310483_INSPECTIONS_20171231

NUH I H LAHULINA
Department of Environmental Quai

31 M y Is
Type of Visit ,C,fompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit C� Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: ti U 'LN Region:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: 'Title:
Onsite Representative: G E /Jo 1<4- /Jo -0 y
Certified Operator: Ot PiA Lro M r(, L, 6x
Back-up Operator:
Location of Farm:
Swine
Phone No:
Integrator:
Operator Certification Number:
Rack -up Certification Number:
Latitude: = c 0 6 0 Longitude: 00= 1=„
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La er
❑
Wean to Finish
❑
Wean to Feeder
Feeder to Finish
2 o
a
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
I. 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
❑ Dai Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dr Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: E
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge'?
❑ Yes Ld No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
El NA
El NE
❑ Yes ❑ o
❑ Yes
El NA
El NE
❑ Yes YNo
❑ NA
❑ NE
12128104 Continued

Facility Number: — Date of Inspection 3 rS o
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes f '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: (,A b
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2- y
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
❑ No
❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
No
❑ NA ❑ NE
through a waste management or closure plan?
eat, notify DWQ
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmentaYNo
7. Do any of the structures need maintenance or improvement? ❑ Yes
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
[2/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
[10
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
❑/
❑ NA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
[�Io
❑ 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) ' ro A 13146
13. Soil type(s) CS
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[XNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
L' No
❑ NA
❑ NE
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'![]
Yes
['No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
Z1No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
L✓J No
❑ NA
❑ NE
t1rDA7'r (..A(
AP (raJIcs V")-_0
Reviewer/Inspector Name JU �!� '�2-I ' ,,�' , ,`:".:"z Phone: �!p �J
Reviewer/Inspector Signature: q4& A&n4zll Date: 6 S
12127104 Continued

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

of Visit OS Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit: Time: _ 1 Time: .�
Q Not Operational Q Below Threshold
M Permitted ® Certified/ © Conditionally Certified 13 Registered Date Last Operatedo
rAbove
Threshold:
FarmName: ...........17�1 I.. .....111illf...........»................................................... County: .......... I ...................................
Owner Name:
Mailing Address:
Phone No:
Facility Contact: ................................................................. .... Title:................................................................ Phone No:...................................................
.........
Onsite Representative:......!.4�.........l.t'!%Phi.......................................... Integrator: ........ >7...................................................
Certified Operator: ................................................... ... ............... ........................................ Operator Certification Number:..........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �' �" Longitude �• �' �"
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ..... ... ........................................................................................................................................
Freeboard (inches): �2
12112103 Continued

)Facility -Number: �j — Date of Inspection Z 6
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes' ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑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 actor 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
Aar Quality representative immediately.
n,.'.. -'a; L !'f '! ..sh8.°.4H. '.. . Y'.i.e l;. i`�. ".:tt:'Y • ,:w:24@ ""r{ .p.,x.. t. =M: { a . °",t'v"3Ruj�l^'3 t-,[f't ,'� •:t6'�€i.l - . '.;V.1, f tt�t.;.,Yit..E En..i� - ! it°t:::;;if E€-!.N"'!.^,9 �at{Eix.i4,�.E3 ° - -Ei t r€,�� ! ,.. 1"
iComments (refer to uestran #) : Explain,an i nswers and/orygny recammendattouslonanyothercomments.[ E`EE i° c, €�t ;. ,.,
xt!} .:? .e6.�.:°� „' ..ttSrN?}!� .- 161 e. a;,,,�zzsE$ggt , IT, 3:§s( "'.3 8se r•� :^".°I;i - ii i�'i4ld,.?w ", '¢, :taPS(tt�,Erna.€c�G',..�anasnmca>L.JP..u.; �u1u;�:3a :aa.:�..:w.' ca.,uce....�d?,at�
Use dMwings }of facil�iy, t6 better explain si ,tuitions':{{use 4ddittoaal pages as �n'ecessary}•t 44 ° ❑Field COPY ❑Final Notes
Wx IEl� �E i�tc t }fie �}"i ! �Il I - ;. i ,i •-E'. t i
t € I-yy-�".1•{�E ��"�a _:� �. `� rF;i�:'ttN!) � a ,i -� 1�� .iL��i.: 0 Ir � -� i �1 3i - �"'7 'I'Sf' + .u.'r ......t` , ��3i��<�'_. x.' � � ,� a ,.ei � eet i.: � t _L,. ' >a a, �fia . t vi} r .4 .s,.,.isk - - 3� �� �L.f:.:.,�.�,�'.�....-iC� . � ad.i <.. s.<.� ESL.. .:i 4 f t ir,�'�b•, t�`t�i'"tYs�itM''i`"'.'�3a.u�'�f���
3-T
p t ; s§ �} tom' p-Y7Rei r °w d �!j 7
Reviewerlins ECiOr Nameg,..a 4y; '' " E t d .. S`9.Es�"9 k
Reviewer/Inspector Signature: AV Date: =igr Aiy
1 L/1ldVJ {.. I& 6"U"

Facility Number: ?;I _ Date of Inspection 3 l�
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 3I-35)
3I . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [:]No
❑ Yes [:]No
12112103

Operator Certification Number:
Latitude • 4 " Longitude ' 9 46
Design Current Desiiga
.Poultry Capacity;'Population ' ,Cattte._ Capadit
Type of Visit XCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint, 0 Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Time: U
10 Not Operational C Below Threshold
Permitted [3Certified0 AC�o1n`diitionally Certified © Registered Date Last Operated or (Above Threshold:
Farm Name: .....%?.1,1t ....1`�\`\l lt� ... ....\................................................... County: .....b-(- ?11.........................................................
Owner Name:
Facility Contact:
........................................................................ Phone No:........................................................................................
Title:
Phone No:
MailingAddress:........................................................................................'.[................................................. ..........................
OnsiteRepresentative: 1^Q .... '` ' `�%...............:..... Integrator:........r ,�r r.........................................._..
Certified Operator:
Location of Farm:
❑ Swine ❑ poultry ❑ Cattle ❑ Horse
I Design Cum
,S�q,5ivineE',..:=t,;, Ca aci "Pa °ula
❑ Wean to Feeder
q Q
;LI; Feeder to Finish
❑ Farrow to Wean
' ❑Farrow to Feeder
€F .,;
❑ Farrow to Finish
4 ❑ Gilts
❑ Boars
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes O No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. if discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes DeNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 4No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes Inj No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......................................................................................................................................................................................................................
Freeboard (inches): Is L
5/00 Continued on back

Facility Number: — Date of Inspection 0
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes Nlo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes KNo
(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 M No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes allo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes JXNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ONo
11. Is there evidence of rer,application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑Yes -UrNo
7
12. Crop type C j wr S—G
13. Do the receiving crops differ with -those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes 1g No
14, a) Does the facility lack adequate acreage for land application?
❑ Yes 10No
b) Does the facility need a wettable acre determination?
❑ Yes PoNo
c) This facility is pended for a wettable acre determination?
❑ Yes WNo
15. Does the receiving crop need improvement?
❑ Yes W40
16. Is there a lack of adequate waste application equipment?
❑ Yes VNo
Reuuired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
RJ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
A No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
[jNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
I10
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
(ie/ discharge, freeboard problems, over application)
,fNo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
t9 No
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
9No
yiQldgfc�e�ies vv revisit; Yojs willi•o itf�i-th�r . .
corres otideike' ab6uf this 'visit:
I 1-- . -• - I I k-- 1
Cotntonents {refer to question #). i Eirpla any YES answers and/or any °recommendations orl any other corepts.C' ' I ", �, ' •'
U drawings: of facility W better1explainsituations{use additionallpages as necessary];"It i.t":. ".,' , .. ,i , s; ° �, sl! ,
(• I a
—'P,
Reviewer/In ector Name { Vim: 4 I � �1I,rr €1
4F_ �s.-�� � r£ f� 1{
Reviewer/Inspector Signature: Date: 5100

Facility Number:3— $ 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 Wes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on'neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes No
lAdditional Comments an or Drawings ' . E
J
5/00

Division of Water Quality
Q Division of Soil and Water Conservation "
0 Other Agency
Type of Visit Ik
Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit OfRoutine O Complaint O Follow up O Emergency Notilication O Other ❑ Denied Access
Facility Number
Date of Visit: I- - 6L Time: Printed on: 7/21/2000
� 3
Q Not Operational Q Below Threshold
13 Permitted 0 Certified © Conditionally Certified [a Registered Date Last Operated or Above Threshold:
Farm Nome: ,....� ,Z,A- � Ni1t'4 / �ol.iW.. .I...... County:....... 1.,,l ...................... ..:...........
................I........I.........I....... ...........
OwnerName:............/..j..........1............................................................ .. Phone No:
Facility Contact: ...N...!!�/lr................"I"itic• p"v`..:Y:�'^ . Phone No: .......................................
........... :.......................................................
MailingAddress: ...........1 ..,M...,.....................................................I—'......I.............. .......................................................................... ..........................
Onsite Representative: 616
Integrator r f,S.,...„...,.,...„........................
..............................................
Certified Operator: .................................................. .............................................. Operator Certification Number:...................... ..............
Location of Farm:
.Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 ` fi • Longitude a 6 «
Design Current Design Current Design Current
Swine Capaci!Z Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder JEJ Layer I I Dairy
E,Fecder to Finish z d ❑ Non -Layer ❑ Non -Dairy
❑ Farro'w to Wean
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity
El Gilts
❑ Boars Tota155LW
Number of Lagoons [[—]Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge urinin;ited at: ❑ Lagoon ❑ Spray Field []Other
a. If discharge is observed, was the conveyance maul -made?
h. If discharge is observed, did it reach Water oi'the State? (II'yes, nolify DWQ)
c. [f dischai-c is observed. what is the cstimaled flow in gal/min?
d, noes discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate'?
Structure I SlruC(Ure 2 Structure 3
Identifier: ............. 3.��....... ....... ............................. .............................
❑ Yes N�No
❑ Yes ❑ No
❑ Yes ❑ No
4'&
❑ Yes ❑ No
❑ Yes 5—(No
❑ Yes U?kio
❑ Spillway ❑ Yeso
Structure 4 Structure 5 Structure b
Frechoard (inches):
5100
Continued on back

. ,Facility'Nnmber: — Date of Inspection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge :11/or below ❑ Yes K No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes M No
❑ Yes 'No
❑ Yes 4NO
❑ Yes KNo
❑ Yes - \No
V ❑ Yes N` o
Additional Comments andor rawings:
A,
5100

ucilitrNumber: LA Date of Inspectiol IV IPrinted on: 7/21/2000
5. Are there any imme iate threats to the integrity of any of the structures abs ved? iel trees, severe erosion, ❑ Yes 0 No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes � No
(If 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
20,1:1 No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
16 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
E�No
Waste Applicatio
10. Are there any buffers that need maintenance/improvement?
❑ Yes
;(No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
KNo
12. Crop type ows a
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
MNo
14. a) Does the facility lack adequate acreage for land application'?
❑ Yes
0�'No
b) Does the facility need a wettable acre determination?
❑ Yes
J No
c) This facility is pended for a wettable acre determination'?
❑ Yes
No
15. Does the receiving crop need improvement?
❑ Yes
No
16. Is there a lack of adequate waste application equipment?
❑ Yes
No
_Required Records & DocurnenLs
17. Fail to have Certificate of Coverage & General Permit readily available'?
❑ Yes
�J No
I ,
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
1� No
19. Does record keeping need improvement? (ic/ irrigation, frecboard, 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
f<No
21. Did the facility fail to have a actively certified operator in charge'?
❑ Yes
[(No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application) ❑ Yes W No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'? ❑ Yes EfNo
24. Does facility require a follow-up visit by same agency? ❑ Yes kNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes kfNo
fo yiQl'attoris ;off de eiencies mere fit ted d> Wifig •tbis;visit; - Y;oi will reeeiye 04 fufthiee . ' . ;
cor'res' orideiice: about: this visit: I I ......... .
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):
ra rpv- i5 vi-,Y�
well. � �c�ll�� /�Or
lr64e l w�a tea.
ZDoO,
A.
IV
Reviewer/Inspector Name
Reviewer/Inspector Signature:
'�1/ /
l / j/jr-� r

z (] Division of Soil and'Water Conservation' OperatiioniReview�
'
�j [3Division of Soil and Water Conservation i ,Compliance InspectroII
Dlvl$lOII' o£ Water �Qua
htyCOm111iaIICe�Inspection
'.© Other A enC era
g y =°Op tion;Rev�ew
Routine Q Complaint O Follow-up of DWQ inspection Q Follow -tip of DSWC review Q Other
Facility Number 3 Date of Inspection
'Time of inspection 24 hr. (hh:mm)
0 Permitted Z Certified © Conditionally Certified (] Registered 113 Not Operational I Date Last Operated:
Farm Name: y� — Count V P ­ ....................
�.!�. !.......'..'!.?...��...1..."�'.rvl.��................. County: ....��.!�....................................
Owner Name: .. ............. ....M.!.../.rr...✓..7.................. Phone No:
FacilityContact: .............................................................................. Title:................................................................ Phone No:........ ...........................................
MailingAddress:.................................................................................................................................................................................. ..........................
Onsite Representative: ... DP.).1 .J��..�.l.f.5VJ...% nofkclll.Yt. ntegrator:.... %`'Tf�O1�r................................................
. �.............. J
Certified Operator: ................................................... .............. Operator Certification Number:
Location of Farm:
w
......................................... ........................ ............................ ................... ..................................... ........ ...................
Latitude 0 6 •' Longitude • & 46
�I Design Current Design Current ;: Design Current
cattle, Caacify CaaciPolatCaacitPoulation tSwin11 t
❑ Wean to Feeder
® Feeder to Finish
1240
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
❑ Layer
I
❑ Dairy
❑ Non -Layer
!
❑ Non -Dairy
E
❑ Other
Fs
]] 11
' Total Design, Capacity
�� �
Total SSLW
, 3 ;;
Number of°La oons I ❑ Subsurface Drains Present ❑ f.agoo ❑ Spray Field Area
g g ��r, �"'Area
din Pon
ds /Solid Tra s .Hof P ❑ No Liquid Waste Management System
Discharges & Stream tmpac
1. Is any discharge observed from any part of the operation?
Discharge originated at; ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Dues discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: 1
Freeboard(inches): ..........3, z.... ........ I..............................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes D�No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes jj�rNo
❑ Yes 10 No
Structure 6
❑ Yes 0 No
Continued on back
3/23/99

Facility Number: Date of Inspection
6. "A're there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
} No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
No
Waste Application
10. Are there any buffers that need maintenancelim pro vemen t?
❑ Yes
No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
No
12. Crop type C, t W 1 5-8
13. Do the receivingcrops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
p. g g ( MP)?
❑Yes
No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
1j No
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
No
15. Does the receiving crop need improvement?
❑ Yes
No
16. Is there a lack of adequate waste application equipment?
❑ Yes
No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
ONO
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.) '
❑ Yes
9No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
41 No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
XNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative`?
❑ Yes
$No
24. Does facility require a follow-up visit by same agency?
❑ Yes
kNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
$No
No • , iolat iOris:or deficiencies -were nrite(l• 00-ting tbis'visit'. • Y:oir will •f, eeeiye Rio l�itrit t r •
corresponi denCe: about: this :visit. '
3/23/99

Date of Inspection
Facility Number: —
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
% Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours'?
❑ Yes
KNo
28.
Is there, any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
� No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e, broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
P�No
rhona omments and/or. rawrngsc' ,: t: ,., , i , 11.
i
3/23/99

Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality
I.SRoutine O Complaint O Follow-up of DWQ inspection O Follow-up of.DSWC review O Other �
Dale of Inspection
Facility Number
Time of inspection ® 24 hr. (hh:mm)
© Registered ertified 13 Applied for Permit © Permitted fi-3NotOperational I Date Last Operated:
[ 1
Farm Name: ��-\�� ` County:...... .!`1...................................................
........................................................ ..... ........... ..... ..
qj G�a-�� 30
Owner Name:...a`- ....1"��`.. Q!r........... Phone No: L1.................................................................
FacilityContact: .............................................................................. Title:..................,. Phone No: ................................................................................................
Mailing Address:.. U. ....! �� � .!' r t -a� �.....1.. ..1 C ...,. g ji0•............... '.. ..................... .
0 ( [ T.... Inte . rator:•,,,, YES... ..
Onsite Representative:!' .,.�� �`'��..�..!:��!..�°+............ >; � �.....................................
Certified Operator:.............................................................................. ................................. Operator Certification Number .........................................
ocati n of F rm
�S�t��.\` .,.. ��.S...Q�. .1..!ht...Q ..G .... ... 1. ..........................-....
Latitude 0001 46 Longitude 0.0`"
Design Current Design Current.
•ine Capacity Population , Poultry Capacity Population Caftle
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
❑ Layer
❑ Non-Laye
❑ Other
Total Desilan
,e
Tot
Capacity
Non -Dairy[
�W
Number nt Lagoons /Holding Ponds ❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area
$ w ❑ No Liquid Waste Management System x
E
General
1.
Are there any buffers that need maintenance/improvement?
❑ Yes
ONo
2.
Is any discharge observed from any part of the operation?
❑ Yes
91 No
Discharge originated at, ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
V<No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
[5No
c. If discharge is observed, what is the estimated flow in gal/min?
6
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ •Yes
0 No
3.
Is there evidence of past discharge from any part of the operation?
❑ Yes
IZ No
4.
Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
WNo
5.
Does any part of the.waste management system (other than lagoons/holding ponds) require
❑ Yes
KNo
maintenance/improvement?
6.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
M No
7.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
Pd No
7/25/97

Facility Number:7J — 3
8. Are there lagoons or storage ponds on'site which need to be property closed? ❑ Yes V�No
Structures (L.aioons.Iioldime Ponds. Flush Pits. etc
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
jXNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: .............................................................................................................................................
...................................
Freeboard(ft):..........1-�7.q..' ................................................................................................................................................................................................
...................................
10.
Is seepage observed from any of the structures?
❑ Yes
0 No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
ONo
12.
Do any of the structures need maintenance/improvement?
Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
PINo
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
45 No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type
.....................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
WNo
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
PNo
18.
Does the receiving crop need improvement?
❑ Yes
91 No
19.
Is there a lack of available waste application equipment?
❑ Yes
,rNo
20.
Does facility require a follow-up visit by same agency?
❑ Yes
O No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
PW No
22.
Does record keeping need improvement?
J4 Yes
❑ No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
CRrNo
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
5�No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
;W No
�] No.violations-or. deficiencies.were noted -during this:visit. You4411 ' eceive,n`ftirth:er-:
.•egrrespondeinceab:outthis:visit:•: :-" :�:-:: ..�:-:: .. .� •.-:�.�.�.�.:: :�:�::�. .: .�
5
7/25/97

�0DSWC Animal Feedlot Operation Review
ME31)WQ Animal Feedlot Operation Site Inspection
e
.v.
IaRoutine O Complaint O Folloki-up of I)NVQ inspL tion O Follow-up of_I)MVC review O Olher
Facility Number II�IY�UYYll1YY-
Date of Inspection 11 ) Y 117 I
Time of Inspection �S 24 hr. (hh:mm)
© Registered M Certified 47 Applied for Permit O Permitted 10 Not Operational Date Last Operated:
}� � y ! t�1
Farm Name: ...•LJ{j..v� D..4 .......!•..t...1...i.R1Y...... Y+...... ....4.. County:...,...` .r,}.Ia..4.t.. 1.......................... .. ...l..L�.,.©
Owner Name :..... �D..4.u-o..4 4L................. .i.......Y........,.................................. Phone No:.... ..�i.f.11�... .,..Z..2,?...=... az-.`.J..q...,
Facility Contact: ...................................................................... Title:............... ........ Phone No:
Mailing Address: ... ac,s ........ Ai4.t.,t..Lx .. .................................................... ...�L.O4.14-i..(Ak ,r..'IN..0 . ...............
Onsite Representative., —AID... ..........., .............................. ...............................................
Certified Operator;Db-1A-1.1.Q1•....,Z?.,........................................... Operator Certification Number, ... 4.7.�... .
Location of Farm:
t.► ....Q.A,.....,Sr.1l..k m.,. ....... &...-7.2ip...�....,.. cy.D. �,.,r�o.Jt.i..,ruA.w...,�,.. r n.r...�s. .,..t!S a. �'.......,..Q. A
........
i,atttuue I 3!1 - 1 56 I' 1 On !., t.ongnuae 1 :1:1a- 1 !Is t .)lrE.
Design Current
Swine Capacity Population
❑ Wean to Feeder
® Feeder to Finish
4 Z
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design CarrenC. k
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Nan -Layer 1E1 Non -Dairy
❑ Other
Total Design Capacity . 12-4A=
Total SSLW l b I q oO
Number of Lagoons / Holding Ponds JE1 Subsurface Drains Present ❑ Lagoon Area
No Liquid Waste Management S stem
10 Spray Field Area
General
I. Are there any buffers that need maintenance/improvement?
❑ Yes
91 No
2. Is any discharge observed from any part of the operation'?
❑ Yes
RNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance. man-made?
❑ Yes
Q 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 glow in gal/min?
d. Dues discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
ER No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
R No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
1p No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
P No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design'?
❑ Yes
0 No
7. Did the facility fail to have a certified operator in responsible charge'?
❑ Yes
®.No
7/25/97
Continued on back

Facility Number: — LA ?�
.8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes ® No
Structures (Lagoons.floldine Pon([,,,. Flush Pits, etc.t
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes I& No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (ft): .......... ...................................................
10. Is seepage observed from any of the structures? ❑ Yes J.No
11. Is erosion, or any other threats to the integrity of any of the structures observed'? ❑ Yes ® No
12. Do any of the structures need maintenance/improvement!
(If any of questions 9-12 was answered yes, and the situation poses
an immediate puhlic health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application`?
(If in excess of WMP, or runoff eniering waters of the State, notify DWQ)
15. Crop type .... (A.n..........................................te,1. 4.A.
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 [mid application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
No.violations or. deficiencies were noted -during this:visit..You'Will receive no ftirther
correspondence ab"oitt this'visit:.: .
❑ Yes ® No
❑ Yes ® No
❑ Yes %No
......................................
❑ Yes ® No
❑ Yes C$ No
❑ Yes ES No
❑ Yes 0 No
❑ Yes 9 No
❑,Yes E'No
® Yes ❑ No
❑ Yes 19 No
❑ Yes B No
❑ Yes ® No
7125/97
Reviewer/Ins ector Name 3 A
p rai-n�bi?'trG.� -(r
Reviewer/Inspector Signature: �,,,�� n t .�`� l� _ Date: 4 q q q

❑ DSWC Animal Feedlot Operation Reviewli!iiid MR.
w
IZDWQ Animal Feedlot Operation Site InspectioM0
n`
Q Routine O Complaint O Follow-up of DNV(2 inspection Q Follow-up of DSWC review O Other
Date of inspection 1.17 4 III
Facility Number r3
Time of Inspection 24 hr. (hh:mm)
Registered 03Certified 13 Applied for Permit 0 Permitted [3Nbt O £rational Date Last Operated:
Farm `al£:D......1"�..-4r* ......C aunty• ..�.w. �.,�..r............... ..............K..lU
.....................,.............................
OwnerName:... .�••.n�.�a .. ..............:....} ..!..`..�..e......................................... 11hone No:..,L.q.�... .... z,. .. ....'...: .�..`,{.: ...................
FacilityContact:..............................•..............,................................ Title:......................... .. Phone No:
Mailing Address: ..3..QS........
, ....... ............... ................................ ...�:..�...1?.k.ti ...i.....4......f.�.. ........................ .. .. :. !..� ...
OnsiteRepresentative:... ,.U. .).0 ..... 1.i...��1✓............................................... IntEt;rxtar:....,. ..r...P..�,.��..C..t,....................,......:................
Certified Operator, ................
Location of Farm:
....................... Operator Certification Number ..........................................
Latitude Longitude �• �� 0'°
DestgnCurrcrit Destgn: Current
Design} Current
Swune,:.; a " Capacity' Population Poultry t Capacity .Population,. Cattle Capacity Population -.
., ,
Kv
Wean to FeederLayer
❑ Dairy
Feeder to Finish
F[J
❑ Non -Layer ❑ Non-Dairy
Farrow to Wean
F ElFarrow to Feeder
❑Other
F. ❑ Farrow to Finish
:Total Design
❑ Gilts'
r," .Capacity';
'
Boars
• � ' 'Total SSLW '<
fie. a'S-
, : :
. �. w+..w l$ �.,::'�$ �:h ..,?_f �`.'"-� - j .• � r
Number of Lagoons /Holding Ponds 0 ❑ Subsurface Drains Present ❑ Lagoon Area
10 Spray Field Are!jr,,
No Liquid Waste Management System
4 z 7
s❑
x
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
2. Is any discharge observed from any part of the operation? ❑ Yes •® No
Discharge originated at; ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes IN No
b. if discharge is observed, dill it reach Surface Water? (if yes, notify DWQ) ❑ Yes ® No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes ® No
3. is there evidence of past discharge from any part of the operation? ❑ Yes ®..No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes ® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ® No
maintenance/improvement?
6. Is -facility not'in compliance with any applicable setback criteria in effect at the time of design'? Cl Yes R No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes M.No
7I25/47 Continued on back

Facility'Number: 1 — Li S
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes ® No
Structures La oo is 1iI 'n fonds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes ®. No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...............................................................................................
................................... ........... .... ....
Freeboard(ft): ..................... ..................................... ................................... ... ................................. .................................... ....................................
10. Is seepage observed from any of the structures?' ❑ Yes 0No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes ® No
12. Do any of the structures need maintenance/improvement? ❑ Yes ® No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers? ❑ Yes ® No
Wasteinniication
14. Is there physical evidence of over application? - ❑ Yes %No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ....Si.!.!!.^..............................:.tL:>~.t.................... ...........................................,.......,.............................................................
16. Do,the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes ® No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes E$ No
18. Does the receiving crop need improvement? ❑ Yes ® No
19. is there a lack of available waste application equipment? ❑ Yes (R No
20..Does
facility require a follow-up visit by same agency?
❑ Yes
® No
21.
Did Reviewer/IriOwt6r fail to"discuss review/inspection with on -site representative?
❑ Yes
[' No
22.
Does record keeping need improvement?
® Yes
❑ No
For
Certified ar Perr]iitted Fucilitic:s Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
21 No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
25.
Were,E.wy�a&di t%nal}problems noted which cause noncompliance of the Permit?
❑ Yes
® No
® No.violations•or. deficiencies. rvere-noted-d66ng this. visit.- .Yoit:will receive no•fdrther
correspQtideko dhouf
c omments(reter to
Use sltawsngoaf fc lgituyesuobne.tEt)er exxp aal>aintuyho�nsanswersancorayreoencaonsoranyothercments prm.z> 4 a
(use additional pages as•.necessary} A '{� y
t tt4 WV, �tp �, At;ct v+na �C Sil+Q 1G uS�& la-.`�.� S iN ,
. yp d ✓ o
P I,
� ys � '1- v C �..� y+n v
vv%,L tiC C j v4,IL4 i ex 1 +
( wi �+�.c. ✓S 4 `'` 1 r .' ' !� it + i J �+ ti''. �, ` U „' a S' t {' t. u i + -i' ✓+ f S a i
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature:
. -/s
Date:

WASTE UTILIZATION PLAN
DATE `? f�6 %4 %
Producer: Donald Miller
Location: 305 Miller Road
Beulaville, NC 28518
Telephone: [phone]
Type Operation: Feeder to Finish
Number of Animals: 1240
The waste from your animal facility must be land applied at a specified
rate to prevent pollution of surface and/or groundwater. The plant
nutrients in the animal waste should be used to reduce the amount of
commercial fertilizer required for the crops in the fields where waste
is to be applied. This waste utilization plan uses nitrogen as the
limiting nutrient. Waste should be analyzed before each application
cycle. Annual soil tests are strongly encouraged so that all plant
nutrients can be balanced for realistic yields of the crop to be grown.
Several factors are important in implementing your waste utilization
plan in order to maximize the fertilizer value of the waste and to
ensure that it is applied in an environmentally safe manner. Always
apply waste based on the needs of the crop to be grown and the nutrient
content of the waste. Do not apply more nitrogen than the crop can
utilize. Soil types are important as they have different infiltration
rates, leaching potentials, cation exchange capacities, and available
water holding capacities. Normally waste shall not be applied to land
eroding at greater than 5 tons per acre per year. With special pre-
cautions, waste may be applied to land eroding at up to 10 tons per
acre per year. Do not apply waste on saturated soils, when it is
raining, or when the surface is frozen. Either of these conditions
may result in runoff to surface waters which is not allowed under DWQ
regulations. Wind conditions should also be considered to avoid drift
and downwind odor problems. To maximize the value of the nutrients
for crop production and to reduce the potential for pollution, the
waste should be applied to a growing crop or applied to bare ground
not more than 30 days prior to planting. Injecting the waste or
disking will conserve nutrients and reduce odor problems.
This plan is based on waste application through irrigation for this
is the manner in which you have chosen to apply your waste. If you
choose to inject the waste in the future, you need to revise this
plan. Nutrient levels for injecting waste and irrigating waste are
not the same.
The estimated acres needed to apply the animal waste is based on
typical nutrient content for this type of facility. Acreage require-
ments should be based on the waste analysis report from your waste
management facility. Attached you will find information on proper
sampling techniques, preparation, and transfer of waste samples to
the lab for analysis.
This waste utilization plan, if carried out, meets the requirements
for compliance with 15A NCAC 2H.0217 adopted by the Environmental
Management Commission.
fill=.3/-yS3
Page 1

WASTE UTILIZATION PLAN
Page 2
AMOUNT OF WASTE PRODUCED PER YEAR (GALLONS, FT3, TONS, ETC.)
1240 hogs x 1.9 tons waste/hogs/year = 2356 tons
AMOUNT OF PLANT AVAILABLE NITROGEN (PAN) PRODUCED PER YEAR
1240 hogs x 2.3 PAN/hog"ar = 2852 lbs. PAN/year
Applying the above amount of waste is -a big job. You should plan time
and have appropriate equipment to apply the waste in a timely manner.
The following acreage will be needed for waste application based on
the crop to be grown, soil type and surface application.
TABLE 1: ACRES OWNED BY PRODUCER
TRACT FIELD SOIL TYPE &CLASS- CROP YIELD LBS COMM
'*
" LBS
DETERMINING PHASE CODE AW N PER
ACRES
AW
PER AC AC
USED
APPLIC.
TIME
5349 5 FOA C 120 150 15
2.04
275.4
5349 —5 FOA W 55 110
2.04
224.4
5349 5 FOA DS8 28 112
2.04
228.48
5349 7 1=0A C 120 150 15
1.415
191.025
5349 —7 FOA W 55 110
1.415
155.65
5349 7 FOA DSB 28 112
1.415
158.48
5349 8 & 9 FOA C 120 150 15
8.98
1212.3
5349 —8 & 9 FOA W 55 110
8.98
987.8
5349 8 & 9 FOA DSB 28 112
8.98
1005.76
0
0
Total 4439.295
Indicates that this field is being over seeded (i.e. interplanted)
or winter annuals follow summer annuals.
NOTE: The applicator is cautioned that P and K may be over applied
while meeting the N requirements. Beginning in 1996 the Coastal Zone
Management Act will require farmers in some eastern counties of NC to
have a nutrient management plan that addresses all nutrients. This
plan only addresses Nitrogen.

WASTE UTILIZATION PLAN Page 3
TABLE 2: ACRES WITH AGREEMENT OR LONG TERM LEASE
(Agreement with adjacent landowners must be attached.)
(Required only if operator does not own adequate
land. See required specifications 2.)
TRACT FIELD
SOIL TYPE & CLASS-
CROP
YIELD
LBS
COMM
"
' LBS
DETERMINING PHASE
CODE
AW N
PER
ACRES
AW
PER AC
AC
USED
71869 1
BNB
C
60
75
15
1.725
103.5
71869 —1
BNB
W
40
80
1.725
136
71 669 1
BNB
DSB
18
72
1.725
124.2
5902 1
BNB
C
60
75
15
5.52
331.2
5902 —1
BNB
W
40
80
5.52
441.6
5902 1
BNB
DSB
18
72
5.52
397.44
0
Total
1535.94
Indicates that this field is being over seeded (i.e. interplanted)
or winter annuals follow summer annuals.
Acreage figures may exceed total acreage in fields due to
over seeding.
* Ibs AW N (animal waste nitrogen) equals total required nitrogen
less any commercial nitrogen (COMM N) supplied.
The following legend explains the crop codes used in tables 1 and 2 above:
CROPCODE CROP
BH
HYBRID BERMUDA GRASS -HAY
C
CORN
SG
SMALL GRAIN OVER SEED
SA
SUMMER ANNUALS
WA
WINTER ANNUALS
BC
HYBRID BERMUDA GRASS -CON GRAZED
SP
HYBRID BERMUDA GRASS -PASTURE
FC
TALL FESCUE -CON GRAZED
FH
TALL FESCUE -HAY
FP
TALL FESCUE -PASTURE
SB
SOYBEANS
DSB
DOUBLE CROP SOY BEANS
W
WHEAT
LBS N APPLY
UNITS PER UNIT MONTH
TONS 50 APR-SEPT
BUSHELS 1.25 MAR-JUNE
AC
50
SEPT-NOV
AC
110
APR -MAY
AC
100
SEPT-NOV
TONS
50
APR-SEPT
TONS
50
APR-SEPT
TONS
50
SEPT-APR
TONS
50
SEPT-APR
TONS
50
SEPT-APR
BUSHELS
4
JUN-SEPT
BUSHELS
4
JUN-SEPT
BUSHELS
2
FEB-MAR

WASTE UTILIZATION PLAN
Page 4
TOTALS FROM TABLES 1 AND 2
ACRES LBS AW N USED
TABLE 1 15.89 4439.295
TABLE 2 14.49 1535.94
TOTAL 30.38 5975.235
N-
AMOUNT OF N PRODUCED 2852
"' BALANCE-3123.235
"' This number must be less than or equal to 0 in order to
fully utilize the animal waste N produced.
Acres shown in each of the preceding tables are considered to be the
usable acres excluding required buffers, filter strips along ditches,
odd areas unable to be irrigated, and perimeter areas not receiving
full application rates due to equipment limitations. Actual total
acres in the fields listed may, and most likely will be, more than
the acres shown in the tables.
NOTE. The Waste Utilization Plan must contain provisions for periodic
land application of sludge at agronomic rates. The sludge will be
nutrient rich and will require precautionary measures to prevent
over application of nutrients or other elements. Your production
facility will produce approximately H59. 5' pounds of plant
available nitrogen (PAN) per year in the sludge that will need to be
removed on a periodic basis. This figure is PAN when broadcasting
the sludge equipment, may be needed when you remove this sludge.
See attached map showing the fields to be used for the utilization of
waste water.
APPLICATION OF WASTE BY IRRIGATION
The irrigation application rate should not exceed the intake rate of
the soil at the time of irrigation such that runoff or ponding occurs.
This rate is limited by initial soil moisture content, soil structure,
soil texture, water droplet size, and organic solids. The application
amount should not exceed the available water holding capacity of the
soil at the time of irrigation nor should the plant available nitrogen
applied exceed the nitrogen needs of the crop.
Your facility is designed for 180 days of temporary storage
and the temporary storage must be removed on the average of once every
6 months. In no instance should the volume of waste being stored in
your structure be within /- 7 feet of the top of the dike.

WASTE UTILIZATION PLAN Page 5
If surface irrigation is the method of land application for this plan, it
it is the responsibility of the producer and irrigation designer to
ensure that an irrigation system is installed to properly irrigate the
acres shown in Tables 1 and 2. Failure to apply the recommended rates
and amounts of Nitrogen shown in the tables may make this plan invalid
Call your Agriment Services representative for assistance in determining
the amount of waste per acre and the proper application rate
prior to beginning the application of your waste.
NARRATIVE OF OPERATION; Scc-/y4 �icc'�

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

WASTE UTILIZATION PLAN
Page 7
10. Waste nutrients shall not be applied in fall or winter for spring
planted crops on soils with a high potential for leaching. Waste
nutrient loading rates on these soils should be held to a minimum
and a suitable winter cover crop planted to take up released
nutrients. Waste shall not be applied more than 30 days prior to
planting of a crop on bare soil.
11. Animal waste shall not be applied closer than 25 feet to surface
water. This distance may be reduced for waters that are not perennial
provided adequate vegetative filter strips are present. (See standard
393 -Filter Strips)
12. Animal waste shall not be applied closer than 100 feet to wells.
13. Animal waste shall not be applied closer than 200 feet of dwellings
other than those owned by the landowner,
14. Waste shall be applied in a manner not to reach other property and
public right -of ways.
15. Animal waste shall not be discharged into surface waters, drainage ways,
or wetlands by discharge or by over -spraying. Animal waste may be
applied to prior converted wetlands provided they have been
approved as a land application site by a "technical specialist".
Animal waste should not be applied on grassed waterways that discharge
into water courses, except when applied at agronomic rates and the
application causes no runoff or drift from the site.
16. Domestic and industrial waste from wash down facilities, showers,
toilets, sinks, etc., shall not be discharged into the animal waste
management system.
17. Lagoons and other uncovered waste containment structures must maintain
a maximum operating level to provide adequate storage for a 25-year,
24-hour storm event in addition to one (1) foot mandatory freeboard.
18. A protective cover of appropriate vegetation will be established on
all disturbed areas (lagoon embankments, berms, pipe runs, etc.).
If needed, special vegetation shall be provided for these areas and
and shall be fenced, as necessary to protect the vegetation.
Vegetation such as trees, shrubs, and other woody species, etc, are
limited to areas where considered appropriate. Lagoon areas should be
kept mowed and accessible. Lagoon berms and structures should be
inspected regularly for evidence of erosion, leakage or discharge.
19. If animal production at the facility is to be suspended or terminated,
the owner is responsible for obtaining and implementing a "closure
plan" which will eliminate the possibility of an illegal discharge,
pollution and erosion.
20, Waste handling structures, piping, pumps, reels, etc., should be
inspected on a regular basis to prevent breakdowns, leaks, and spills.
A regular maintenance checklist should be kept on site.

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

WASTE UTILIZATION PLAN
Page 9
NAME OF FARM:
OWNER 1 MANAGER AGREEMENT
I (we) understand and will follow and implement the specifications
and the operation and maintenance procedures established in the
approved animal waste utilization plan for the farm named above.
I (we) know that an expansion to the existing design capacity of
the waste treatment and storage kystem or construction of new
facilities will require a new certification to be submitted to the
Division of Water Quality (DWQ) before the new animals
are stocked. I (we) also understand that there be no discharge
of animal waste from this system to surface waters of the state
from a storm event less severe than the 25 year, 24 hour storm.
The approved plan will be filed on -site at the farm office and at
the office of the local Soil and Water Conservation District and
will be available for review by DWQ upon request.
I (we) understand that I must own or have access to equipment,
primarily irrigation equipment, to land apply the animal waste
described in this waste utilization plan. This equipment must be
available at the appropriate pumping time such that no discharge
occurs from the lagoon in a 25-year 1-day storm event. I also
certify that the waste will be applied on the land according to
this plan at the appropriate times and at rate that no runoff
occurs.
NAME OF FACILITY OWNER: Donald Miller
SIGNATURE: DATE: q 16 4 %
NAME OF MANAGER (if different from owner):
SIGNATURE: DATE:
NAME OF TECHNICAL SPECIALIST: RONNIE G. KENNEDY JR.
AFFILIATION: Agriment Services Inc.
PO Box 1096
Beulaville 5113
SIGNATURE: DATE: /� 7

NARRATIVE OF WASTE UTILIZATION PLAN:
DUE TO THE LARGE NITROGEN DEFECIT ON THIS FARM MR.
MILLER MAY HAVE 6 ACRES OF TRACT 5349 FOR USE OF
TOBACCO PLANTING FROM YEAR TO YEAR. HE DOES NOT NEED
THIS ACREAGE TO FULFILL THE AGRONOMIC REQUIREMENTS OF
THIS FARM. HOWEVER, NO WASTE SHOULD BE APPLIED TO
TOBACCO UNLESS AN APPLICATION IS USED FOR PREPLANT.
ALL FIELDS MUST MEET MONITIORING AND REPORTING
REQUIREMENTS WHEN USED. MR. MILLER PLANS TO APPLY HIS
WASTE IN ACCORDANCE WITH HIS SPECIFIC WASTE ANALYSIS
NOT TO EXCEED THE HYDRAULIC LOADING OF THE SOILS. 25
FOOT BUFFERS WERE TAKEN IN ACCOUNT IN THE CREATION OF
THIS PLAN TO PROTECT " WATERS OF THE STATE".
9/16/97
RONNIE G. KENNEDY JR.
TECHNICAL SPECIALIST

NORTH CAROLINA COOPERATIVE EXTENSION SERVICE - NC NMP
Field Background Information
Field Name: T71869,T5902 F1,F1
Soil Map Unit: BLANTON 0-8
Total ASCS Acres: 17.71
Total Useable Acres: 14.49
Soil Sampling Date : <ENTER>
Soil Test Class
Soil Test Results:
pH Acid CEC %BS P-I K-I Cad Mg% Mn-I Zn-I Cu-I
Field Irrigation Information
Average Soil Depth : 3.0+
Available Water Holding Capacity - 1.5 feet 1.0
Maximum Irrigation Rate - inches per hour 0.75
Maximum Amount per Irrigation Event - inches: 0.48
LIMITATIONS: This program is based on the best available data.
Since many uncontrollable variables can affect plant growth
and nutrient requirements, North Carolina State University Cooperative
Extension Service is not resposible for any losses incurred from
the use of this program. The software is provided 'AS IS' and
without warranty as to performance.
Printed :9/16/1997

NORTH CAROLINA COOPERATIVE EXTENSION SERVICE - NC NMP
Field Background Information
Field Name: T5349 F5-F9
Soil Map Unit: FORESTON 0-8
Total ASCS Acres: 19.35
Total Useable Acres: 15.89
Soil Sampling Date : <ENTER>
Soil Test Class
Soil Test Results:
pH Acid CEC %BS P-I K-I Cad Mgt Mn-I Zn-I Cu-I
Field Irrigation Information
Average Soil Depth : 3.0+
Available Water Holding Capacity - 1.5 feet 1.3
Maximum Irrigation Rate - inches per hour 0.50
Maximum Amount per Irrigation Event - inches: 0.72
LIMITATIONS: This program is based on the best available data.
Since many uncontrollable variables can affect plant growth
and nutrient requirements, North Carolina State University Cooperative
Extension Service is not resposible for any losses incurred from
the use of this program. The software is provided 'AS IS' and
without warranty as to performance.
Printed :9/16/1997

,,,--;WASTE-_UTILISATION.-P_L.AN _;-
ANIK71L WASTE UTILIZATION AGREEMENT
(toad-( aalr 1t additional load boa to ha ]aaaad, eta.)
L hereby give
permission to apply animal waste from his Waste Utilizatlon system
on r/.Qy _ acres of my land for the duration of -time shown below.
I understand that this waste contains nitrogen, phosphorous,
potassium, and other trace elements and when properly applied
should not harm my Land or crops. I also understand that the use
of waste will reduce my need for commercial. fertilizer.
Adjacent Landowner: 1 _ _Date
Waste Producer: ��� Date; JU-3a� 96
Technical Representative: Date : ZQ
SWCD Representative: Date:
Term of Agreement: /p/3o , 1.9 p6 to _ 10/30 20 O 7
(Mlnimum of as mars on Cost Shared Items) T �_
(Soo Required Specitication No. 2.)
0

URI--:•WASTE-UTIL-IZATION.P_L-AN • --
ANIMAL WASTE UTILIZATION AGREEMENT
(Xa.d.d aalr 11 8441tlooal 1Ja4d ham to h+ laaaad, etc.)
I , .JOB CA rKT hereby give Z �Aic� 'rYl ; 1�1�
permission to apply animal waste from his Waste Utilization System
on .S acres of my land for the duration of'tzne shown below.
I understand -that this waste contains nitrogen, phosphorous,
potassium, and other trace elements and when properly applied
should not harm my land or crops. I also understand that the use
of waste will reduce my need for commercial fertilizer.
Adjacent Landow
Waste Producer:
Technical Repre
SWCD Representative:
Date:
Date : _/,:p _
Date:. /p � o - ? l
Date:
Term of Agreement: /P /3p 19 9G to Z2 / 3L 20 o T
(Xinimum of ran Iaars on Cast Sharod ILe=s)
(Sea Roquired Speciticatian No. 2.)
0

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Site Requires Immediate Attenti n: /V©
Facility No. %tA
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATION SITE VISITATION RECORD
DATE: 2 .1995
Time: :!
Farm Name/Owner:
Mailing
County:
r L,l.C�2.
C:,,
Integrator: - 6�S/_Atc7z:�_ _ Phone:
On Site Representative: �1� //1� _,.,. _ Phone:
Physical Address/Location: _ • 3 H • /y•yc,
1-1,05-- Cry",
Type of Operation: Swine V Poultry ' Cattle
Design Capacity: / 2- � 7-OP Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude:° `1 Elevation: Fees
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches <9r No Actual Freeboard'`' Ft. Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes q %
Is adequate land available for ray? Yes or No Is the cover crop adequate? Yes r No
Cro (s) bein utilized S
P g �.
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? es r No
100 Feet from Wells? Yes r No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal, waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes q6 If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acre4ge with cover crop)? Yes or No
Additional Comments:
Inspector Name
41
cc: Facility Assessment Unit
Use Attachments if Needed.