310439_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Quai

Type of Visit: 9NCompliance inspection U Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit: � Routine Q Complaint Q Follow-up D Referral 0 Emergency Q Other 4 Denied Access
Date of Visit: Arrival Time: Departure Time: County: I y'1 Region: f
Farm Name: arm Owner Email:
Owner Name: one:
Mailing Address:
Physical Address:
Facility Contact: }, A Title:
Onsite Representative: �� �y� 4 IVU (LV
Certified Operator: '
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number: oC�U
Certification Number:
Longitude:
Design Current
WVC-11
en
Wet Popacity
Pop.
Cattle
Capacity Pnp.
Wean to Finish
Layer
DairyCow
Wean to Feeder
Nan -La er
DairyCalf
Feeder to Finish
D
DairyHeifer
Farrow to Wean
Design
Current
D Cow
Farrow to Feeder
D . P,oultr
Ca aci .y
l?o
Non -Dairy
Farrow to Finish
Layers.
Beef Stucker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other
Turke Poults
OtherF
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 OW R)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes XNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes [—]No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑NA []NE
Page I of 3 21412015 Continued

aclli Number: Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
�No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): )�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
k,
❑ 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
X 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 No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [] Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes M'No ❑ NA ❑ NE
maintenance or improvement? Lfk
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
{
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12, Crop Type(s).
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes 9No
❑ 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 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 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. ❑ Yes No
❑ Waste Application El Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tr nsfers
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No
Page 2 of 3
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
21412015 Continued

Taelli Number: -I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26, Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31• Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33, Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
VNA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
r0J No
❑ NA
[] NE
❑ Yes
ez No
❑ NA
❑ NE
❑ Yes O�No ❑ NA ❑ NE
❑ Yes
KNo
❑ NA
❑ NE
O Yes
&.No
❑ NA
❑ NE
❑ Yes
0 No
❑ NA
❑ NE
Comments (refers;to giiesti6fi.H): EKplaiti, any.,Y ;S ans►vers :and/or any additianal,i eeomnieridations. or any_other comments: q y ..=A ..�} .L 33...$ A'.'" �. .. r a." l i c .. $..i li..XY.. 6, e tii, tr •�' xP'v :i� tL •i i. 41 f . t%���.96 e 1i'G'1,
Use drawings of_facility�to;lietterexpla€p situatlons (rise Hilditional pages as necessaryj,.
FGvYYY� 1�'�f� \�S� G�AIYI 0� �YuUG �iirc �v� �nI 2�I�.
�►�. �� rJ�l►V�� � N1U�0000g2A, �4D hCWSS
-�r avGuluAI
�Wiw
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: -l_l VIC10 1
Date: fli-I Ln
4/20 3

U Division of Water Resources
Facility Number] _ 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: UCo fiance Inspection Q Operation Review D Structure Evaluation Q Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Arrival Time: Departure Time: County: 1hRegion:
Owner Email:
Phone:
Title:
Onsite Representative: 4 Nax
1 M). , 1�
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
0thcr
Latitude:
Phone:
Integrator:
Certification Number: q6 1 :2,
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
[,a er
Non -La er
Pullets
Other
Poults
Design Current
Discharses 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)?
Longitude:
Design Current
Cattle Capacity Pop,
Dairy Cow
Dai Calf
Daia Heifer
Dry Cow
Non-Dai
Beef Stocker
Beef Feeder
Beef Brood Caw
❑ Yes ZNo [] NA ❑ NE
❑Yes ❑No ❑NA ❑NF
❑ Yes ❑ No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (if yes, notify DWR) ❑ Yes D No ❑ NA ❑ NEr
2, is there evidence ofa past discharge from any part of the operation'? 0 Yes NJ [DNA [:]NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

IFaciKty Number: - hate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes n No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
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 20 [] 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 environ meng 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 [] N E
maintenance or improvement?
Waste Ai mlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application'? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14.
Do the receiving crops differ from those designated in the CAWMP?
Yes
No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
Yes
o
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
fN-o
❑ NA
❑ NE
acres determination?
17.
Does the facility lack adequate acreage for land application?
❑ Yes
[;3 No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
�o
❑ NA
[] NE
Required
Records & Documents
19.
Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
E N~o
❑ 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 NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rai nfaII 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 D NC
Page 2 of 3 21412015 Continued

Facifity Number: - Date of Inspection:
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 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 ❑ ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [%NNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss reviewlinspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes LJ SO ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No
❑ Yes
❑ Yes
❑ Yes
❑ NA ❑ NE
EIr �No,❑NA [3 NE
PCrN_❑ NA ❑ NE
o ❑ NA [] NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments..: .
Use drawines of facillty.to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
C LL�_
Phone,716 1 1 1_ 1 s 9
Date: d 1
2141245

Type of Visit: (D 7Routine
pliance Inspection U Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Q Complaint Q Follow-up Q Referral Q EpergencZ Q Other Q Denied Access
Date of Visit:NP# Arrival Time: 3 Departure Time: 1® County: kAlzRegion:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
+�
Onsite Representative; s�� lYjg�°���LLkQ
Certified Operator:
Back-up Operator:
Location of Farm:
Wean to Finish
La er
Wean to Feeder
Non-L
Feeder to Finish
Farrow to Wean
D P,t
Farrow to Feeder
Farrow to Finish
Layers
Gilts
Non-L
Boars
Pul lets
Other
Latitude:
Poults
Phone:
Phone:
Integrator:
Certification Number: 01D1 of),
Certification Number:
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?
K 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 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:
iry Cow
iry Calf
iry Heifer
v Cow
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[] No
❑ NA
❑ NE
❑ Yes o ❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 21412014 Continued

Facili Number: - Date of inspection: MfiyjO
Waste Collection & Treatment
-4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
Yes
❑ o
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
[ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: L
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
ff/yes
❑ No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment 1 threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
0N❑
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
FZ/No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
0
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
[—]Yes
�No
❑ NA
❑ NE
[] Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable crop window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
j o
E] NA
❑ NE
lb. Did the facility fail to secure and/or operate per the irrigation design or wettable
�] Yes
C:,
No
❑ 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
No
❑ NA
❑ NE
Required Records &_Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
VN0o
❑ NA
C] NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ NA
❑ NE
the appropriate box.
❑WIMP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes eNo ❑ 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 VNo
N ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facifi Number: - Date of Inspection:
24.4Did the'facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ZNo ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge7 if yes, check ❑ Yes [2� 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 2No ❑ 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
I XNo ❑ 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
EXo ❑ 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
[3/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
C'PV ❑ NA
0 NE
❑ AppIication Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
I_J o ❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
ZN ❑ NA
❑ NE
omments' rever�to,pquest.on� :a xp a n any -answers any .fir nny§a ona ;reco.mmen at.nns ar,:any of er �ammente..=y:
r �.. ! .t. ;:.R � I 01 :<
[Ise drawln2s:of.facilitybto;betteriexnliiih situations;{usexadditional Ones .as,necessar..yj.�:��,,,3&r.) �t� .x�„k,•u
�f �A W� s'�1�1r� Rx�+jr�u. (v61'17,s m .SPnr4.
�6-6 P L'_Cr�, 6 r 1(/Ce is Fog ��L. SAS^"LS CA uu� rip-
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
Phone(22)2M �
Date: / 0
21412015

Type of Visit: 0 Compliance Inspection D Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: Routine 0 Complaint Q Follow-up Q Referral Q Emergency Q Other ❑ Denied Access !1
Date of Visit: Arrival Time: Departure Departure Time: 1 County: VIZA Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facllity Contact:
Title:
Owner Email:
Phone:
❑nsite Representative: ` uhP L] r j lY 1.= u _�� Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number:
Certification Number:
Longitude:
110 1 ';�
Design Current Design Current
Swine Capacity Pop. Wet Pouitry Capacity Pop.
Wean to Finish La er
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Wean to Feeder
Non -La er
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design Current
Dry Cow
Non -Dairy
Farrow to Feeder
Dr. P,oultr. Ea acl I!o
Layers
Farrow to Finish
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars Pullets
turkeysPuults
er
Beef Brood Cow
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)? _
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 ONE
D Yes
No
NA
NE
Yes
No
NA
[] NE
D Yes C] DNA NE
[] Yes � ❑ NA ❑ NE
Yes No ❑ NA D NE
Page 1 of 3 21412014 Continued

acili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No
a. If yes, is waste level into the structural freeboard? ❑ Yes [:]No
Structure l Structure 2 Structure 3
Identifier:
Spillway?:
Designed Freeboard (in):
❑ NA ❑ NE
❑ NA ❑ NE
Structure 4 Structure 5 Structure 6
Observed Freeboard (in): 5 b
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
(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
waste management or closure plan?
No ❑ NA [] NE
10 ❑ NA ❑ NE
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 ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 0N❑ ❑ NA ❑ NE
maintenance or improvement? 111
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes PNo ❑ 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. Soii 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
� o
❑ 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 tacility lack adequate acreage for land application?
❑ Yes
[2r/No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? [] Yes [2rNo ❑ NA ❑ NE
Reguired Records & Documents
14. Did the facility fail to have the Certificate of Coverage &Permit readily available?
❑Yes
0/1
❑ NA
❑ NE
20, Does the facility fail to have all components of the CAWMP readily available? If yes, check
E(yes
[] No
❑ NA
❑ NE
X.
the appropria6WUP
❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
2 t . Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
ZNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall [] Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and i" Rainfall Inspections
[]Sludge Survey
��' NA NE
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑
❑
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
rNo
❑ NA
❑ NE
Page 2 of 3 21412014 Continued

JFVilityNumber: jDateof Inspection: 6
24. Did the facility fail to calibrate waste application equipment as required by the permit. ❑ Yes ZN ` ❑ NA ❑ NE
25' Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ YesVNo❑ 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 N ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 0 No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the [:]Yes No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tilc drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
❑ 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).
20) OfMrG �A)e Cal F(S CA VV N rya f. L4M('
Reviewer/Inspector Name: �Jtlt�i _ ��[.L. Phone: 11 6/ 34
Reviewer/Inspector Signature: Date: AA 6 11 o
Page 3 of 3 '2A 014

0 Division of Water Quality
,,Facility Number 3� - ® 0 Division of Soil and Water Conservation
❑ Other Agency
Type of Visit: 0 CgMpliance Inspection ❑ Operation Review a Structure Evaluation Q Technical Assistance
Reason for Visit: Routine a Complaint 0 Follow-up D Referral Q Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: © Departure Time: ® County: 3)LRtxr11, Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
Onsite Representative: �_)OW* -i,,taoj M-zl-a_j - Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Certification Number: 2Q�2•�
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Poults
Design Current
Discharges and Stream Im�actsand 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:
Design Current
Cattle Capacity Pop.
Dairy 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 ❑ [DNA ❑ NE
❑ YesrNo
❑ NA ❑ NE
❑ Yes [3 NA ❑ NE
Page 1 of 3 21412011 Continued

Facility Number: 7, l - q -cc; I Date of Inspection: 427 ,,'t
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: l *(i�
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes �No[] ❑ 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 CZ/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 ❑ ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes Yo ❑ NA ❑ NE
(not applicable to roofed pi(s, 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 ADplication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ 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 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes 5/No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes fNo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis [:]Soil Analysis ❑ Waste Transfers [] Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

liacilit Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permi ❑ Yes ❑ 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 PDA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes v ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ YesgNo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29, At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33, Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes NA ❑ NE
❑ Yes ZI /No ❑ NA ❑ NE
0 Yes No ❑ NA ❑ NE
❑ Yes D40,
❑ Yes
❑ Yes gNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments..
Use drawinss of facility to better explain situations (use additional paves as necessary).
Reviewer/inspector Name: Phone:
(
Reviewer/Inspector Signature: Date: k1 Z
Page 3 of 3 21412011

LAAI
!Type of Visit: C rC opliance Inspection Q Operation Review 0 Structure Evaluation ❑ Technical Assistance I
Reason for Visit: ,. , Routine. a Complaint Q Follow-ue Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: , Arrival Time: ® Departure Time: ® County: 01' Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Owner Email:
Phone:
Onsite Representative: A K) WUL- Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Wean to Finish
Wean to Feeder
Feeder to Finish (ep
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Latitude:
Poults
Phone:
Certification Number: _-21-1/
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:
IN
Cr ow
Cy alf
Hy eifer
Cow
Stocker
Feeder
Brood Cow
❑ Yes Q No ❑ NA ❑ NE
❑ Yes
[] No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facile Number: jDate of Inspection: t., i
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 I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Frecboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [�/No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment threat, notify DWQ
7. Do any of the structures nerd maintenance or improvement? ❑ Yes [No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 6<0 ❑ 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 VNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks,.or compliance alternatives that need ❑ Yes ZNto ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12, Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ From those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reouired 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 [I l"o ❑ NA ❑ NE
❑ Yes 0 No
❑ Yes b/No
❑ Yes rNo
o
❑ Yes
❑ Yes �o
❑ Yes d No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. 26es ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall []Stocking rop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [�o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes WNo ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Fail Number: - Date of Ins ection:
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 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
❑
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT') certification?
❑ Yes
co[C
❑ 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:
❑ Yes C No ❑ NA ❑ NE
[:]Yes No ❑ NA ❑ NE
❑ Yes 2No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
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 YN,❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? [:]Yes o ❑ NA ❑ NE
Comments.1refer;to question*) .:Explain.;any, ES!answcra and/or any;additlonal?rerbrtimeiidatlons;ur, any;other comments: :`4i'
�,.. �r,..rx r 3y e,:k 71..r..yS r_•.. iai; i�,.'�'ry'�; •.r"�_,....yt.Yq:i't �i a'' 1.;?
I]se"drawings of°facility;{o Metter:explalri:sitpatlans?(tssetaddItional pages: as.necessary).� .. �, t � ;;� , ;kf, S,pl ,�• �� z <�;.
2i,) LJPDPT(- CP-op -LcLDS
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
�oA j
Phone 0 1
Date: U I Iq I 1
Page 3 of 3 2/4/2411

10 Division of Water Quality
Facility Number �31 - `-� j S a Division of Soil and Water Conservation
D Other Agency
Type of Visit: Co liance Inspection Uperatian Review Q Structure Evaluation ❑Technical Assistance
Reason for Visit: Routine 0 Complaint Q Follow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: Arrival Time: Departure Time: t❑ County: J)t jet'gtj_ Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Phone:
Ousite Representative: (_ 'a m A'} W4,1 Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Certification Number:
Certification Number:
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish 1 36
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Layer
Non -La er
Design Current
Dry Poultry Capacity Pop.
Lavers
Non -Layer
Pullets
Turkeys
Turkey Puults
Other
Discharees and Stream Imgaets
1. Is any discharge observed from any part or 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:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
,Non -Dairy
Beef Stocker
Bee r Feeder
Beef Brood Cow
❑ Yes �No ❑ NA ❑ NE
❑Yes
❑No
❑NA
❑NE
❑Yes
❑No
❑NA
❑NE
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes 0 ❑ NA ❑ NE
❑ Yes VNo ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facillt Number: - Date of Inspection: tt/1151,1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 2N❑ ❑ 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): 11 _�)-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[? f No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
dNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
I threat,
or environm7No
notify DWQ
7. Do any of the structures need maintenance or improvement?
El 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)
4. Does any part of the waste management system other than the waste structures require
❑ Yes
C; No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
dNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below,
❑ Yes
ZNo
❑ 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 Types):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
g �No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes [2No
❑ 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 go
❑ NA
❑ NE
Reaiuired Rccords & 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 VNo
❑ 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 allo ❑ 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 I__l is ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �10 ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: 31-Lt.24 Date of Ins ectlon: it
' 4. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 2 ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes rNoo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ failure to develop a PDA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
25, 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 TNNo ❑ NA 0 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:
❑ Yes Nv ❑ NA ❑ NE
❑ Yes
❑ Yes
❑ Yes
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33, Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34, Does the facility require a follow-up visit by the same agency? ❑ Yes
040
No
CZ No
No
No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments. (refer to question #): Explain any YES answers and/or any,additional recommenidatl6ns,or.any. otheracomments: - �P.
tlse`:drawln s offacili to"better ex lain situations use additional ages as.necessa
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
N�)
Phone: t m, 7 7 6 J 36
Date: 4ltc> yt
21412011

Facility Number
(j Division of Water Quality
Q Division of Soil and Water Conservation
Q Other Agency
Type of Visit (3 Co Inspection Q Operation Review C) Structure Evaluation Q Technical Assistance
Reason for Visit Routine Q Complaint a Follow up Q Referral O Emergency Q Other ❑ Denied Access
Date of Visit: h D Arrival Time: Departure'1'ime: County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: JOA A Mc L
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feedej
Farrow to Finish
Gilts
Boars
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number -
Back -up Certification Number:
Latitude: = e ='
= Longitude: = ° =' 0 "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
�� ❑ Non-Lallon err
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
DischarLes & Stream I motets
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
❑ Daky Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stacker
❑ Beef Feeder
❑ Beef Brood Cow
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: �:J]
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes O/No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑NA
El NE
El Yes
❑No
❑ Yes O No ❑ NA ❑ NE
❑ Yes Cl/No ❑ NA ❑ NE
Page I of 3 12128104 Continued

)Facility Number: � 2 — 3°i Date of Inspection t�
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 I Structure 2 Structure 3 Structure 4
Structure
5
Structure 6
Identifier: (Aer6ar'
Spillway?. -
Designed Freeboard (in):
Observed Freeboard (in): 3
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
IdNo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat,
notify DWp
7. Do any of the structures need maintenance or improvement?
❑ Yes
ENo
❑ 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 12/No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Arc there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ZNo
`❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12, Crop types)
13. Soil typc(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ED No ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
eyes
❑ No ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination 7
❑ Yes
12/,No ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application'?
❑ Yes
L/f N ElNA
ElNE
18. Is there a lack of properly operating waste application equipment?
ElYes
L.et'No ❑ NA
❑ NE
Comments (refer to question#]:.. > xplain any YES answers and/or: any reeummendations nr any other :comments.,
gy P [ pg. y);...
OwArawin s of; facility to better ex lain situations: use additional. a es'as necessar :: °: '. ; •: . ` . , : ; ,
HELP r049CA C AXW r&v%�# AAIV kl(tCA
COAIPUG AI66iNI-
A.
Reviewer/Inspector Name.
Ph e: 10
Reviewer/Inspector Signature:
Date: 11ly
Page 2 of 3 121281041 Continued

Facility Number: Date of Inspection
Required Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
o
❑ NA
❑ NE
20,
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21,
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
JNo
Cl 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 InspectionVNo
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
El Yes
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
�o
El NA
El NE
24,
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
WNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
Ef'j o
El NA
[I NE
26,
Did the facility fail to have an actively certified operator in charge?
❑ Yes
YNo
❑ NA
❑ NE
27.
Did the facility flail 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
�o
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
WNo
❑ NA
❑ NE
30.
and report the mortality rates that were higher than normal?
At the time of the inspection did the facility an odor or air
pose quality concern?
❑ Yes
Z� o
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
El Yes Yes
�f
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
ZNo
❑ NA
❑ NE
Additional Comments and/or Drawings: -A,
Page 3 of 3 12128104

M
Type of Visit rRoutine
piiance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit O Complaint O Follow up O Referral O Emergency ❑ Other ❑ Denied Access
Date of Visit: y ! Arrival Time: ® Departure'i'ime: County: L Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: Ot✓.,���
Certified Operator:
Back-up Operator:
Location of Farm:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: o Q' = Longitude: C
o=1 =1i
Design Current
Design . Current
Design Current
Swine Capacity Population
Wet Poultry Capacity Population
Cattle
Capacity Population
❑ an to Finish
❑ Layer
❑Dai Caw
Wean to Feeder
❑ Non -Layer
❑Dairy Calf
Feeder to Finish
4ko
Mo
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
ElNon-Dairy
❑ Farrow to Finish
Layers
El Stacker
❑ Gilts
❑ N ers .
ElBeef Feeder
El
Boats
Nets
El Pullets
❑ Beef Brood Cow
❑ Turkeys
Other
❑ Other
❑ Turke Poults
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed From any part of the operation?
❑ Yes
E 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
EYNo
❑ 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

1~acilitpNumber: — Date of Inspection 1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural Freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
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 U No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes [_yNo ❑ NA ❑ NE
❑ Yes L*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? El Yes E i No ❑ NA ❑ NE
8. 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 ENo ❑ 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. ElC 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 frotn those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. is there a lack of properly operating waste application equipment? ❑ Yes
ffNo
El NA
❑NE
2 No
❑ NA
❑ NE
❑ NA
El E
E"No
LR"No
❑ NA
❑ NE
Q4o
❑ NA
❑ NE
Camments(refer�question #}� Explain u>ny�Y�S answers and�Ina�ycvmme�E�Ilons ter any.other cn�mments..� .
[Ise drawings�of facility toh�e�tter�explainsit ations�. [use additienai�ages,ia'�s�nccessary)•,
Reviewer/Ins ector Name ='
P R f 'ter Phone.
Reviewer/Inspector Signature: Date: & j
12128104 - Corilinued

Facilfry Number: -3 — W Date of Inspection 6
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ W UP ❑ Checklists ❑ Design El Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
[]Yes Lr No ❑ NA ❑ NE
❑ Yes l.,,dNo ❑ NA ❑ NE
❑ Yes LJ"No ❑ NA ❑ NE
❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
E• No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
�o
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
04o
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
[-- ,Ko
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes ,_.01' o
❑ Yes [2No
❑ NA ❑ NE
❑NA El NE
❑ Yes
Q/NNo
❑ NA
❑ NE
[I Yes
0No
El NA
❑NE
❑ Yes
L2�No
❑ NA
❑ NE
❑ Yes
(;Io
❑ NA
❑ NE
❑ Yes
ONo
❑ NA
❑ NE
❑ Yes
J�No
❑ NA
❑ NE
12128104

Facility Number E-0/3-11"ate of Visit: 'Tune:
6c4' Q Nat O erational Q Selow Threshold
®-Permitted 53 Certified 0 Conditionally Certified 0egLste dR/ Date Last Operated or Above Threshold: •.......................
FarmName: ............. ...........4'*Ae'l................................... County:....... /I .. ........ ................ ........ ..............
Owner Name:
Mailing Address:
....................................................................... Phone No:.......................................................................................
FacilityContact: .............................................................................. Title:..........................
Onsite Representative: ,,•Avltx-e-
Certified Operator:
Location of Farm:
................................. Phone No:.................................................
Integrator:..._/ ...e;` ...�...........................................
Operator Certification Number: ....................................
❑ Swine ❑ Poultry ❑ Cattle ❑ Home Latitude Longitude 64
Deli urgent ' 1 t'
Current' j gu Yi C ,r, sf' �..•per C
'L-... •1 :3' . 'Rn' _'I• {'!:"' '. ;t S£4i'.i• ��""'!' '{ i,i it
Swine- Swine .;: , .��'Cliaci Po illation .'Poultry ; Ca aci "g Pn ulatiozl<' ;:;Cattle °'.; =g ;}%•:Capacity? Pogsilation ,!!
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Layer
I
❑ Dairy
❑Non -Layer
r
;Y,
❑ Non-1
"❑
f1r4"DIY{a';6:
3 Other
i1'
' ,�x,'I psi ...,�. .,
' ':� € i ;. =M�.. a
w•:t-r i.._
;Total'DesiO:,CaPac
Ntimlier'ofLagnons�
itx;`�;
Discbarzes & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated au ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier: ......... ..._..J................ _....... .... »........ ....... .............. ............... ......... ....... ...................... ..... ......................................................................
Frccboard (inches): �Z
12112103 Continued

Facility Number: — <4Date of Inspection
5- Are there an immediate threats to the irate t of an of the structures observed? (iel trees, severe erosion,
Y _ � Y Y [I Yes '❑ Na
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ❑ No
closure plan?
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
❑ No
elevation markings?
Waste Apodeation
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? If yes, check the appropriate box below,
❑ Yes
❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
❑ No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
❑ No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes
❑ No
Air Quality representative immediately.
.....x.•n,:a[i.:.m.,;�-....y.::n•4%3:"::$:�...:.....:.sh=:t.':d&:'...._:•it'n':tl!:�..:•P:vlC':�Irv.�AG1i'..�:....�.:7}'iY, .i��:�-... .. �F.::iiF:[�:'n•M S•: '=1U'.m.il.
Comments:.txet'er,tagnesban'#) F,xplauat'z y YIS answers andlor.any,recommendations or. any:ati eucomme&;X: fin; }
. s. • t esti �+ :, R".IY.II•. y,.g� y,.�awwr,a:.�i�LIL;�:4p
Zserdrawi oi.facili to >better. lain situations use adiijtianal pagas rhecessa
�k� ;7_ O Field Copy ❑Final Notes.
y�•,':[:lj'i�:Ni�. 3�, !i•r'I Ei � .€.. :ill l+ .;: �y, .�r'i•�I';i�'.i :EIS.., t;.ik?
i aa��,��� .4.i,:[ w,nk•':: �� .ii. .`r :.i.,...i€s';:?kr.,s.�.t!t•. •n'. ..
. ...... + ::�=5f�:,*�, .�riii.h.: ielatiu.....ia.1�a. �4If!&� •. ).i.>,�����R�n[s��+�:... €� .. ...:....:.'"
n-91 ave rc- Sc4r&� z 1et-aQ -d-err �cscue,
Reviewer/Inspector
12112103 [:ontmued

Facility Number: Date of Inspection
,340er,? �
Required
Records &Documents
21.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
22.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
23.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
26.
FaiI to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
❑ Yes
❑ No
27.
Did Reviewer/Inspector fail to discuss reviewlinspection with on -site representative?
❑ Yes
❑ No
28.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
❑ No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

[r•,wd: Ri►+bnbarkl
3r 4311
Subject: tFwd: Rivenbark]
Date: Tue, 26 Feb 2002 11:01:09 -0500
From: Dean Hunkele <[e-mail]>
Organization: NC Division of Water Quality
To: Stonewall Mathis <[e-mail]>
CC: gale stenberg [e-mail]>, Chester Cobb <[e-mail]>
Findings of site visit by Tim Hall to assess the fescue fields for one of Geno's growers.
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Date: Mon, 29 Oct 2001 12:56.01 -0600
From: Tim Hall <tim.hallamcmail.net>
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To: Dean Hunkele <dean.hunkele([e-mail]>
Subject: Rivenbark
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Did I send this to you already? If s❑ forgive my senility. But here it
is again. TSH
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1 of 1 2/27/2002 9:48 AM

October 24, 2001
Ronnie "Geno" Kennedy, Jr.
Ag riment Services, Inc.
PO Box 1035
Beulaville, NC 28518
Dear Geno,
I met with Mr. Scott Rivenbark on September 21 and took a look at the
sprayfields where he is having a problem keeping a fescue stand. The problems I
observed are as follows:
1) There are low areas in the field where water, and presumably waste irrigation,
apparently ponds. Fescue can tolerate wet soil conditions, but not saturated
conditions. When the fescue weakens and dies in these areas, summer
annual grasses often invade and out -compete the surviving fescue.
2) The surviving sward showed a substantial amount of "brown patch" disease
(Rhizocfonia) which is very destructive to fescue. Brown patch is induced by
moist sward conditions and lush growth, and is a common problem when
substantial nitrogen is available to the grass during warm and humid weather,
It is highly prone to occur when excessive growth accumulates during the
summer, creating an ideal microclimate in the sward for fungi to grow.
3) Mr. Rivenbark doesn't have haying equipment and is therefore dependent on
the services of a neighbor to harvest the forage. Therefore he has little control
over how and when the hay gets cut and baled. From my discussion with him,
it would appear that the fescue may have been repeatedly cut too closely.
This will also weaken the stand and make it more susceptible to invasive
grasses and broadleaf weeds.
My suggestions for remedial actions are:
1) Consider abandoning hay as the receiving crop for the swine waste. Since
Mr. Rivenbark already tends some row crops, and since he isn't in the
hay/cattle business, I would look at his management capabilities and try to
make the waste plan work with what he is already doing, L e. corn —small grain
—soybean rotation. Since he has added some additional land to the plan, I
would guess that he may now have the acres for that cropping sequence to
work.
2) if he chooses to remain with fescue hay, he will need to address the
aforementioned problems. First, shape the fields to alleviate the ponding

problem. I would ask for help from NRCS to get the shape right; it needs to
allow outward dispersal of water without the risk of runoff. Eliminating the
standing waterproblem will be essential regardless of the cropping on the
site. Second, I would recommend not applying very much waste to the field
after about April"'I0. That is to allow the N to be metabolized into the spring
flush of growth and, hopefully, be mostly removed in the first harvest.
Unfortunately, that important management practice is usually inconvenient for
the grower, since April and May are when conditions become most favorable
for spray irrigation. Third, Mr. Rivenbark would need to get more control over
when and how the hay is cut. Fescue should never be cut closer than 3", and
4" would be better. The hay needs to be cut first at boot stage and then every
time growth reaches about 12" thereafter. Allowing excess growth to stand
will promote brown patch and create a clumpy stand. Don't allow hay to lie on
the field for more than 3 or 4 days after cutting.
3] Another, and perhaps better alternative for managing a forage system is to
graze with animals. I discussed some possible designs for fencing and
providing water with Mr. Rivenbark, and there may be some cost -share
assistance for him if he is thus inclined. That system would have fescue on
the wet field and bermudagrass or a rye -pearl millet rotation on the field next
to the farm road. Movable water tubs and temporary fencing would be used to
control the grazing and optimize the effectiveness of cattle or goats for
managing the grass growth. Much less haying would be required.
I hope these comments will be of use, and I apologize for the delayed response.
Please call if I can be of further service.
Sincerely,
Tim Hall
910-324-9924
PO Box 444
Richlands, NC 28574
cc: Scott Rivenbark
cc: Dean Hunkele

r�
Facility Number Date of Visit: —G ( Time:
Not Operational 0 Below Threshold
Permitted [3 Certified © Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: ..»l'``"':.!�'ehl- ............. County:...,................................. ....,.....•».....
OwnerName:............................,.............................................................................................. Phone No:................................................................. »............
»_..
Facility Contact:.............................................................................. Title:,............,.,.............,.,...............................• Phone No: .................. ............ ................. .
Mailing Address:................................................................................................................ ........................................
..............
...........
.........................,
Onsite Representative: ..11!��,2 L ........................... Integrator:.................................4...................
Certified Operator:................................................................................................................ Operator Certification Number:,,.....,..................................
Location of Farm:
0 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • a fig Longitude • 9 it
Design 'Current Design Current Design Current'
:Poultry Cete CapacityPopulation . Capacity Po ulafiuia':
❑ Wean to Feeder 10 Layer ❑ Dairy
Feeder to Finish 10 Non -Layer I ❑ Non-Dai
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other 1 1777
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ soars Total SSLW
Number of Lagoons • ❑ Subsurface Drains Present JJE3 Lagoon Area Spray Field Area !ff-
Holding Ponds I Solid Traps ❑ No Liquid Waste Management System
Discharees & StreamImnacty
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 galhnin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes tgNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ZNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes bio
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure G
Identifier: .................................... .................................... ................................... .................................... .............,..........................................................
Freeboard (inches): 3 T1
5/00 Continued on buck

Faeil16 Number: -3 t — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes J� 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 4 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 maintenancelimprovement? ❑ Yes KNo
S. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidenzgns.
ver application? j {❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes No
12. Cragtype� l t..11 5-ir
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes &No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes RNo
b) Does the facility need a wettable acre determination? ❑ Yes UNo
c) This facility is pended for a wettable acre determination? ❑ Yes No
15. Does the receiving crop need improvement? , Yes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes XNo
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
�kRo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
❑ Yes
(ie/ WUP, checklists, design, maps, etc.)
EkNo
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
�rNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
ONo
(iel discharge, freeboard problems, over application)
23.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
ONo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
9No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
Jarwo
ft �# ris:ak 444000 *Ore )n#t�4- �priog t�is:visit, • *Y 4 ►r ti t ee�iye o tiu #� r
carrel• ondeitce', 66t f this visit:
Comments (refer. to question #): "Explain any YES answers 'andloir. any �recommendatlnias a city otlser"aoie>meafs:.; '; ' ` E 0 ij
Ilse drawings of facility to better explain situations. [use 'addido;n pages as riecetisaryyi . h rM ' E ; [;. 3� i , :
rt
1 h L� � �, �*•� e���-fi1u-� . �� es� ��c: j ,i }-e tit �' �!- t'� ,
AL
.r
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: c(r- [3 -c i 5/00

'Facility Number; ' 1 Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge aVor below []Yes ONO
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes N No
28, Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes V 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 A No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes No
..-. ...... _ , ._... .._ -t.. ...
AdditionalCommentsand/orDrawings: -
1 S t: ) `N 1 '�e� cG-�--z �e �-e>~o we� per, l-� ►-�
C�3) czt,�i
4- ~
+ a) i.� vet P'*U e.- 1t -,
��-''✓ ►"`� � �" �"'� Gl^'Q_�� ► ■ 1 `�C� � �►"G'11p►^"�[tf�' G r
�C� F•_s-i ate-` � e�--� �, Gl� o�---� �`� .
5100

��ESTAr,E
Plan Amendment to Include S&WCC Chronic Rainfall Practices and Standards through March 31, 2000
1. If this facility can comply with its existing permit and CAWMP it must do so.
2.
Temporary Addition of New Sprayfields (*) (Check appropriate boxes.)
[] A. acres of cropland. List crop types used:
[] B. acres of hardwood woodland Q 100 lbs PAN I acre added.
[] C. acres of pine woodland added [cry 60 lbs PAN 1 acre added.
3. Summer Perennial Grass (Check appropriate box.)
H A. Application window extended for acres of perennial grass until first killing frost.
0 B. An additional 50 Ibs of PAN applied to acres of perennial grass prior to killing frost.
4. PAN Application Increased for Small Grains & Winter Grasses to be harvested. (Check appropriate box.)
[1 X PAN application increased up to 200 lbs per acre 5r,79. ►3 acres of small grains or winter grasses to be harvested.
0 B. PAN application increased up to 150 lbs per acre for acres of overseeded summer perennial included in 3. B.
5. VA.
e Analysis (Check appropriate box.)
Prior to December Ix, 1999 the calculation of PAN will be based on a 35% reduction of the last analysis taken
prior to the first 25 year 24 hour storm event. (Current waste analysis must be used after Dec.11.)
[] B. Use current waste analysis to determine PAN.
b. Required -Maximum Nitrogen Utilization Measures for Small Grains and Winter Grasses.
A. Use of higher seeding rates,
B. Timely harvest of forage to increase yield, and
C. irrigating during periods of warmer weather.
7. Required - Irrigation Management Techniques to Reduce Runoff and Ponding Potential.
A. Making frequent, light irrigation applications, and
B. Not irrigating immediately before predicted rainfall.
S. The owner 1 manager is required to manage the movement of animals to and from the facility to minimize environmental
impacts, ensure compliance with the facility's permit and amended CAWMP, and avoid discharge to surface waters.
9. Authorization to use the additional practices included in this amendment expires if a facility discharges to surface waters.
Any discharge is a violation and may result in an enforcement action.
10. The owner 1 operator is required to keep records of all waste applications.
11. This revision must include a map or sketch of new land application areas.
Facility Number 3 —L- —i 3
v s, b 0.r [—
Facility Owner 1 Manager Name (PRINT)
1 '4 L&—'
Facility Owner 1 Manager Signature
Date / r — Z--- ~ Q 9
Grge Seo+T ?,tVF, 1'$PIkk 1►4RN"
Facility Name
�. C-,LE140 CLt1z"ro4
Technical Specialist Name (PRINT)
Technical Specia ist Signature
Date I t l Z.te 19 9
This document must be filed at the SWCD office and be attached to the facilities CAWMP
and be available for inspection at the facility.
(*) New temporary sprayfields must meet applicable buffer and setback requirements. Waste must not be applied to wetlands.
t 1►1711000

GA Division of Water Quality
Q Division of Soil and Water Conservation
Q Other Agency
Type of Visit XCompliance Inspection D Operation Review Q Lagoon Evaluation
Reason for Visit 9Routine O Complaint Q Follow up Q Emergency Notificatlon Q Other ❑ Denied Access
Facility Number Date or Visit: Printed on: 7/21/2000
Q Nnt —Operational Q Below Threshold
© Permitted © Certified E3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farin Name : ............. 4 �....................lG*.►..Y. E' .'................................ C:ounty':.....................
�a�li +'L.
[' w L_ ,
Owner Name:.........5......�.................
���f� ....��GJSIC................................. Phone Itin:.......................................................................................
Facility Contact: !. ......4f�.�ekl.-...'Title: �%1�. Phone No:.. .................................................
MailingAddress:..........................................................................:........................................................................................................................ ..........................
Onsite Representative:. �.F �f r '.�P.P^t'�.. �lfl... �, { i1....... Integrator:.......... R.eSj.'6.'C..r.......................................
Certified Operator ,,, Operator Certification Number:
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �� �' �•� Longitude
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder JE1 Layer ❑ Dairy
der to Finish p JE1 Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
[]Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons 1 10 Subsurface Drains Present ❑ Lagoon Areu ❑ Spray Field �Irea
Holding Ponds 1 Solid Traps • ❑ No Liquid Waste Management System
Discharges & Stream Imuact4
1. Is any discharge observed from any part of the operation?
❑ Yes
Id 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 Staic? (If yes, notify DWQ)
❑ Yes
❑ No
c, If' discharge is observed. what is the estimated flow in gallrrtin?
— '&A
d. Does discharge bypass a lagoort system" (If yes, notify ❑WQ)
r
❑ Yes
❑ No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
4 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
I�No
Waste Collection & 'Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes ANo
Stl'UCAlrc I Structure 2 Structure 3 Structure 4 Structure 5
Structure G
3Z►�
Freeboard (inches):
5100
Continued on back

Facility Number: — Date (if Inspection Id Printed on; 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures obse ved'? P(jc/ trees, severe erosion, 0 Yes )kNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes K No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any part of the waste management systern 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 FRNo
Waste Aunlication
10. Are there any buffers that need maintenance/improvement'' ❑ Yes No
IL Is there evidence of over application'? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes No
12. Crop type P
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ]&,No
14, a) Does the facility lack adequate acreage for land application? ❑ Yes JNo
b) Does the facility need a wettable acre determination? ❑ Yes D12No
c) This facility is pended for a wettable acre determination? ❑ Yes �Nfo
15. Does the receiving crap need improvement? ❑ Yes KNa
16. Is there a lack of adequate waste application equipment'? ❑ Yes '&LNo
Reouired Records & 0ocumenLs
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes *o
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 19(No
19. Does record keeping need improvement? (ic/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes 19Na
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 4No
21. Did the facility fail to have a actively certified operator in charge'? ❑ Yes 8:!&o
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ANo
23. Did Reviewer/Inspector !'ail to discuss review/inspection with on -site representative'? ❑ Yes P�140
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 WNo
'�IQ yiblafionjs.o�' . ficien es •were oaten.00.6og thisMsic • You will ceceiye o f`ut t tgt ;
carres• otideh&' aba' u' f this'Visit:
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
I�)-' _D k.-i -� t"4- `I p%$FeCwA-
Vie.-_ Gw.co� 6y S,1� W CaLI'y�
44l")
Reviewer/Inspector Name iV V
ReviewerAnspector Signature: Date: 1 / / 16V 51O0

Facility Number: — [late of Inspection �j � ] Printed on: 7/2112fl00
WOr Issues
26. Does the discharge pipe From the confinement building to the storage pond or lagoon fail to discharge ttUor helow ❑ Yes VNo
liquid level of lagoon or storage pond with no agitation?
27, Are there any dead animals not disposed of properly within 24 hours? ❑ Yes Q.No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes XNo
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes �Io
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 [7No
31, Do the animals feed storage bins fail to have appropriate cover? ❑ Yes '060
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes CfNo
n
�l.r.
kx-s cc�p 4' cosh- 5hc�✓�.. �-c
J
5/00

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
Eugene Rivenbark
Eugene Rivenbark Farm
281 Jack Dail Road
Wallace NC 28466
Dear Eugene Rivenbark:
1 * ■
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AN❑ NA;rURAL REsouRces
December 30, 1999
Subject: Fertilizer Application Recordkeeping
Animal Waste Management System
Facility Number 31-439
Duplin County
This letter is being sent to clarify the recordkeeping requirement for Plant Available Nitrogen (PAN)
application on fields that are part of your Certified Animal Waste Management Plan.
In order to show that the agronomic loading rates for the crops being grown are not being exceeded, you
must keep records of all sources of nitrogen that are being added to these sites. This would include nitrogen
from all types of animal waste as well as municipal and industrial sludges/residuals, and commercial fertilizers.
Beginning January 1, 2000, all nitrogen sources applied to land receiving animal waste are required to
be kept on the appropriate recordkeeping forms (i.e. M1, IRR2, DRY1, DRY2, DRY3, SLUR1, SLUR2,
SLD1, and SLD2) and maintained in the facility records for review. The Division of Water Quality (DWQ)
compliance inspectors and Division of Soil and Water operation reviewers will review all recordkeeping during
routine inspections. Facilities not documenting all sources of nitrogen application will be subject to an
appropriate enforcement action.
Please be advised that nothing in this letter should be taken as removing from you the responsibility or
Iiability for failure to comply with any State Rule, State Statute, Local County Ordinance, or permitting
requirement.
If you have any questions regarding this letter, please do not hesitate to contact Ms. Sonya Avant of the
DWQ staff at [phone] ext. 571.
Sincerely,
Kerr T. Stevens, Director
Division of Water Quality
cc: Wilmington Regional Office
Duplin County Soil and Water Conservation District
Facility File
1617 Mail Service Center, Raleigh, North Carolina 27699.1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled110% post -consumer paper

1r, 0 Division of Soil and'Water Conservation - Operation -Review ' • ;'r ',"
Division of Soil and: Water Conservation'- Compliance inspection'; "
{-
Division of Water, trality Compliance pee a Fs
Other Agency Operation Review
14D Routine 0 Complaint Q Follow-up of DWQ inspection 0 Follow-up of DSWC review Q Other E
Facility Number 3 1 Date of Inspection
Time or Inspection 1 24 hr. (hh;mm)
®Permitted 0 Certified O Coonditiona)lly Certified© Registered 113NotOgeratio—np�al Date Last Operated: ••
Farm Name: > tJ. ��. Iti J�+� Ij "1'�..�.......rACounty: ..i.'!............,.............................................
Owner! ....— .........UJ.%r1C....... �..i• IL....--•-•---• ............................... Phone No: ........ ......... -.................................................. .-.................
Facility Contact: ...... Title: Phone No:
FlailingAddress . ....................................... ................................................................... -.......... ..................................................... ............................... ..........................
R Onsite ep:-esentative: „ . .................................. Integrator:... c 4!! j.....................................................
J a
Certified Operator; .......................... ............ I ................ I ......................... I ............ I.... Operator Certification Number:
Location of Farm:
Latitude ' ` " Longitude 0 4 44
Design Current
Swine.: CBnaL'1tV Pnoulatian
❑ Wean to Feeder
® Feeder to Finish
a (p 6
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population I.
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total'Design Capacity
'•, r ° . ;� - Total SSLW
Number of Lagoons Subsurface Drains Present ❑ Lagoon Area 1E1 Spray Field Area
Holding Ponds 1 Solid Traps E= , ❑ No Liquid Waste Management System
Discharges & Stream Impacts
Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. I1' 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 eslimated flow in gal/min?
❑ Yes 19 No
❑ Yes ❑ No
❑ Yes ❑ No
d. Does discharge bypass a lagoon system'? (Ii'yes, notily DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes XNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (Freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes kNo
Structure I Structure 2 Structure 3 Structure; 4 Structure 5 Structure 6
Identifier: j
Freeboard (inches). ........ 33..........
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes �rNo
Continued on back

Facility Number: 3/ Date rrf Inspection
6. Arc there structures on -site which are riot properly addressed and/or managed through a waste management or
'Closure plan'? ❑ Yes )9No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. D❑ any of the structures need maintenance/improvement? ❑ Yes M No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ,ZNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes XNo
Waste rl unlication
10, Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is [here evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes j No
12. Crop type - _— A FP, C, WAS
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pcndcd for a wettable acre determination? ❑ Yes ❑ No
15.
Does the receiving crop need improvement?
N Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
9 No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available'?
❑ Ye3
`dNo
18,
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Ye
;0 No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑.Ye i
ONO
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
JdNo
22.
mail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
)!I No
(ie/ discharge, freeboard problems, over application)
23.
Did reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
XNo
24•
Does facility require a follow-up visit by same agency?
❑ Yes
ONO
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
fii�.NNo
yi¢1Pi 111s.vr d # cknOm •were jiped- c�59hKv.s,tYAt�•vepeiye not0ker' '
carres otidence: a�Guf this :visit
Comments (refer to question #): Explain any YES'. answers and/or any recommendations or any other e`ommIe.nts:ci4 t,i13 u
Use drawings of facility to better explain situations. (use additional' pages'as necessary):
y
r 5. �cs�u e ;n oJ.a�G �re� y]esols ►,.Nrfa Vere%eV) e-n-er /v tans
.\I
Reviewer/Inspector Name
Reviewer/inspector Signature: Date:
3/23t99

Facility Number: - Date of inspection
Odor issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
' No
liquid level of lagoon or storage pond with no agitation?
27,
Are there any dead animals not disposed oi' properly within 24 hours?
❑ Yes
No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
$ No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan baits, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
f No
31,
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
19 No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
2-6. Yes
❑ No
Additional Comments and/orDrawings:Ti
rl
3/23/99

Revised April 20, 1999
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number jy - Operation is flagged for a wettable
Farm Name: _� �_ r �.ru'M. acre determination due to failure of
On -Site Representative: t,�— Part If eligibility ►tern(s) F1 F2 F3 F4
inspector/Reviewer's Name: Operation not required to secure WA
Date of site visit:
Date of most recent WUP: 1�
Annual farm PAN deficit: �` pounds
determination at this firukbased on
exemption E7 E2 E3 E4
Operation pended for wettable acre
determination based on PT P2 P3
irrigation Systems} - circle -Hose Traveler , center -pivot system; 3. linear:move system;
4. stationary sprinkler system wlpermanent pipe; 5. stationary sprinkler system wlportabie pipe;
6. stationary gun system wlpermanent pipe; 7. stationary gun system wlportable .pipe
r :.' T °'' : Determination Exemptions (Eligibil fty failure, Part 11, overrides Part I exemption.)
E1 Adequate irrigation design, including map depicting wettabie.acres, is complete
and signed by an I or PE.
E2 Adequate D, and D)D3 irrigation operating parameter sheets, including map
depicting wettable acres, is complete and signed by an 1 or PE.
_�ZF_3 Adequate D, irrigation operating parameter sheet, including map depicting
wettable acres, is complete and signed by a WUP.
E4 75% rule exemption as verified in Part Ill - (NOTE:75 % exemption cannot be
applied to farms that fall the eligibility checklist in Part It. Complete eligibility
checklist, Part €1 - F1 F2 F3, before completing computational table in Part 11€).
Pawl" if. 75% Rule.Eligibility -Checklist and -Documentation of WA Determination
Requirements.. WA Determination.required because operation .fails -one of the eligibi€ity
requirements listed below:
Lack -of acr-eage-whichTesultedin-over_-application-of -wastewater: (PAN) on:spray.
field (s) :@ ccord in gfofarm's Jast two years Df in igafion:record s:
_ F2 Unclear;-.-illegible,-or lack of information/map:
_ F3 ObviousJie€d-limitations -(numerousxiitches;daii€ure:to:deductTequired
buffer/setback:acreage;-or.25°/0:of#otalmcreage-idenfffibd_iri' AWMP-:ihc€udes_,._.
small ,-€rregular€y-.shaped -f€e€ds :-fields:lessIhan:5:acres-for:travelers-or-less than
2 acres -for..-stationary -sprinklers).
F4 WA determination required because CAWMP credits field(s)'s acreage in excess
of 75% of the respective field's total acreage as noted in table in Part Ill.

Revised April 20, 1999
Facility Number
Part III. Field by Field Determination
of
75% Exemption Rule for WA Determination
TRACT
NUMBER
FIELD
NUMBER',2
TYPE OF
IRRIGATION
SYSTEM
TOTAL
ACRES
CAWMP
ACRES
FIELD
%
COMMENTS'
i
�
E
I
�
�
S
f
i
i
FIELD NUMBER' - hvdrant- null.zone. or ooint numbers -may be used in place of field numbers denenrlinn on CAWMP
and type of irrigation system. If pulls, etc. cross-Tnore-than one field, ins pe'ctorireviewer will have to combine fields to
calculate 75% feid by field determination for exemption; -otherwise operation will be subject to WA determination.
FIELD.NUMBER2 - must be clearly delineated -on Tnap.
COMMENTS' -back-up fields with CAWMP.acr•eage.exceeding 75% of its total'acres m-n-0 having Teceived.less than 50%
of its annual PAN as:dpcumented in the.farm'sprevious-two .years' (1997 & 1998) of irrigation Tecords; cannot serve -as -the
sole basis-for-requiringa WA Determination.-:Back-up1elds-must -be noted in the -commentzectiommnd must be accessible
by irrigation -system.
Part IV. Pending WA-Detenninations
Pi Plan: lacks:fvliowing-information:
P2 Plan revision m ay:satisfy 75% rule .based on adequate overall PAN deficit -and by
adjusting -all fiie]d:acreage:to,.below75% use•rate
P3 Other (ielin process of installing new irrigation system):

State of North Carolina 7FEB
EIVE
Department of Environment2 2 1999
and Natural Resources
Division of Water Quality BY:
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
February 19, 1999
Eugene Rivenbark
Eugene Rivenbark Farm
281 Jack Dail Rd
Wallace NC 28466
4LTW,A i
�
EK
NORCDENR
ENVIRONMENT ANu NATURAL RESOURCE5
Subject: Application No. AWS310439
Additional Information Request
Eugene Rivenbark Farm
Animal Waste Operation
Duplin County
Dear Eugene Rivenbark:
The Non -Discharge Permitting Unit has completed a preliminary engineering review of the subject application.
Additional information is required before we can continue our review. Please address the following by March 21,
1999:
1. Please provide irrigation parameters in the Waste Utilization Plan (WUP). Irrigation events are to
be listed in the WUP as the maximum application allowable for that soil type from the time the
pumps are turned on until the time.they are shut off. It is currently recommended that total
application amounts not exceed one inch in any application event for any soil type. Please have
your Technical Specialist revise your WUP to reflect the appropriate application amount per event.
If the rates exceed the recommended one inch, please have your Technical Specialist justify the
increased application rate in the narrative of your WUP,
2. The WUP submitted calculates the amount of nitrogen produced in one year. However, it appears
that the WUP uses a two-year crop rotation. Your WUP should be revised so that the nitrogen
produced and the nitrogen utilized by crops is calculated for the same time period. Some options
for revising the WUP include: calculating the amount of nitrogen produced for a two-year period
of time, revising your WUP to show waste utilization for Year One and Year Two of the two-year
rotation in separate tables, or showing a two- year crop rotation with corn and soybeans on half the
acreage from each field.
3. Please provide documentation that the animal waste application and handling equipment has been
installed and meets the requirements of the WUP and/or a third party application agreement that
meets the requirements of the WUP. Please provide irrigation system design information as
necessary.
Please note that all WUP revisions must be signed and dated by both the owner and the technical specialist.
Please reference the subject permit application number when providing the requested information. All information
should be signed, sealed, and submitted in duplicate to my attention at the address below. The information
requested by this letter must be submitted an or before March 21, 1999 or the Division will return your application as
incomplete in accordance with 15A N.C.A.C. 2H .0200 and your facility will be considered to be operating without a
permit.
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled! 10% post -consumer paper

Application No. 31-0439
Eugene Rivenbark
Page 2
Please be advised that operation of the subject animal waste management system without a valid permit is a violation
of North Carolina General Statute 143-215.1 and will subject you to the enforcement authority of the Environmental
Management Commission.
If you have any questions regarding this request, please call me at [phone], extension 546.
Sincerely,
�,,�,�1��
Psa Cauley
Environmental Engineer
Non -Discharge Permitting Unit
cc: Wilmington Regional Office, Water Quality
Permit File

n.
[3 Division of Soil and Water Conservation 13 Other Agency
k , Division of Water Quality f ;k
Routine D Complaint Q Follow-up of DWQ inspection 0 Follow-up of DSWC review ❑ Other
Date of Inspect ionFacility Number Time of Inspection ® 24 hr. (hh:mm)
[3 Registered Wertified E3 Applied for Permit (] Permitted 113 Not Operational I Date Last Operated:
r t
Farm Name: .�...�.... ��.....�1�.�.�':*�,.................................... County: ......... ..................................................
OwnerName:.... ''-' .,.... � 2.................................................... Phone No:...,,,.........................................................fir......,.................
FacilityContact:.............................................................................. Title:..,............................................................. Phone No:
Mailing Address:.......�ri�........}!'"�.......... .`�1. \`LL 0 1��...................................... ..........................
` ..............................
Unite Representative,...``4 ... .... Integratur:......'r?.. i,L-!'�1C...................
Certified Operator;............................................................................................... .... Operator Certification Number:
Latitude R 6 64 Longitude * A C 46
.Design Current : ;: estgnCurrent Design current;'i::
Swine " Capacity .Ybpulaton. Poultry Capacity. Population Cattle;;;;;';:;.;;; «::Capacity,,.Populati n
❑ Wean to Feeder ❑ Layer Dairy
Feeder to Finish d ❑ Nan -Layer I I JE1 Non-Dairy
Farrow to Wean •. •.Fie !: '�.
❑ Farrow to Feeder ❑Other IN
❑ Farrow to Finish Total Design Capacity'"
❑ Gilts
❑Boars Total SStiW,`!
".:: �..::..
Nuttaber',nF,iagotiits ! Holding Ponds. ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
.. .�£,. ... .. .. .....5 ;FF:FF"•$'.eyes.,.. r .
,
` . ❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenancelimprovcment? ( Yes ❑ No
2. is any discharge observed from any part of the operation? ❑ Yes (g 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 gaVrnin? A
d. Does discharge bypass a lagoon system'? (if yes, notify DWQ) ❑ Yes No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes (3 No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes 1A No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes lJ No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes (A No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes MNo
7125197

Facility Number: t3—
8. Are there lagoons or storage ponds on site which need to be properly closed?
-tructur Lagoons.11olding Ponds, Flush sits, etc,}
9. is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3
Identifier: L
Freeboard(fo: ........... s...........................................................................................
14, is seepage observed from any of the struc(ures?
Structure 4
11. is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes ZNo
❑ Yes M No
Structure 5 Structure 6
12. Do any of the structures need maintertancelimprovement?
(Irany of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify ❑WQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(if in excess WIMP or runoff enterin waters of t e State, notify DWQ)
15. Crop type��..."1.... ....... >�!r"�. !rac' ' 1... 4............................ ..... ...................... ....................................
t �
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement'?
For Cedified. or Permitted Facilities Only
23, Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0 No.vWaitions•or defidekidwi e're nvte'd._dur-ing this visit: You;Will receive' ito-fti iher
. wort! pOhdeb& tiboiA this: visit:
❑ Yes P(No
❑ Yes No
Yes ❑ No
❑ Yes OdNo
❑ Yes W No
❑ Yes
($j No
❑ Yes
No
,Yes
❑ No
❑ Yes
W No
❑ Yes
fR No
❑ Yes
N[ No
❑ Yes
El No
❑ Yes No
❑ Yes No
❑ Yes to No
Cri�s (refer ta' uestiori # :' Rx Wh a4Y. YES answers undlo`r,an 'recommendations nr'nn to er corments
Is. iT y �1i
Use kawinp t. Fad,: y�tri' kielt explaftt sttuatttihs. (rtsc additigI
Q� «. «.3i `•E. e psi
l�� F►e��s Tz -1 `���d-��} �h�{ l���lra� r��} ��� �.pl�� �� 1�rL��,
�,1 `1c V"r'w —Cc
: �� 7/25/97
Reviewer/Inspector Name
Reviewerllnspector Signature: Date: O -z-._ a

..... ..... ... .........:........ ................................. .. -.-................ ............. ..........
DSWC Animal Feedlot Operation Review
.,1M,.1MDWQ Animal Feedlot Operation Site Inspection
..........
1WRoutine Q Com laint O Follow-u of l)1'L ins cction Q Foil ow -up (if DSWC review Q ether
Date of Inspection
Faculty Number 3
Time of Inspection 24 hr. (hh:mm)
[l Registered ® Certified 13 Applied for Permit 13 Permitted 10 Not Operational I Date Last operated:
Farm Name:...iru..c�.&.�n.R........ .....1..►1.fn�, �ar�^-. ..... .Y... .................. County: ....,�.up..i,t.�.............. ...................
..�I�.t...�.�
Owner Dame:..... �J�.t n .iti................... . ....................... Phone No: ... '(13,11.. U .). ? E.E.5 .....3..S.P.f .........
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
Mailing Address:.....................0,.r. ;........�."-"..-t ........ $Lo.c%.. .......... ............................ .114.9.1.
onsite Representative........... ......... Y- orx...,, Integrator: ..... ,............ ...........
Certified �......�,.�............�,.... Operator Certification Number.....:?. C 1.2-2 ..........
Location of Farm:
Latitude ��" l y, I` ��"
Longitude
13 -7
Design Current
Design;., Current
Design :.:. Current ...;
Swine Capacity Population
Poultry
Capacity Population Cattle,-
Capacity Population:; .:
❑ Wean to Feeder
Layer
10 Dairy
Feeder to Finish
l L p
❑ Non -Layer
I
JEI Non -Dairy
❑ Farrow to Wean
❑Farrow to Feeder
ID Other
❑ Farrow to Finish
Total Design Capacity
❑ [lilts
Total SK W1
1D D
❑ Boars
Number of Lagoons 1 Holding Ponds JEJ Subsurface Drains Present FO Lagoon Area ❑ Spray Field Area
❑ No Liquid waste ;Management System J.3. .
General
1. Are there any buffers that need maintenancelimprovetnent?
2. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the convevance man-made"
b. 1f discharge is obwr►•cd, did it reach Surfacc Water:' [11` ves. notify DWQ)
c. If discharge iti observed, what is the estimated flow in galloon?
d. Does discharge bypass a lagoon system? (if'yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
mai ntenanceli m prove Wien(?
6. Is facility not in compliance with any applicable Setback criteria in effect at the time of design'!
❑ Yes la No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes R No
❑ Yes 0 No
❑ Yes ® No
❑ Yes M No
7. Did the facility fail to have a certified operator in responsible charge'?
7/25/97
❑ Yes ® No
Continued on back

Facility Number: -
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures La goons Iioldin Ponds Flush fits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2
Identifier:
Freeboardjo............. I ................... ....................................
Structure 3 Structure 4
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the Structures observed'?
❑ Yes P4 No
❑ Yes ® No
Structure 5 . Structure 6
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate mininwm or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ... ................
lb. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)'?
17. Does the facility have a lack of adequate acreage for land application?
I S. Does the receiving crop need improvement?
19, Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with can -site representative?
22. Does record keeping need improvement'?
For Certiried or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit'?
No.violkions or deficiencies ►'ere no't'ed-during this:visit..Yoit.will receive no further
correspondence AhoUt this:visit:•:
❑ Yes Eff No
M Yes ❑ No
$9 Yes ❑ No
Yes ❑ No
❑ Yes ORrNo
❑Yes HNo
❑ Yes 9 No
® Yes ❑ No
❑ Yes 19 No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes Off No
❑ Yes ® No
❑ Yes ® No
Comments (refer to question #) Explain any'YES answers and/or any recommendations or any otlieir c6. iiients.
Use drawtu ings of facility to better explain Siationsse. [uadditional pages as necessary}F.:';$'
.��:.... .. .. .:. - .. �..iiFSel:
.. .. ... .. .................. .. �..: .. ..
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7125/97
Reviewer/Ins cOor Name 1
P e
Reviewer/Inspector Signature: rf -, nu„} _,,� Date: y f [Z 9-1

State of North Carolina
Department of Environment,
Health and Natural Resources
Divlsion of Water Quality
James B• Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
April 3, 1997
Eugene Rivenbark
Eugene Rivenbark Farm
281 Jack Dail Rd
Wallace NC 28466
EDEHNR
SUBJECT: Notice of Violation
Designation of Operator in Charge
Eugene Rivenbark Farm
Facility Number 31-439
Duplin County
Dear Mr. Rivenbark:
You were notified by letter dated November 12, 1996, that you were required to designate a
certified animal waste management system operator as Operator in Charge for the subject facility by
January 1, 1997. Enclosed with that letter was an Operator in Charge Designation Form for your
facility. Our records indicate that this completed Form has not yet been returned to our office.
For your convenience we are sending you another Operator in Charge Designation Form for your
facility. Please return this completed Form to this office as soon as passible but in no case later
than April 25, 1997. This office maintains a list of certified operators in your area if you need
assistance in locating a certified operator.
Please note that failure to designate an Operator in Charge of your animal waste management
system, is a violation of N.C.G.S. 90A-47.2 and you will be assessed a civil penalty unless an
appropriately certified operator is designated. Please be advised that nothing in this letter should be
taken as absolving you of the responsibility and liability for any past or future violations for your
failure to designate an appropriate Operator in Charge by January 1, 1997.
If you have questions concerning this matter, please contact our Technical Assistance and
Certification Group at [phone].
Sincerely,
for Steve W. Tedder, Chief
Water Quality Section
bb/awdeslet 1
cc: Wilmington Regional Office
Facility File
Enclosure
P.O. Box 29535, �� FAX [phone]
Raleigh, North Carolina 27626-0535 '"f,C An Equal Opportunity/Affirmative Action Employer
Telephone [phone]% recycles/ 10% post -consumer paper

State of North Carolina
Department of Environment,
Health and Natural Resources
James B. Hunt; Jr.. Governor
Jonathan B, Howes, Secretary
November 13, 1996
Eugene Rivenbark
Eugene Rivenbark Farm
281 Jack Dail Rd
Wallace NC 28466
SUBJECT: Operator In Charge Designation
Facility: Eugene Rivenbark Farm
Facility ID#: 31439
Duplin County
Dear Mr. Rivenbark:
Senate Bill 1217, An Act to Implement Recommendations of the Blue Ribbon Study
Commission on Agricultural Waste, enacted by the 1996 North Carolina General Assembly,
requires a certified operator for each animal waste management system that serves 250 or more
swine by January 1, 1997. The owner of each animal waste management system must submit a
designation form to the Technical Assistance and Certification Group which designates an
Operator in Charge and is countersigned by the certified operator. The enclosed form inust be
submitted by January 1, 1997 for all facilities in operation as of that date. Failure to designate a
certified operator for your animal waste management system is a violation of 15A NCAC 2H
.0224 and may result in the assessment of a civil penalty.
If you have questions concerning operator training or examinations for certification, please
contact your local North Carolina Cooperative Extension Service agent or our office.
Examinations have been offered on an on -going basis in many counties throughout the state for
the past several months and will continue to be offered through December 31, 1996.
Thank you for your cooperation. If you have any questions concerning this requirement please
call Beth Buffington or Barry Huneycutt of our staff at 91gn33-0026.
Sincerely,
A.' Preston Howard, Jr., P.E., Director
Division of Water Quality
Enclosure
cc: Wilmington Regional Office
Water Quality Files
P.D. Box 27687. �.
Raleigh, North Carolina 2761 1-7687 r� An Equal Opportunity/Affirmative Action Employer
Voice 919-715-4100 50% recycled/10% post -consumer paper
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