;cvrrespat'idetie' O dhout :this`,visit: , '' . • • . , • ...
.. ........"_......... ..... _..............
_..,....,».....»,» __..,K .
•�°` :..'':�i ex. 9.`�' .. �::: �'?i3 �.Y`'�W�.eesi e`•. � R#3i333:'i'$43iiiSsal4� � F
. Use winps€af�f&ilit ;to better ex lainiituatibi ', tis4 addittnnal: a es as neeessa F ! °
# - . »4.i •.fix \ .s.. �b7 .•.1 J.�:i 3:3 'S . H ..• . F Yrdiii$f
�:.v..�:'♦ro'Y . � 3Ps3F4•.k�$�..: e :.3iFff:......�€: �..:."":..?''f': 3�n..,. 3�¢;r�.. .�1tt7tt€:3�u Aiiiis�is.:'�i..�eE€S•?:§�'8h'.#iis. e6:;'��.:•�:�i€�I�i....:ttFi3a:,�`:'�oFSE:ij::H�jitjif:Ejw.i.E�....iF`.'�.FE�iiifi�f`:�:c
I-�y[}rn�t�5 4 {,t �� [d; rya {" ;,F� ;.ltitit 5�:. ; .• '. •„ � ^„ ;,, - • • � � i
r �s ov+ r wail yon. ,,h (� l a 5
& Y'G5�(jn LsJ - Ors `� • 04:: �A�. U� �JK- t �.e � ytlt'� c_�0 t�+^ jY°af � OC � �
TYFFS' S�OJ�C} �Q ''rt11,VgJ Z F�t�.} 'OuKrw ALAI, -4 •IcgX4 t• C0 F,4aIf' SO 1 4
'�piS9li�Oirl4,Lr. i y 1 �.
��.:' •"�S: �' r~��'�� ac� ,an ���� �►�� i,{,'�[ a���1 ,y s�o�r• '� �t i.�� rc��dor•; �houlc� ��F i �� �I.Gn
�lrn��o,� t}4�,�, . ��3�. .� ho.� �eeJ\ art air ;
+I:#i..lslw�f lie , a�v'ar+
Fiuti�l� -arJ� eda }GGF' .7125/97
n; � e�rrex �°° 3:�€ ye S' ( 1I �n ;(r•.�,,.. F _ p�,. >w
:;b; ;!!;- .,Y Ei 4'''��... :fF'% :'?t t t i i ' i:i `.�irin 1 �: 'F �L•r`:F: Fi:s" 3
Reviewerlins ector, Name ea .. ; �: 'F: „� ; F.sF�.
[`ttt e.:-.�€': tS ht, . 's;; ;;,.i, 7-..ii
'';` Reviewer/irispector Signature: Date:

Y
y. .
. f1
k - State of North Carolina
r Department of Environment, Health, and Natural Resources
Wilmington Regional Office
James B. Hunt, Jr:` Division of Water Quality Wayne McDevitt
i,
i, Governor'' * ` ` �.: ! ! : =.s , . . . Secretary .
- Certhfled+Mail''# Z3125639'981
Tom Whitfield
`1' , i' . Tom Whitfield Farm
f12954 NC Hwy. 11land 903 North
lAlbertson, NC 28508
Dear Mr. Whitfield:
September 15, -1997
Subj ect: NOTICE OF 611k6 ENCY
Tom Whitfield Farm
-- Facility; Number: 31-418' '
Duplin , County
!
• On September 11, 1997 Staff from the Wilmington Regional Office of the Division of Water Quality,
inspected your animal ap it a6n'4nd the lagoon(s)# serving this operation. It was observed that some erosion
of the clay liner.has occuired on the lagoon. 1!12 cuts were obsery larialle ,outer dike
wall of th It is'our r�nce_ rn that some of�e ay become deep enough to cut through the
to acreage not'included in the certified animal waste management plan.
L�
�,�Rs-•;.; -As discussed at the time of the inspection, the cuts should be filled with a suitable clay material,
compacted and reseeded with an appropriate vegetative cover. USDA -MRCS requirements
acreage on which waste is to be a lied should be desi in the certified waste management plpn.
Vaste application to field #1 should be discontinued until the situation is corrected. In addition, a crop
' rotation of soybeans and wheat should be added to the certified plan. Berms should be built around any
hydrants located near field ditches, and the trees should be removed from the outer wall of the lagoon. We
suggest that you contact your service company, local NRCS or Sail and Water District office for any
assistance they may be able to provide to correct the situation,
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, , t
to do so may result in the facility lasing it's deemed permitted status,, requiring it to obtain an individual non j #
`4 discharge permit.
# , 127 Cardinal Drive Extension, Wilmington, N.C. 2M5-3845 + Telephone M-395-3900 Fax [phone]
r'- M Equal Opportunity Af'fzrma64Action Employer
it i
i

Tom wmuield
September 15, 1997
-page L.
Tlease be aware it is a violation of North Carolina General Statutes and Rules to discharge wastewater
to the surface waters of the State without a permit and/or to fad to follow a certified waste managernehi plan.
The Department of Environment, Health and Natural Resources has the authority to levy a civil penalty of
not more than $10,000 per day per violation.
TL
VxXWhen the iupired'coftective actions are complete, please notify this office in writing at the address
Abelow...If-you have any qu6stions concerning this matter, please call David Holsinger, Andy Helminger 'or
Brim Wrenn at 910-395-3900.
4.'Yield 1m Sincerely,
Brian L.'Wreinn
Environmental Specialist
4vi 'L
Billy Houston, County Soil and Water Conservation� i
4 Sandra Weitzel, NC Division of Soil and Water Coniervation
J on D -Butler, Carroll's Foods
Operations Branch
Wilmington Files

EMERGE.NCY ACTION PLAN
,PHONENUMBERS
DIVISION OF WATER QUALITY' (DWQ) [phone]
EMERGENCY MANAGEMNET SERVICES (EMS) [phone]
SOIL AND WATER CONSERVATION DISTRICT (SWCD) [phone]
NATURAL RESOURCES CONSERVATION SERVICE (NRCS) [phone]
COOPERATIVE EX:TERSION SERVICE (CES) [phone]
This plan will be implemented in the event that wastes from your operation are leaking,
overflowing or running off site. You should not wait until wastes reach surface waters
or leave you property to consider that you have a problem. You should make every
effort to ensure that this does not happen. This plan should be posted in an accessible
location for all employees at thlefacility. The following are some action items you should
take, ;
1. Stop the release of wastes, 'oepending'on the situation, this may ore may not be
possible, 'Suggested responses to some possible problems are listed belwo.
A. Lagoon..o�erflow;p.o..ssible:solutivns are:
a..''►4dd;soI, to berm;to increase elevation of dam.
b. �Purnp°:wastes to; fields at an acceptable rate.
c. ,:`Stop'�aII flows to:the lagoon Immediately.
d. Call`a'pumping..contractor.'
e. Ma"ke',sure-na,.sur.face. water. is,entering lagoon.
B. Runoff from'waste,application field -actions include:
a. 1mmeolately sta-p waste. application.
b. •treate'a temporary diversionito contain waste.
c, ,:'iricarpor,ate.,ii dste tb reduce runoff.
d. Evaluate and eliminate the reason(s) that cause the runoff.
e, ..Evaluate the application rates for the fields where runoff occurred.
C. Leakage from the waste pipes and sprinklers -action include;
a,=';Stop _recycIe pump;
b..:Sfap irrigation pump,
C. `°Close"valves .to•eliminate further discharge.
d.- Repaie.all leaks.prior, to restarting -pumps.
D. Leakage from flush systems, houses, solid separators -action include:
a. ,Stop..recycle pump:
b:. ..Stop=Irrigation pump.
c: °•Make sure siphon. --occurs.
d. `Stop ail flows in the house, flush systems, or solid separators.
E. Leakage -from base or sidewallof lagoon. Often this is seepage as opposed
to ,flowing'.leaks-possible, action:
a. Dig a small sump or ditch from the embankment to catch all
'seepage; 'put In a submersible pump, and pump back to lagoon.
b.. If holes are. caused by burrowing animals, trap or remove animals and fill
holes'and. compact -with ai clay' type soil,
c. Have a professional evaluate the condition of the side walls and lagoon
botto-m:as -soon as`p6ss1ble.

2, Assess the extent of the spill and note any obvious damages.
a. Did the waste reach any surface waters?
b.- Approximately how much 'was released and for what duration?
c. Any damage notes, such,.as employee injury, fish kills, or property damage?
d. Did the spill leave the property?
e. Does the spill'•have the potential to reach surface waters?
f. Could a future rain event cause the spill to reach surface waters?
g. Are potable water wells'.in danger (either on or off the property)?
h. How much) reached surface waters?
I Contact appropriate agencies,
a. During normal business hours call your DWa regional office; Phone - After
hours, emergency number: 919-733-3942. Your phone call should include: your
name, facility number, telephone number, the details of the incident from item 2
above, the exact location of the facility, the location or direction of movement of
the spill, weather and wind. conditions. The corrective measures that have been
under taken, and the seriousness of the sitution.
b. If spill'leaves property or'enters surface waters, call local EMS phone number.
c. Instruct'EMS to contact local Helath Department.
d. Contact CEs, phone number - , local SWCD office phone number - -, and local
NRCS office. for. advice/technical .assistance phone number - -.
4. If none of the above works call 911 or the Sheriff's Department and explain you
problem to them and ask the person to contact the proper agencies for you.
5. Contact the contractor of your choice to begin repair or problem to minimize off -
site damage, r�
a. Contractors Name:
b. Contractors Address: 2eyy e&Irr 3 ,z s-y
c. Contractors Phone: n1 _ <yr z -V w
E. Contact the technical specialist who certified the lagoon (NRCS, Consulting
Engineer, etc.)
a, Name:­
� A,y
b. Phone: Cr ol1�0( ;21ae
7, Implement -procedures as advised by DWQ and technical assistance agencies to
rectify the damage, repair the system, and reassess the waste managment plan to
keep problems with release of wastes from happening again.
2

BIG GUN@ PERFORMANCE TABLES U.S, UNITS
100 SERIES BIG GUNS
- 249
TRAJECTORY"
100 T TAPER BORE NOZZLES
M1+ottry Notz14
NOT
NDti1v
Noltla
Nozzle
Nozzle
NDztle
I No7r1p
•.
0
r
5' '.55'
PIS I GPM OrA. GPM ❑+A.
6'
GPM CIA.
65'
e•�G.P�Ms,� CIA.
7"
GPM CIA.
GPM
75'
DIA.
a'
CAM
CIA.
65'
GPM
CIA. ,
9'
GPM
'31A
I GPM
D1d
$0 50 20S, 64 215'
74 225'
1 87 235'
100 245'
115
25W
130
265'
150
273,
165
260'
I 204
300' ,
I 7p 60 225' 75 238'
68 250'
f03 260,
t20 275'
138
263,
155
295'
177
302•
197
710'
l 24
mcommoll
90 69 245, 83 250'
100 27p'
It7 .• 283,
135 295'
Rllimm
I55
306'
17a
315,
201
325'
223
335'
274
362' '
1 110 76 265 92 278'
111 290'
129 303'
150 315'
111
324'
195
335'
222
344'
20
355'
, 301
36:'
'A.a,14LJa only wren F100 a SIR 100.
100 R RING NOZZLES
100 ON DIFFUSER NOZZLES
P51
A+NG
GPM CIA
77 RING
CAM DIA
!j 81 RING
l GPM (11A
8t RING
GPM tlli
`�
69 RING
GPA1 QIA
93 RING
GPA1 CIA
96 RING
(iPM DIA
0.5 ON
i3PM CIA
06 ON
PM CIA
0 1 ON0 8 DL
GPA1 DIA GPM 0'.
134 238
152 242
46 IS4
66 lea
8re1I
91 162 lie 19±•
40
66 2pa
78 212
91 215
103 224
110 255
1 :.i!I
60
61 275
1 96 240
1f0 245
125 260
141 270
164 275
163 2 0
IlO 2�Dy0143 21i
00
94 255
1t! 265
127 275
145 205
163 30p
109 305
211 315
-
-
- - - -
l0p
105 270
24 280
142 295
162 305
182 320
212 325
236 335
- - - -
0`r=fit
1ME
rein o'amere+ of Inr" is ADPIV1+mereiy u•1y+aea ror Ine 11' Ira+e[l Dry Angie, n% +ass ror IV.
150 SERIES BIG GUNS -" 240 TRAJECTORY"
M T TAPER BORE NOZZLES
P$ I
4
Noz:Ie
GPM
�
CIA.
Not11■
GPM CIA.
t
Nod"N
GPM DIA.
No lie
GPM
CIA,
Nozzle
GPM CIA.
Nozzle
GPM OIA I
%0:14
G,M
CIA
60 j
110
265'
143
265'
182 305'
225
325'
275
345'
330
30,
385
380
7
'13 mvzmm
ao 1
121i
290'
165
310,
210 335'
i
260
355'
315
375'
380
395'
44j
41".
100 I
43
31 p'
185
330,
235 355'
290
375'
35�4m�
20'
S00
�
44:
r
�161�5
120 I
157
33o•
204
350'
258 375'
320
395'
7a40'
S45
46:
150 R RING NOZZLES Z itki' & /,qjs 41S.aen 4C 3 Td •hJClT��49lxiGto{�
PSI
Ring
66'
GPM CIA.
Air
97'
GPM CIA.
%7in4
a ad'
GPM fl:A
Rin
l.16
GPM CIA.
RIn{�
1.26
GPM ❑lR
R+ng
1 34'
GPM CIA
R,ng
+1'
GPM ]I:
fig
110 26p'
43 280'
182 300,
225 315'
275 335'
330 350'
395 36:
a �
� 7,YiL� I31IL,
a 1rSt�.TsA6p,:�
80
128 280,
165 300,
2r0 Vol
260 340,
315 360,
300 380-
44$ 33,
ZS�"R10413L�
100
143 300,
195 320'
235 340'
290 360'
355 360'
425 400
500 415
.111. 1
xssa°%�
2p
Si 3'r5'
204 335'
258 360'
320 380'
306 400'
465 4V'
S+5 435
rnr 01AMelU dr Inron ri ap010•m8101y J%% 146S rOr In/ 21" tralv:[Ofy il%SW
200 SERIES BIG GUNS -- 270 TRAJECTORY"
200 T TAPER BORE NOZZLES
N01410
105-
i PSI GPM 01A.
NO>;xle
1.1•
GPM DIA,
NOlt+e
1.2.
GPM CIA.
Iloizltl
I-3'
[1P+.1 CIA.
r4o4zio
1,4"
GPM CIA.
Nozzle
f.5'
GPM CIA.
N02114
16'
CPU DIA.
Nottle '•tittle A
l.7S" I 19'.
GPM QIA COM 01,
10 270 360'
310 380,
355 395'
Al! 410,
480 430,
555 450'
an 465'
756 495' 1 890 $1,
=80'
r 90 ll0 390,
350 410,
405 425'
475 445'
545 465'
625 465'
716 505'
055 535, 1005 555
' t 10 Sao 41p'
390 430'
445 45p'
m
525 d70'
605 495'
695 515'
790 $35'
945 SW I r 10 S9i,
�130r f 37c 425'
425 44,•
M1n
405 465'
u85 a05'
655 515'
1 755 540'
860 560'
t025 5901710 E2=
200 R RING NOZZLES
1 ';' arng
I I1 29• acluall
_
t 1p- Ring
(l,46' ac1,a11
1 ry- Hrn�r t >i� Ring
{! ;6" a"lv Iq 11.66. actw0
I44" Ring
11 74' acluarl
t 14' Ring
p 03' acluali aCLail
P'S+ 1 : Phi 01A.
GPM CIA.
G••M CIA. GPM CIA
GPM DIA
GPM DIA GPM DI:
515 425'
605 440• 1 595 455
i 60, 1 250 340,
330 370,
3�i710'
e45 410,
=xa=
80 1 2i0 370'
380 400,
4.15 4.0,.
515 440'
590 455'
875 470, 1 105 49c
MIM
=115117151
107 1 325 ]90'
a25 425
5[+3 411;
4$5'
1 660 480'
7Y: S00' i00 52C
'n4 c:arneler o' rnro.. rs "Pro.lmataly 24v less ror Ina 24' lralecl:ry angle.'_''. less for the 21. lrajeclory angle.
Tna ?,G GUN1 rer ldrmanCe aara rias baeri oolalneD under Iva+ le $l [vn:il,onj end may be m0versvly arlecled by wind, poor tlydeavllc enlranee Conddlro% or o! e, Ia;:: 1
NP+ad+1 IlrrgallDn rorporal+Dn rllsAvS no rI'prhsnnlaliDn regarding Droplel coodllion- vmformrly, or apGrcalipn rile

WASTE UTILIZATION PLAN
DATE -Y/-2A/9' 7
Producer: Tom Whitfield
Location: 2954 NO 111 & 903 North
Albertson, NO 28508
Telephone: [phone]
Type Operation: Feeder to Finish
Number of Animals: 1800
The waste from your animal facility must be land applied at a specified
rate to prevent pollution of surface andlor groundwater. The plant
nutrients in the animal waste should be used to reduce the amount of
commercial fertilizer required for the crops in the fields where waste
Is to be applied. This waste utilization plan uses nitrogen as the
limiting nutrient. Waste should be analyzed before each application
cycle. Annual soil tests are strongly encouraged so that all plant
nutrients can be balanced for realistic yields of the crop to be grown.
Several factors are Important in Implementing your waste utilization
plan in order to maximize the fertilizer value of the waste and to
ensure that it is applied in an environmentally safe manner, Always
apply waste based on the needs of the crop to be grown and the nutrient
content of the waste. ❑o not apply more nitrogemthan the crop can
utilize, Soil types are Important as they have different infiltration
rates, leaching potentials, cation exchange capacities, and available
water holding capacities. Normally waste shall not be applied to land
eroding at greater than 5 tons per acre per year. With special pre-
cautions, waste may be applied to land eroding at up to 10 tons per
acre per year. Do not apply waste on saturated soils, when it is
raining, or when the surface is frozen. Either of these conditions
may result In runoff to surface waters which is not allowed under DWQ
regulations. Wind conditions should also be considered to avoid drift
and downwind odor problems. To maximize the value of the nutrients
for crop production and to reduce the potential for pollution, the
waste should be applied to a growing crop or applied to bare ground
not more than 30 days prior to planting. Injecting the waste or
disking will conserve nutrients and reduce odor problems.
This plan Is based on waste application through irrigation for this
Is the manner in which you have chosen to apply your waste. If you
choose to Inject the waste in the future, you need to revise this
plan. Nutrient levels for injecting waste and irrigating waste are
not the same.
The estimated acres needed to apply the animal waste Is based on
typical nutrient content for this type of facility. Acreage require-
ments should be based on the waste analysis report from your waste
management facility. Attached you will find information on proper
sampling techniques, preparation, and transfer of waste samples to
the lab for analysis.
This waste utilization plan, €f carried out, meets the requirements
for compliance with 15A NCAC 2H.0217 adopted by the Environmental
Management Commission.
Page 1

WASTE UTILIZATION PLAN
Page 2
AMOUNT OF WASTE PRODUCED PER YEAR (GALLONS, FT3, TONS, ETC.)
1800 hogs x 1.9 tons wastelhogslyear = 3420 tons
AMOUNT OF PLANT AVAILABLE NITROGEN (PAN) PRODUCED PER YEAR
1800 hogs x 2.3 PAN/hogs/year = 4140 lbs. PAN/year
Applying the above amount of waste, is's big job. You should plan time
and have appropriate equipment to apply the waste in a timely manner.
The following acreage will be needed for waste application based on
the crop to be grown, soil type and surface application.
TABLE 1: ACRES OWNED BY PRODUCER
TRACT FIELD
SOIL TYPE &CLASS-
CROP
YI ELD
LBS
COMM
**
* LB5
DETERMINING PRASE
CODE
AW N
PER
ACRES
AW
PER AC
AC
USED
APPLIC.
TIME
5629
2
AUB
C
93.75
20
5.5
405.625
75
5629 —2
AUB
W
90
5.5
495
45
5629
2
AU8
DSB
18
72
5.5
396
5883
4
NOA
C
137.5
20
6.3
740.25
110
5663 —4
NOA
W
120
6.3
756
60
5683
4
NOA
❑SB
33
132
6.3
831.6
5663
B
NOA
C
110
137.5
20
5.03
591.025
5863 -T
NOA
W
120
5A3
603.6
60
5683
B
NOA
D58
33
132
5.03
663.96
56B5
1
AUB
C
75
93.75
20
10
737.5
5685 —1
AUB
W
120
10
1200
80
Total 7420.56
Indicates that this field is being over seeded (l,e. Interplanted)
or winter annuals follow summer annuals.
NOTE: The applicator is cautioned that P and K may be over applied
while meeting the N requirements. Beginning in 1996 the Coastal Zone
Management Act will require farmers in some eastern counties of NC to
have a nutrient management plan that addresses all nutrients. This
plan only addresses Nitrogen.

WASTE UTILIZATION PLAN
Page 3
TABLE 2; CONTINUED FROM TABLE 1
(Agreement with adjacent landowners must he attached.)
(Required only if operator does not own adequate
land. See required specifications 2.)
TRACT FIELD SOIL TYPE & CLASS- CROP YIELD
DETERMINING PHASE CODE
5665 1 AUB
DSB 18
Indicates that this field Is being over seeded (i.e. interplanted)
or winter annuals follow summer annuals.
LBS COMM ** * LBS
AW N PER ACRES AW
PER AC AC USED
72 10 720
** Acreage figures may exceed total acreage in fields due to
over seeding.
Ibs AW N (animal waste nitrogen) equals total required nitrogen
less any commercial nitrogen (COMM N) supplied.
The following legend explains the crop codes used in tables 1 and 2 above:
CROP CODE CROP
SH
HYBRID BERMUDA GRASS -HAY
C
CORN
SG
SMALL GRAIN OVER SEED
SA
SUMMER ANNUALS
WA
WINTER ANNUALS
BC
HYBRID BERMUDA GRASS -CON GRAZED
BP
HYBRID BERMUDA GRASS -PASTURE
FC
TALL FESCUE -CON GRAZED
FH
TALL FESCUE -HAY
FP
TALL FESCUE -PASTURE
SB
SOY BEANS
❑SB
DOUBLE CROP SOY BEANS
W
WHEAT
0
0
0
E
0
0
Total 720
LBS N APPLY
UNITS PER UNIT MONTH
TONS 50 APR-SEPT
BUSHELS 1.25 MAR-JUNE
AC
50
SEPT-NOV
AC
110
APR -MAY
AC
100
SEPT-NOV
TONS
50
APR-SEPT
TONS
50
APR-SEPT
TONS
50
SEPT-APR
TONS
50
SEPT-APR
TONS
50
SEPT-APR
BUSHELS
4
JUN-SEPT
BUSHELS
4
JUN-SEPT
BUSHELS
2
FES-MAR

WASTE UTILIZATION PLAN
Page 4
TOTALS FROM TABLES 1 AND 2
ACRES LBS AW N USED
TABLE 1 43.88 7420.56
TABLE 2 10 720
TOTAL 53.88 8140.56
AMOUNT OF N PRODUCED 4140
*** BALANCE -4000.56
*** This number must be less than or equal to 0 In order to
fully utilize the animal waste N produced.
Acres shown in each of the preceding tables are considered to be the
usable acres excluding required buffers, filter strips along ditches,
odd areas unable to be irrigated, and perimeter areas not receiving
full application rates due to equipment limitations. Actual total
acres In the fields listed may, and most likely will be, more than
the acres shown In the tables.
NOTE: The Waste Utilization Plan must contain provisions for periodic
land application of sludge at agronomic rates. The sludge will be
nutrient rich and will require precautionary measures to prevent
over application of nutrients or other elements. Your production
facility will produce approximately 40 pounds of plant
available nitrogen (PAN) per year in the sludge that will need to be
removed on a periodic basis. This figure is PAN when broadcasting
the sludge equipment, may be needed when you remove this sludge.
tee attached map showing the fields to be used for the utilization of
waste water.
APPLICATION OF WASTE BY IRRIGATION
The irrigation application rate should not exceed the intake rate of
the soil at the time of Irrigation such that runoff or ponding occurs.
This rate is limited by initial soil moisture content, soil structure,
soil texture, water droplet size, and organic solids. The application
amount should not exceed the available water holding capacity of the
soil at the time of irrigation nor should the plant available nitrogen
applied exceed the nitrogen needs of the crop.
Your facility is designed for 180 days of temporary storage
and the temporary storage must be removed on the average of once every
8 months. In no Instance.should the volume of waste being stored in
your structure be within Jj feet of the top of the dike.

WASTE UTILIZATION PLAN Page 5
If surface irrigation is the method of land application for this plan, it
it is the responsibility of the producer and irrigation de signer to
ensure that an irrigation system is installed to properly irrigate the
acres shown in Tables 1 and Z. Failure to apply the recommended rates
and amounts of Nitrogen shown In.the tables may make this plan invalid
Call your Agriment Services representative for assistance in determining
the amount of waste per acre and the proper application rate
prior to beginning the application of your waste.
NARRATIVE OF OPERATION: Is A yac.1�.4ti �"

WASTE UTILIZATION PLAN
Plans and Specifications
Page 6
1. Animal waste shall not reach surface waters of the state by runoff,
drift, manmade conveyances, direct application, or direct discharge
during operation or land application. Any discharge of waste which
reaches surface water Is prohibited. Illegal discharges are subject
to assessment of civil penalties of $10,000 per day by the Division
of Water quality for every day the discharge continues.
2. The Local NRCS office must have documentation in the design folder that
the producer either owns or has long term access to adequate land
to properly dispose of waste. If the producer does not own adequate
land to properly dispose of waste, he shall provide NRCS with a copy
of a written agreement with a landowner who is within a reasonable
proximity, allowing him/her the use of the land for waste application
for the life expectancy of the production facility. It is the
responsibility of the owner of the facility to secure an updated Waste
Utilization Plan when there is a change in the operation, increase in
the number of animals, method of utilization, or available land.
3. Animal waste shall be applied to meet, but not exceed, the Nitrogen
needs for realistic crop yields based on soil type, available moisture,
historical data, climate conditions, and level of management, unless
there are regulations that restrict the rate of application for other
nutrients.
4. Animal waste may be applied to land that has a Resource Management
System (RMS) or an Alternative Conservation System (ACS), if an ACS
is used the soil loss shall be no greater than 10 tons per acre per
year and appropriate filter strips will be used where runoff leaves
the field. These fitter strips will be in addition to "Buffers"
required by OEM. (See FOTG Standard 393-Filter Strips and Standard
390 Interim Riparian Forest Buffers),
5. Odors can be reduced by injecting the waste or disking after waste
application. Waste should not be applied when the wind is blowing.
6. When animal waste is to be applied on acres subject to flooding, it
will be soil Incorporated on conventionally tilled cropland. When
applied to conservation tilled crops or grassland, the waste may be
broadcast provided the application does not occur during a season
prone to flooding. {See "Weather and Climate in North Carolina" in
the NRCS Technical Reference - Environment file for guidance.
7. liquid waste shall be applied at rates not to exceed the soil infil-
tration rate such that runoff does not occur off -site or to surface
waters and in a method which does not cause drift from the site during
application. No ponding should occur in order to control conditions
conducive to odor or files and to provide uniformity of application.
8. Animal waste shall not be applied to saturated soils, during rainfall
event, or when the surface is frozen.
9. Animal waste shall be applied on actively growing crops in such a
manner that the crop Is not covered with waste to a depth that would
Inhibit growth. The potential for salt damage from animal waste should
also be considered.

WASTE UTILIZATION PLAN
Page l
10. Waste nutrients shall not be applied in fall or winter for spring
planted crops on soils with a high potential for leaching. Waste
nutrient loading rates on these soils should be held to a minimum
and a suitable winter cover crop planted to take up released
nutrients. Waste shall not be applied more than 30 days prior to
planting of a crop on bare soil.
11. Animal waste shall not be applied closer than 25 feet to surface
water. This distance may be reduced for waters that are not perennial
provided adequate vegetative filter strips are present. (See standard
393 - Filter Strips)
12. Animal waste shall not be applied closer than 100 feet to wells.
13. Animal waste shall not be applied closer than 200 feet of dwellings
other than those owned by the landowner.
14. Waste shall be applied in a manner not to reach other property and
public right -of ways.
15. Animal waste shall not be discharged Into surface waters, drainage ways,
or wetlands by discharge or by over -spraying. Animal waste may be
applied to prior converted wetlands provided they have been
approved as a land application site by a "technical specialist'.
Animal waste should not be applied on grassed waterways that discharge
into water courses, except when applied at agronomic rates and the
application causes no runoff or drift from the site.
16. Domestic and industrial waste from wash down facilities, showers,
toilets, sinks, etc., shall not be discharged into the animal waste
management system.
17. Lagoons and other uncovered waste containment structures must maintain
a maximum operating level to provide adequate storage for a 25-year,
24-hour storm event in addition to one (1) foot mandatory freeboard.
18. A protective cover of appropriate vegetation will be established on
all disturbed areas (lagoon embankments, berms, pipe runs, etc,).
If needed, special vegetation shall be provided for these areas and
and shall be fenced, as necessary to protect the vegetation.
Vegetation such as trees, shrubs, and other woody species, etc. are
limited to areas where considered appropriate. Lagoon areas should be
kept mowed and accessible. Lagoon berms and structures should be
inspected regularly for evidence of erosion, leakage or discharge.
19. If animal production at the facility is to be suspended or terminated,
the owner is responsible for obtaining and implementing a "closure
plan" which will eliminate the possibility of an illegal discharge,
pollution and erosion.
20. Waste handling structures, piping, pumps, reels, etc., should be
inspected on a regular basis to prevent breakdowns, leaks, and spills.
A regular maintenance checklist should be kept on site.

WASTE UTILIZATION PLAN
Page 8
21. Animal waste can be used in a rotation that includes vegetables and
other crops for direct human consumption, However, if animal waste
is used on crops for direct human consumption it should only be applied
pre plant with no further applications of animal waste during the crop
season.
22. Highly visible markers shall be Installed to mark the top and bottom
elevations of the temporary storage (pumping volume) of all waste
treatment lagoons. Pumping shall be managed to maintain the liquid
level between the markers. A marker will be required to mark the
maximum storage volume for waste storage ponds.
23. Waste shall be tested within sixty days of utilization and soil shall
be tested at least annually at crop sites where waste products are
applied. Nitrogen shall be the rate - determining element. Zinc
and copper levels in the soils shall be monitored and alternative crop
sites shall be used when these metals approach excessive levels. pH
and waste analysis records shall be kept for five years. Poultry dry
waste application records shall be maintained for three years. Waste
application records for all other waste shall be maintained for five
years.
24. Dead animals will be disposed of in a manner that meets North
Carolina State regulations or other States' regulations.

WASTE UTILIZATION PLAN
Page 9
NAME OF FARM:
OWNER 1 MANAGER AGREEMENT
I (we) understand and will follow and Implement the specifications
and the operation and maintenance procedures established in the
approved animal waste utilization plan for the farm named above.
I (we) know that an expansion to the existing design capacity of
the waste treatment and storage system or construction of new
facilities will require a new certification to be submitted to the
Divislon of Water Quality (DWQ) before the new animals
are stocked. I (we) also understand that there be no discharge
of animal waste from this system to surface waters of the state
from a storm event less severe than the 25 year, 24 hour storm.
The approved plan will be filed on -site at the farm office and at
the office of the local Soil and Water Conservation District and
will be available for review by DWQ upon request.
J�
r .
I (we) understand that I must own or have access to equipment,
primarily irrigation equipment, to land apply the animal waste
described In this waste utilization `plan. This equipment must be
available at the appropriate pumping time such that no discharge
occurs from the lagoon in a 25-year 1-day storm event. I also
certify that the waste will be applied on the land according to
this plan at the appropriate times and at rate that no runoff
occurs.
NAME OF FACILITY OWNER: Tom Whitfield
SIGNATURE: DATE:
NAME OF MANAGER Of different from owner):
SIGNATURE: DATE:
NAME OF TECHNICAL. SPECIALIST: RONNIE G. KENNEDY JR.
AFFILIATION: Agriment Services Inc.
PO Box 1096
Beulaville
op
SIGNATURE: DATE: 01

ADDENDUM TO WASTE UTILIZATION PLAN.,
FACILITY NUMBER 31-418
FARM NAME: TOM WHITFIELD FAM
OWNER NAME: TOM WHITFIELD
DESIGN CAPACITY: 1800 FEEDER TO FINISH
DUE TO THE LARGE NITROGEN DEFICIT (4000.56LBS) NOTED IN
THIS WASTE UTILIZATION PLAN. IT IS PERMISSIBLE FOR THE
WHITFIELDS TO ROTATE 15 ACRES OF TOBACCO'BETWEEN
TRACTS 5629, 56631P AND 5665. NO WASTE SHOULD BE APPLIED
TO THIS AREA WHEN TOBACCO IS GOWN UNLESS FOR
PREPLANT APPLICATION. ALL FIELDS MUST MEET MONITORING
AND REPORTING REQUIREMENTS WHEN USED. THE WHITFIELDS
PLAN TO APPLY THEIR WASTE IN ACCORDANCE WITH THEIR
SPECIFIC WASTE ANALYSIS NOT TO EXCEED THE HYDRAULIC
LOADING OF THE SOILS.
ZYWIRA
RONNIE G. KENNEDY JR.
TECHNICAL SPECIALIST

NORTH CAROLINA COOPERATIVE EXTENSION SERVICE - NC NMP
Field Background Information
Field Name: T5663 F4, F6
Soil Map Unit: NORFOLK 0-8
Total ASCS Acres: 24.99
Total Useable Acres: 22.66
Soil Sampling Date : <ENTER>
Soil Test Class
Soil Test Results:
PH Acid CEC %BS P-I K-1 Cad Mgt Mn-I Zn-I Cu-I
Field Irrigation Information
Average Soil Depth : 3.0t
Available Water Holding Capacity - 1,5 feet 1.7
Maximum Irrigation Rate - inches per hour : 0.50
Maximum Amount per Irrigation Event - inches: 0.96
LIMITATIONS: This program is based on the best available data.
Since many uncontrollable variables can affect plant growth
and nutrient requirements, North Carolina State University Cooperative
Extension Service is not resposible for any losses incurred from
the use of this program. The software is provided 'AS IS' and
without warranty as to performance.
Printed :912211997

NORTH CAROLINA COOPERATIVE EXTENSION SERVICE - NC NMP
Field Background Information
Field Name: T5629,5665 F1-F2
Soil Map Unit: AUTRYVILLE 0-8
Total ASCS Acres; 34.93
Total Useable Acres: 31
Soil Sampling Date : <ENTER>
Soil Test Class
Soil Test Results:
pH Acid CEC %BS P-I K-I Cad Mgt Mn-I 2n-I Cu-I
Field Irrigation Information
Average Soil Depth : 3.0+
Available Water Holding Capacity - 1.5 feet 1.3
Maximum Irrigation Rate - inches per hour : 0.60
Maximum Amount per Irrigation Event - inches: 0.72
LIMITATIONS: This program is based on the best available data,
Since many uncontrollable variables can affect plant growth
and nutrient requirements, North Carolina State University Cooperative
Extension Service is not resposible for any losses incurred from
the use of this program, The software is provided 'AS IS' and
without warranty as to performance.
a aaV- a'0&MIU A&111t

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Site Requires Immediate Attention:
Facility No. 3 i
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANT_MAL FEEDLOT OPERA NS S VISITATION RECORD
DATE. 95 2 �9
�s = Time:
Jf
Farm Name/Owner:1
Mailing Address: o_ D
or
County:
Integrator:
On Site Representative:
Physical
Type of Operation: S wine t./ Poultry Cattle
Design Capacity: Number of Animals on Site:
DEM Certific 'on tuber• ACE _ DEM. Certification Number: ACNEW
Latitude: i'.' Longitu0_e:7Zj_'_Elevation: Feet
Circle Yes nr No
Does the Animal Waste Lagoon hav ufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) & or No Actual Freeboard: -Ft. ----Inches
Was any seepage obse ved from the lagovr�;s]? Yes or� Was anv erosion observed? ,.'es ar
Is adequate land available for spr;}y? Yes or i' ,o Is the cover clop adequate? Yes or No
Crops" being utilized: �1G�
Does the facility tneet SCS minimum setback criteria?, 200 Feet from Dwellings?fiA or No
100 Feet from Wells? e o
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes ore
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or
Is animal waste discharged into waters of he state by man-made ditch, flushing system, or other
similar man-made devices? Yes or If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage w th cover crop)? Yes or No
Additional Comments: K; ►7 i 5 i12W - Ot!>P le'_
rot
Inspector Name
Si
cc: Facility Assessment Unit
Use Attachrnenrs,iLNeeded.