310503_INSPECTIONS_20171231

NOHTH CAHOLINA
Department of Environmental Qual

1 • Div`i`sion of Water Resources
`Facility Number - Sp Divisi�Ag�ncyZi
Water Conservation
Other
Type of visit: O Compliance Inspection 0 Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit: O Routine O Complaint O Follow-up O Referral Q Emergency O Other O Denied Access
Date of Visit: / Arrival Time: Departure Time: County:
Farm Name: �'1 !`� �M Owner Email:
Owner Name: /gam I�QiMa.✓ Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Regionlc,
Design C*urrent
Swine Capacity Pop.
Wean to Finish I
Design Current
Wet Poultry Capacity Pop.
JLayer
Design Current
Cattle Capacity Pop.
Dairy Cow
Wean to Feeder
I
lNon-Layer
I
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Design Current
D.. P,oulti► Ca Be! I;o ,
Lavers
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Qther
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes To ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWR)
❑ Yes
❑ No [] NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ No ❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
o ❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
o ❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412015 Continued

Facili Number: 21 - ed 7 JDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes 5]Xo
[] NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes wro
NA
❑ NE
Structure I 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 /K�J'Fio
❑ NA
ONE
(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 ©'1Qo
❑ 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 1::-.Ko
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes �o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes [,;Xo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes JEJ to
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
/
❑ Yes []�O
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ®. T ❑ 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 [L]� ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
❑ Yes gg.`b ❑ NA ❑ NE
[:]Yes [E do ❑ NA ❑ NE
19, Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes
Q-?,Co
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
[] Yes
/
[E�
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? if yes, check the appropriate box below.
❑ Yes
o
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
[] Weather
Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
[ No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[ -No""
❑ NA
❑ NE
Page 2 of 3 21412015 Continued

Facilitv Number: 2 Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
L.0,X5
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
®
❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
[g-11o'-
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
IA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes [�o ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes �o ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes G],Qo ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
3 L Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes [ 1Go ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes �o ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 0 o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 2"N/o ❑ NA ❑ NE
Comments -(refer to question #). Explain any YES=answers and/or-anyFadditiottal recommenda.tions,,or any other liniments.
Use 'drawin s dffacilltyjom.better explain situatlon&,(use additional pages as necessary).'
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 210 36 Z5ZI
Date: / Z
21412015

type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Z Arrival Time:® Departure Time: County: lr✓"1 Region:,/
Farm Name:_ ? Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Phone: _
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current
SwiPa itM Pap.
Wean to Finish
Wean to Feeder
Wet Poultry
Layer
Non -La er
Design
Capacity
I
Current
Pop.
E]
Cattle
Dairy Cow
Dairy Calf
Design Current
Capacity Pop.
Feeder to Finish
Dairy Heifer
Farrow to Wean
D.�, P.ouit ,
Layers
JKLMOSUgn
Ga aci
Current
P,o P.
Dry Cow
Non -Dairy
I Beef Stocker
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Ot
Other
JEL
Turke s
key Poults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes �'No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ONo ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes JC2'No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes 2TNo ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ZNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continuer!

Facili Number: 3- ,3 Date of Inspection: 4-171
Waste Collection & Treatment
4. Is.storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes o ❑ NA ❑ NE
i
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 E 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 / ff 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 LD-Ro
❑ NA
❑ NE
8. Do any of the structures 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 ❑1To
❑ NA
D NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes ZNo
❑ 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 Cj.No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes �E;I'No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes ;2-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 ffKo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes pNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes EErNo
❑ 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 [2-Vo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes E�`No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes FD No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
DNA ❑NE
,❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: (- Date of Ins action:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ;2fNo ❑ NA ❑ NE
25. Ps the fadility 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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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? 1f 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
evNo
KNo
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
�!fNo
❑ NA
❑ NE
[:]Yes
PNo
❑ NA
❑ NE
❑ Yes
P No
❑ NA
❑ NE
❑ Yes
ONo
""VNo
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
Reviewer/Inspector Signature: �_ Date: 4/2— //zA
Page 3 of 3 2/4/2015

1
"� Di'vi"sion of Water Resources
�Famber 4 - ®Division of Sail and Water Conservation
+0 vy er Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: CrRoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I l! / Arrival Time: T ?, eq Departure Time: County: egion:
Farm Name: ��yY�a,.� r �� Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Phone:
Title: Phone:
Onsite Representative: {r,LA-C, _ L'1 p C rw_�
Certified Operator:
Back-up Operator:
Location of Farm:
Integrator: n 18
Certification Number:
Certification Number:
Latitude: Longitude:
Design Current DesiapGu1'�nt
C. Wet Poultry C+
Design CurrenSwine
Cattle C►apacity Pop.
Wean to Finish
La er
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
Dairy Heifer
Farrow to Wean
to Feeder
F6D;iesn Current
Dr, P,oultr, it P,o
La ers
on-La ers
pil
D CowFarrow
Non-Dairy
Beef Stocker
Beef Feeder
Farrow to Finish
Gilts
Boars
ullets
113eef Brood Cow
Qther
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence ofa past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge`?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
D NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page l of'3 21412015 Continued

Facility Number: jDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ED-No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes E '1Po ❑ 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 -EDNo ❑ 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 environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes �o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes E '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 )DINo
❑ 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 r
❑ 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 E'No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yess'fia
❑ NA
0 NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Ye§%
❑ NA
❑ NE
Required Records & Documents
N. 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
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists 0 Design ❑ Maps O Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes n,"'o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Tra�ns`fers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes fJ Z ❑ NA ❑ NE
23. If selected, did the facility fait to install and maintain rainbreakers on irrigation equipment? ❑ Yes No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

�0 3
Facili Number: jDate of Inspection:
24.,Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 7No ❑ 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. J�
❑ 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 2INo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes FNo ❑ 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:
❑ Yes 2fNo ❑ NA ❑ NE
❑ Yes lNo
❑ Yes No
❑ Yes No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 0No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes gNo ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers,and/or any additional recommendation's or any other comments;
Use drawings of facili to better explain situations (use additional pages as necessary).,
SC��e Ilbl nJ Ir -el S
w l4-. ILI) C
ql �
311011r
Reviewer/Inspector Name: Phone:3z3
Reviewer/inspector Signature: 1� Date:
Page 3 of 3 214,12014

Type of Visit: j2rCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: J2&outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Q Arrival Time: eparture Time: County: L4 Ir Region: �J/
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: Title: Phone:
Onsite Representative: Lc_a24ei Integrator: ! /I16
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Design C*urgent
Wet Poultry Capacity Pop.
La er
Cattle
Dai Cow
Design
Capacity
Current
Fop.
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
Design Current
Dr. Poultry Ca acit P,o P.
La ers
DairyHeifer
D Cow
Non -Dal
Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other_v
Turke s
Turkey Poults
10ther
Discharizes and Stream Impact
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes AnNo ❑ NA [:]NE
❑ Yes
,TNo
❑ NA
❑ NE
[—]Yes
,n No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (if yes, notify DWR) ❑ Yes 0—No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [2,lQo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters [:]Yes �o ❑ NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412014 Continued

Facility Number: 3 - Date of inspection: �!
Waste Collection & Treatment
4. Is`storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ENo ❑ NA ❑ NE
�~a. If yes, is waste level into the structural freeboard? ❑ Yes )ZNo ❑ 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
❑ 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 environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes �Eg No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes No
❑ NA
[] NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes 4No
❑ NA
❑ NE
maintenance or mprovemen .
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 E7 No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes .n-No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ NA
❑ NE
Reuuired 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 Z: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 E5'Ro ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes E3"'No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 6/No ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: - Ds ection: Q Z)
24. Did -the facility fail to calibrate waste application equipment as required by the pe t? ❑ Yes VfNo ❑ NA ❑ NE
11
25. Is the, faci�ity out of compliance with permit conditions related to siudge? If yes, check ❑ Yes ONo ❑ 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 rNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 7No ❑ 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 review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes P No ❑ NA ❑ NE
❑ Yes ErNo [] NA ❑ NE
[:]Yes PNo ❑ NA ❑ NE
❑ Yes ;'No ❑ NA ❑ NE
❑ Yes C"No
❑ Yes o
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Signature: LZ Date: 1O1..)-% 1
Page 3 of 3 2 4/201

Type of Visit: 0 Compliance Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit: outine 0 Complaint 0 Follow-up 0 Referral O Emergency 0 Other O Denied Access
Date of Visit: b Arrival Time: eparture Time: O Coun Region: G
Farm Name: !/'7G.�%fI11 IMI-Mc,7� IT1z71-1 Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: &14k�-.
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wet Poultry
Design Current
Capacity Pop.
Design Current
Pop
Cattle Capacity .
La er
DairyCow
Wean to Feeder
on -Layer
DairyCalf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Dr. P,oultr�
Design Current
Ca aci P,o ,
DairyHeifer
D Cow
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -La ers
Beef Feeder
Boars
Qthe
Other
IPUIlets
Beef Brood Cow
Turkeys
ITurkey Poults
Other
Discharees and Stream Impacts
I. Is any discharge observed from any part of the operation? ❑ Yes ;"No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other: T
a. Was the conveyance man-made? ❑ Yes eNo ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑Yeso
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
[ffNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[3No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[ No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

lFachity Number: - 0T11 jDate of Inspection:
Waste Collection & Treatment
4. h storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ;2- No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ;2-No
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: f --
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ��o ❑ 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 1/� No ❑ NA ❑ NE
waste management or closure plan? T
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 2Ti4o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ONo ❑ 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 PfNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes P"N0 ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.))
❑ PAN ❑ PAN > 10% or 10 lbs. [] Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes
❑ NA
❑ NE
�No
Yes No
❑ NA
❑ NE
❑ Yes �eNo
❑ NA
❑ NE
❑ Yes
P[&o
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
[]Yes {_,_�No ❑ NA ❑ NE
❑ Yes VNo ❑ NA ❑ NE
❑WUP El Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes )EI No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 9No
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA ❑NE
Page 2 of 3 21412011 Continued

Facili Number: - Date of Inspection: Q
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 ,E�j No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes ONo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes z 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 1;3No 0 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
2 No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
T
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[] Yes
J7No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ff No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
ff No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
�No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional as necessary).
_pages
/ad1G da dl�
-7 1 � / 1 '5 /, �q
ill 1/3
I / o 02
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: �� 7��
Date: 16
21412011

FaMity N6ffiUerg,
��.
1" :.11,:. 'O 15. ,. %.,..,,,
(Type of Visit A,Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit so Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Time: Departure Time: County:
Owner Email:
Facility Contact: 41 Title:
Onsite Representative: 60-'r4A
Certified Operator:
Back-up Operator:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Regionk✓__1fz_&2P
Location of Farm: Latitude: = e = [ = 4f Longitude: = e = ' 0 H
t F.. e�4;,. �i.�xy..}. y,.a. .. i tig•. N1 s`.N'�" ..
" > za, ;,, �neSlgrl' a`C1trr�etlt, eft . k`• .xS V;. "DesigwA Cgllrrent.:: i N • i Deslgn Current
'. �` Cd aCltb PO az'aW:et':POultr ,o ' ; » tt a'. $ • 8; ;'$ y>#ts1 a
Swlne pj y . `pulahon",. y�;Capacty PvPulat�on�, Cat�tle� Capacity Papulaton:
'E�+-�5`..
❑ Wean to Finish ❑ Layer ❑ Dairy Cow
❑ Wean to Feeder ❑ Non -Layer ❑ Dairy Calf r
❑ Feeder to Finish ? $ ❑ Dairy Heifer
❑ Farrow to Wean'DryxPgvultry`� `�"}, ❑ D Cow
El Farrow to Feeder ? ❑ Non -Dairy
❑ Layers
�] Farrow to Finish ❑ Beef Stocker
❑ Gilts s, ❑Non -Layers
❑ Beef Feeder
❑ Pulletsi
Boars � � ❑Beef Brood Cowl
s�,`Va+ ❑Turkeys m. ;
•Other 4y
': Turkey Poults
❑ Other ther ;''Number of Structures: ;�,
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge`?
❑ Yes ;aNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
J�2'No
❑ Yes
ZNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility.Number: Date of Inspection
Waite 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?
Structyre 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 eNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 01No ❑ NA ❑ NE
❑ Yes tONo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes P No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes PTNo ❑ 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 [3 NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes o ❑ NA ❑ NE
maintenance/improvement?
11, Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes /Z No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes )2No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes E1 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes K"'No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes VJ'No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ;2'lffo ❑ NA ❑ NE
Comments (refer to question #): 'Explain any YES answi ers and/or any m recomry�endahons ar ady'otherkcomments
°Use drawls s.of fa •t to better. eR Lain-sltuatlons.use addltlonai a e5 ,as neCessary).
'p
IReviewer/Inspector Name �' '' ;.;rY} wq.�; Phone: ^^
Reviewer/inspector Signature: Date: qzzt0
Page 2 of 3
1V28/0 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes j2TNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ]dNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other.
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ;2N0 ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
,no
❑ NA
❑ NE
24,
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
EfNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
RNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
6No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
fNo
❑ 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
,
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
JOIRo
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
4 No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
Z No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
CeNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency'?
❑ Yes
IJ No
❑ NA
❑ NE
Additional Comments and/or Drawings:.-6--
14
' �Cd� f'l�e �a c �Q`�
-7k110 ;1,2
-moo-:�� - 4 C
3/r/lb 1 T
1a11Y10? 1�c
Page 3 of 3 12128104

Type of Visit 'Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: D 0 Arrival Time: ,�QQ Departure Time: County: In Region: C'.JZ
Farm Name: .6g 44 `vo/-,r an n�� Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: ,,�� `` 'Title: Phone No:
Onsite Representative: 1/Sa h Integrator: U✓
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =o =I =" Longitude: 0o =, =
11
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish 7D O
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ La er
❑ Non -La et
Dry Poultry
❑
Layers
❑
Non -Layers
❑
Puilets
❑
Turkeys
❑
Poults
—Turkey
❑
Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heilei
❑ Dry Cow
❑ Non-Dai
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: =1
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 _01�o ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes TNo ❑ NA ❑ NE
❑ Yes—ONo ❑ NA ❑ NE
12128104 Continued

Facility Nupber: 3J —,5-0_ Date of Inspection /G G
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes .0-No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
❑ NA ❑ NE
Stricture 1 Structure 2 Structure 3 Structure 4
r
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 .0 No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes �jNo
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes _'No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes ❑-No
❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes J: No
❑ NA ❑ NE
maintenance or improvement? ,
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ YesE No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes _BNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 1bs ❑ 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) e( m8a /•A C. e j S fo ( w I. R , 0)
13. Soiltype(s) r—nrP57t7V1
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes �3 No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes 3—No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination, El Yes 12No
❑ NA ❑ NE
t7. Does the facility lack adequate acreage for land application?
❑ Yes ONo
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes Q-No
❑ NA ❑ NE
.� 4 _ ;_ � < � a s 91 .r �: /""` +5� - '. A' o -: 4 ee4 3 � e :<ila�'
#c Fr
Comm�entsre�fei„ta question,#),�Explain�any.YESanwer`andor�tnyr„ecoenmendattons or. any other comments
Usedrawtngs�of,fac�lity; tobetter'explain situations.+(useadditionalpages,"ecessary)t:
Reviewer/inspector Name ��
Reviewer/inspector Signature:
�'` °� ;� . ;., Phone:
Date: d G
12128104 Continued

Facility Ni*ber: 3 — g'Ct3 Date of Inspection
Re wired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes M No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check OYes ❑ No ❑ NA ❑ NE
the appropirate box.
❑ WUP ❑Checklists ,0 Design El Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield 0120 Minute Inspections ❑ Monthly and I" Rain Inspections ,Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
2No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
2'No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
.ETNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ONo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
4EINo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
.ENo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
J:�No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
E;.Pdo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
El NA
El NE
If yes, contact a regional Air Quality representative immediately
Jallo
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
2-No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
PNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
L:�No
❑ NA
❑ NE
alCoinme+ n`adraw
Me1zuSe�,
��� `�!
ar j��C�J CQmL,1r110
0�
UJec o-a r Cti c1R s
rec.6rh
rw of i`
12128104

Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Q1 Routine O Complaint O Follow up O Emergency Notification p Other p Denied Access
Facility Number Hate of Visit: 11 `x n Tune: O
10Not Operational 0 Below Threshold
0 Permitted © Certified 13 Conditdo]naallly Certified ❑ Registered Date -Last Operat& or Above Threshold: _.........._. ..
Farm Name: .....�,:._!. �...,/ �� ... f�!% County: „ Lr..:ZZ&V...................
...
.....
...»..........
OwnerName: ............................... » »...... »».....W» _... »_ _ ._.. _ _._W. 'Phone No: ........._..._........... .... ....................... _.............. ........
MailingAddress:..._. ._..._._........ ___ ._ _ .. _.__ _._... ___ __ ..... _ . w_ .._..... _......._._ ........ ............
Facilitv Contact: ........ /.......... ___-__--Title: Phone No•
Onsite Representative :,�fq/! LY1 1r� _.__...... Integrator• r/i�___ . Y Y. YW
CertifiedOperator: . . ................ . ........... . .... »....w_ .._ ._... _.......... , . __ Operator Certification Number:.M..._._.....»......._........
Location of Farm:
r1
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 " Longitude • 4 4;
(� DCiirrcnt`, rl Dgn esU� Desrga �Curreat
4.
Swine
Po'ulation, .,�EPoultry :� ci "Po ulatioii-,- Cattle , ,. aci -Po tuanon
Wean to Feeder A ❑ Layer q R❑ Dairy
Feeder to Finish ❑Non -Layer r Non -Dairy
Farrow to Wean?t.�N.,,.......,
-r
Farrow to Feeder Other
Farrow to Finish � ' Tatsi Dp�� 3 Capra
❑ Gilts
Boars
Q vow r e =i
'„C_.j y a 1
S
'.,' Tatal SSL`w
Number of Lagoons, ,�
r,
�' v,� � -+� r �r ri •1 sr N�c-Y
s. ..a ,p.q. i✓�i:z. '� ��.
Discbmes 8 Stream LnpaCtS
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Stricture 3 Structure 4 Structure 5
Identifier: _�� _.. _ .. .. .._._....._.._. _........ ............................. _._ _.. ..._........,
Freeboard (inches):
12112103
© Yes ,G-No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes -ONO
❑ Yes 2*90
❑ Yes
Structure 5
Continued

Facility Number. — Date of Inspection J-31
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑yes )2'No
.-r- seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ;2-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 12filo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes ,ONO
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes —E No
elevation markings?
Waste Aaulication
10. Are there any buffers that need maintenance/improve rent? ❑ Yes ETNo
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes J2-Ko
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground Copper Copper and/or Zinc
12. Crop type �yNi ci ' Gt l A' �P vet
13. Do the receiving crops differ/with those designated in the Certified Animal Waste anagement Plan (CAWNiP)? ❑ Yes No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes f:J 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 O'%
16. Is there a lack of adequate waste application equipment? ❑ Yes 2 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 i] 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 / " --
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 J R-Ro
Air Quality representative immediately.
G e
Reviewer/inspector Name
Field Covv ❑ Final Notes
ra
Reviewer/Inspector Signature:
12112103
Date: A,

Facility Number: _7/ Date of Inspection llIlI.L��
RenuirA Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ,E[ No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes ONo
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes j2-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 0'No
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes '21vo
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes P.Aio
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes PXO
28. Does facility require a follow-up visit by same agency? ❑ Yes ,.9?Oo
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes [;Wo
NPDES Permitted Facilities
30. is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ZT�es ❑ No
3 L If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes f3'No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes ,0"NO
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes [ZrNo
34. Did the facility fail to calibrate waste application equipment? ❑ Yes .0,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 Afar 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
[0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit. I
12112M3

(Type of Vlslt ZCompliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit .E)"Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number / (y Date of Visit: II ZZ OL Time: % ' +�
.�� 10 Not O erational Below Threshold
©Permitted M Certified -El C�onditionally Certified D Registered Date Last Operated or Above Threshold:
Farm Name: /&7T 4 ✓ pl_'* yr X County: ��'h
Owner Name: Phone No:
Mailing Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Location of Farm:
Title:
Phone No:
Integrator:✓
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse. Latitude Longitude
Design
Swine Ca aci
Current
%'.o ulation
Design Current Design Current
P,oultr Ca aci P,o ulal*on Cattle Ca aci " P,o ulat on
❑ Wean to Feeder
❑ Layer
❑ Dairy
Feeder to Finish
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design C*apacity
Total SSLW
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 l Spray Field Area
Holding Ponds 1 Solid Traps ❑ No Li uid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure S
Identifier: _ /
Freeboard (inches): 39
05103101
❑ Yes"No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes EE`No
❑ Yes B-No
❑ Yes 9-110
Structure 6
Continued

Facility Number: 3Z — Date of Inspection j
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste ADDlication
❑ Yes 0 No
❑ Yes 4 No
❑ Yes 0 No
❑ Yes ❑ No
❑ Yes JO No
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
O No
11.
Is there evidence of over application? ❑ Excessive Pondiing ❑ PAN ❑ Hydraulic Overload
❑ Yes
❑ No
12.
/
Crop type (.. �r0A
13,
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
�INo
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
ZNo
16.
Is there a lack of adequate waste application equipment?
❑ Yes
O No
Renuired
Records & Documents
17,
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
ETNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
No
19,
Does record keeping need improvement? (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
ZNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
Ej No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
0 No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
i. �.
C6murents (refer to,question;#) Explaiq any 1'S answers and/or any recommendations or,any,other comment ,g, gip, 3„t L'
Use ctrawingsYof facility to'bctter eX lam Atuiitions. (use additional pages as necessary) ' ❑ " �'
p_° Field Conv El Final Notes Ir,
14
t..r....n...,—.r.r.,..r—r.r...--.+rr.n�-/�` -
Ar ��4 Arfir'
p /o� 200' �v✓
,h�Jar .t��t �v.�.j � /f�� � % � 7 l
L L
Ad A4 O r t� 71tdf G /g �e/%D/7�. `S 14& Alt G 411,"�
T
r 7rf r - ..r
Reviewer/Inspector Name ,C5 .
_ F
Reviewer/inspector Signature: Date:�2-
05103101 v Continued

4
Facility Number: — Date ref inspection !/
4
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes E3"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 0 No
28. Is there any evidence of wind drift during land application'? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes P 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 P No
31. Do the animals Iced storage bins fail to have appropriate cover? ❑ Yes V1 No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes Z} No
1 lona -ommen an or' raWings-
j ; `oej
9.'Y.,
T

Type of Visit', ' ompliance Inspection Q Operation Review Q Lagoon Evaluation
Reason for Visit QlRoutine O Complaint. O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 3 s 3 Date of Visit: I J O 1 Time: 1 Z I
Q Not Operational Q Below Threshold
U Permitted 13 Certified [3 Conditionally Certified © Registered Date Last Operated or Above Threshold: ..................
Farm Name. ....... i!.�.L....I..... A o^!!! ��1, ..., a,.. ........................... County:... U ... j............................................................
OwnerName: ............. ). U.1c : '......N d . n-►r?'"'............. .................................... Phone No:.....,.................................................................................
FacilityContact:............................................................................... Title:................................................................ Phone No:...................................................
MailingAddress:................................11............................................................................................................................................`.1.......................................................
Onsite Representative: .!; in... nr.-.. ,Ann ....VQ��. ....+`.................. Integrator:.., ur'j�yV
Operator Certification Nu�ber:...............................
CertifiedOperator:................................................................................................................ p............I.............................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude s ° 46 Longitude s 4 06
• •Design " .Current Design . Current
swine ,- Canacift Pnnnlabnri Poultry Cg"r acfty; Pni mA i in" • Citittle 4
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
LJ � ;lo-. u jalry
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
• �Tota1�SSLW .�
" Lagoon Area Spray Field Area ,
Number of Lagooidis Subsurface Drains Present ❑ ❑
Holdrin Ponds ! Salid •Traps t ❑ No Liquid Waste Management System i '" ; t "
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes .0No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ,E!rNo
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes eNo
c. If discharge is observed, what is the estimated flow in gal/min? h J A
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes 0
2. Is there evidence of past discharge from any part of the operation? ❑ Yes 2"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 ;2110
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ................ ................... ...... ......... ..................... ................................... .................................... .................................... ....................................
Freeboard (inches):
5/00 Continued on back

Facili ' ' Number: -7 j - sd Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes ZNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ZNo
(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 ,fNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes PfN0
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ONo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes101&o
��tt
12. Crop type C d � ✓� I („� l'lBal 3 d �PY h` V�I� [ a e-4'1C, T eS6W &f2a 7-e
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? '0Yes ❑ 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 XNo
16. Is there a lack of adequate waste application equipment? ❑ Yes�No
Reauired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes,,,&N0
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes �No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) &Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes _Q440
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes �No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ,,&No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ,21"No
24. Does facility require a follow-up visit by same agency? ❑ Yes ,ff-No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? Yes ❑ No
yi01Aii0t7 s;off dg cue lcie$ vqre pe1 �43gt�js;v}s};Yojii eeie�off�ttAw. t
6 res' o Bence: abatiti this visit.
Cori ents'(refer toguestion #) , Explain enyt,YFS'answers and/or any, rpecyo�m„m/epned�etions'orr any othei co'Fmmffents(f'
I)Se�drawimg4'otfarllftjr t4`I etterc'eaplafn'situatiot s: (use additional page&M necessary)'.
1,3.,',,,_ V r I S I O a►-. of l 2 Ae ed nq�Qd qS esc.VC rn 4 kC lnlaAe pIa�
ThGie 1"ClAs ap tie ,,,.►eSS �n0� �wrn�1G�o4
ensure s4 �61h 6ii Ol Gry in 42C -ieId Ark «, a fee+'Ie1]a.
JVeedi - �� hA3 hIa e �o
`& svre 4v toe et �*4a q►'WI its Amded I..�.-jk;� 64 dAy.s or rid, c.Gt�►`�h
cven4 ,a on -Pine -:50, 2+4 , geysvre +'0 cites a 4a p" 1 C eo f on +c
:5ai1 sev-,piler. 1`1ecd 4o kee f 2-2'S fey, -&esC.ve Gro by Grow�''�
SeaSb"N o,r GCIepAae `ecir. M.^. lllo��,� hoo aL, st? 1-}Jk,ft} clv*lj—
a
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: "A 0 j 5100

Fac4ity Number: — j p3 Date of 111spection ►f /C�
f
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or Iagoon 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 CTRO
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes /2 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 M-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.) ❑ YesO'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
AdditionalKointnentsand/or, Drawings:
�� {ca►��� �� Tke
`s des Y►c, eOl �a� II )0 ►���p lathr n. �
neeA,5 46 ��5svfe 4-.o,-� Aff-'ccord +vt4tL1 4e
woo4e IOWh a-\d 4W G1'o� ;'
25. P^.r4s W 19UPS 6 ct�d 9 arse on bew,✓dal avid rarJ oh
Aow G-rO f S. /Vee„l 4D ka\jc 4e0A rZ► Ga ,q 1+ �� e1Vq� S ri h�
gc�ca �or CAol^ C'r t"\ eaG� �ot�l qn a( is be 7�,e �or��or.s
o(;9�,rc. r y �p r��d ,�GGrd kw;'Nj f�%Ie
be, as yCcQs A '� q�d r+�ca�d k�o9
r v;r)Olows ih +"t° was4e yhn nmd 4v /0&
Na-1e : `T`),e - ��>�✓d� ��+� �cndl ��-�e greG ot✓o�.n�
411e f.ew--!res An,4 Ioyvo►% is ,lec14l j kefV
J
5/00

g ` ,O Division of Water,Quality
0
P Water Conservation
Drv�stoa"of Soiland
r, Q [Other;Agencyr
e„
e.
(Type of Visit O Compliance Inspection Q Operation Review Q Lagoon Evaluation j
for Visit •O Routine Q Complaint Q Fallow up Q Emergency Notification Q Other ❑ Denied Access
Facility Number 31 503 Date of Visit: 11-14-2041 Time:
12:10
Not O crational O Below Threshold
® Permitted ® Certified [3 Conditionally Certified E3 Registered Date Last Operated or Above Threshold: _.-..._ _.
Farm Name: QAkGh.l!iarwaAJF.axm............................................................. County: DXzdjU.................................... } JJjQ--•--•
Owner Name: -------------._--.- NDr tl._._----------------------- Phone No: 9J.QZ$9 _4LQ�_ .--- ----- - ----- ---------
MailingAddress: ��.>3Q.................................................................................................S?S.Mill..N........................................................,4t..............
Facility Contact: ...........................................................Title:........................................... Phone No
Onsite Representative: �I1tCb.&Aiw.L�4x>x1aA.----------- Integrator:�pjiy��fpl�y�g----------- _
Certified Operator:ftlel..W ............................... t!IAx'.irll a............................................ Operator Certification Number: t.7.2S7..............................
Location of Farm:
Dn SR1953, approximately 2 miles east of Greenever. (on northwest side of SR1953.) A,
T
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 34 • F 50 D6 F30 Longitude 77 • 53 11
Design Current
Swine Canacity Ponulation
❑ Wean to Feeder
® Feeder to Finish
4896
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non Layer I ❑ Non -Dairy
❑ Other
Total Design Capacity 4,896
Total SSLW 660,960
Number of Lagoons JE1 Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps JE1 No Liquid Waste Management System
Discharges & Stream Imeacts
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 I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1............. ........................... ......--•--•--•--•--r--•---•--.--•--.....-•--r-----............................. ...........................
Freeboard (inches): 49

f
VJib:D�JI ,-
Facility Number: 31-503
Date of Inspection 11-14-2001
""roue"
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes ®No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ®No
12. Crop type Corn, Soybeans, Wheat Coastal Bermuda (Graze) Fescue (Graze) Small Grain Overseed
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ® Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
16. , Is there a lack of adequate waste application equipment?
Required Records &_Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
10 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
( a # • l±,x lam an Y
ai y! $answers and/or an 'recommendations or any other comments Comments refer<to,
ystion
o better explain
Use:deawin s.of, facU t' p ions (use additional pages as necessary) ? ❑Field Copy ❑Final Notes
13. Pulls 10 and 12 are designated as Fescue in the waste plan. These fields appear to have mostly summer grass and Bermuda. Need to
ensure that waste plan and crop in the field are in agreement.
_+
19. Be sure to use a waste analysis dated within 60 days of application event on the IRR-2's. Be sure to designate the proper crop on the
soil samples. Need to keep IRR-2's for Fescue crop by growing season or calendar year. Mr. Norman has an IRR-2 that shows an
application on pull 10 on small grain. Fescue is designated for pull 10 in the waste plan. Mr. Norman needs to make sure that the
application records match the waste plan and the crop in the field.
w
Reviewer/Inspector Name Stonewall Mathis. entered by Bette Rose
Reviewer/Inspector Signature: Date:

05103101 Continued
Facility Number: 31-503 Date of Inspection 11-14-2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below . ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
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, mussing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ® No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ®No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional omrnents an orDrawings: �, r
25. Parts of pulls 6 & 8 are on Bermuda and part on row crops. Need to have technical specialist evaluate the acreage for each crop
in each pull and label the portions differently to aid in record keeping. The waste plan should be modified as necessary and records
kept accordingly. The application windows in the waste plan need to be followed.
The Bermuda fields and the area arould the houses and lagoon are neatly kept.

f
gi ty
°DrVlsyon' of Water QU li �
0 ej
Division of Soil and Water Conservhtion
•
O'Other Agency;. ;< t
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0• Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 3l 503 Date or visit: 11-14-2p01 Time: 12:10
0 Not Operational 0 Below Threshold
® Permitted ® Certified © Conditionally Certified p Registered Date Last Operated or Above Threshold: ...
Farm Name: H.UtChAuruman.JEarm............................................................. County: 1)xWitx.................... ................ WIR0 ......
Owner Name: �u------------------- 1�91n-- ----------------------- Phone No: 4JA$9 =4,Q9------------------------------
MailingAddress: jP..QBQ;K.3.$............................................................................................... RQNI;..Wg..NC ........................................................ Z8.45A ..............
Facility Contact:........................................................... Title: ............................................... Phone No:
......................................
Onsite Representative:tCb.&�?JIU.L�CRimeR----_-.-_--._---_-----_-- Integrator:l�uzp�apa)(yk�------------------•
Certified Operator: Rlatwt~b..W................................. Norman.................... ... Operator Certification Number: )L7�.7,,,,.,,,,,,,,,,,,,,,,,
Location of Farm:
:)n SR1953, approximately 2 miles east of Greenever. (on northwest side of SR1953.)
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 34 • 50 16 30 fL Longitude 77 • 53 11 «
Design Current
Swine CanaeitV. PODnlation
❑ Wean to Feeder
® Feeder to Finish
4896
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ GiIts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑Dairy
❑ Non -Layer ❑ Non -Dairy
. .. . .:........ ......
❑ Other
Total Design Capacity 4,896
Total SSLW 660,960
Number of Lagoons ❑ Subsurface Drains Prescnt ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds I Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ® No
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ) [] Yes 0 No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes 0 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 Stnicture 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ............. 1............ ............................ -----•---------------------------------•-------.._............ .....
Freeboard (inches): 49

I
UJ/UNU, �N
Facility Number: 31-503
Date of Inspection 11-14-2001
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
12. Crop type Corn, Soybeans, Wheat Coastal Bermuda (Graze) Fescue (Graze) Small Grain Overseed
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ® Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15, Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ®No
® Yes ❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about visit.
{this
Comments (refer to:questron #) Ezplam any YES,,,answers andlor any recommendations or any other commentsa
Use,deawings of 66ilfty�to better explain'sjtuatrons. (use.addrtwnal pages,as�)necessary) ❑Field Copy ❑Final Notes ' `)
; ,I
13. Pulls 10 and 12 are designated as Fescue in the waste plan. These fields appear to have mostly summer grass and Bermuda. Need to
ensure that waste plan and crop in the field are in agreement.
19. Be sure to use a waste analysis dated within 60 days of application event on the IRR-2's. Be sure to designate the proper crop on the
soil samples. Need to keep IRR-2's for Fescue crop by growing season or calendar year. Mr. Norman has an IRR-2 that shows an
application on pull 10 on small grain. Fescue is designated for pull 10 in the waste plan. Mr. Norman needs to make sure that the
application records match the waste plan and the crop in the field.
Reviewer/Inspector Name Stonewall. Mathis entered by Bette Rose
Reviewer/Inspector Signature: Date:

OSIV3101 Continued
Facility Number: 31-503 Date of Inspection 11-14-2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ® No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ®No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additionat CommentS 8n Or;, raW1i1S s� , ,°�;;,_1, ;y, < �� ! t ;
25. Parts of pulls 6 & 8 are on Bermuda and part on row crops. Need to have technical specialist evaluate the acreage for each crop +
in each pull and label the portions differently to aid in record keeping. The waste plan should be modified as necessary and records
kept accordingly. The application windows in the waste plan need to be followed.
The Bermuda fields and the area arould the houses and lagoon are neatly kept.

i
t , Al Divisiontof Water Quality
Division ofSorl°and Water Conservation,
Q`OtherA'gency.
.-
]Type of Visit © Compliance Inspection O Operation Review O Lagoon Evaluation ]
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 31 503 Date of Visit: 11-14-Z001 Time: 1Z:10
Q Not Operational Q Below Threshold
® Permitted ® Certified 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: HUtell.NQr1P2AJF4XM............................................................. County: Dawilt.................................... WIRG......
Owner Name: �u------------------- lY9t)--------------------------- Phone No:_,iQ9------------------------------
MailingAddress: JpA. ............................................................................................... Ro5e. C........................................................ 18.45.8 ..............
Facility Contact: ...........................................................Title Phone No
Onsite Representative: 11]ttcb_�cAriU.NAXUIOR.-------------------_------- Integrator:�pjyJpll`y�tiy�------------------.
Certified Operator: l r.11 .. ............................... Noirmaix............................................ Operator Certification Number: 1.7257..............................
Location of Farm:
3n SR1953, approximately 2 miles east of Greenever. (on northwest side of SR1953.)
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 34 50 i 30 fG Longitude 77 • 53 ° 1111
Design Current
Swine Canacitv Ponulation
❑ Wean to Feeder
® Feeder to Finish
4896
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I ❑ Dairy
❑ Non -Layer I ❑ Non -Dairy
❑ Other
Total Design Capacity 4,896
Total SSLW 660,960
Number of Lagoons 1 ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps JEI No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ® No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ® No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ® No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4, Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ®No
Structure i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ............. 1............. ........................... ..........................
Freeboard (inches): 49
ne ma in■ r-...._... ...f

ul/awut t.unrrnuea
Facility Number: 31-503 Date of Inspection 11-14-2001
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Apnlication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes ® No
❑ Yes ® No
❑ Yes ®No
❑ Yes ® No
❑ Yes ®No
❑ Yes ®No
❑ Yes ®No
12. Crop type Com, Soybeans, Wheat Coastal Bermuda (Graze) Fescue (Graze) Small Grain Overseed
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ® Yes ❑ No
I4. a) Does the facility lack adequate acreage for land application? ❑ Yes []No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
16. ' Is there a lack of adequate waste application equipment?
Required Records & ,Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes [--]No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
- :: ,
Comments refer to # Expla►i� any YE5 answers and/or any
{ q" ) `, mendations or,an other comments
_.__...__..
Use. drawings, of facilrty to better explain situations. (use additional pages as necessary) f❑ Field Copy Final Notes
13, Pulls 10 and 12 are designated as Fescue in the waste plan. These fields appear to have mostly summer grass and Bermuda. Need to
ensure that waste plan and crop in the field are in agreement.
_
19. Be sure to use a waste analysis dated within 60 days of application event 'on the IRR-2's. Be sure to designate the proper crop on the
soil samples. Need to keep IRR-2's for Fescue crop by growing season or calendar year. Mr. Norman has an IRR-2 that shows an
application on pull 10 on small grain. Fescue is designated for pull 10 in the waste plan. Mr. Norman needs to make sure that the
application records match the waste plan and the crop in the field.
Reviewer/Inspector Name Stonewall Mathis entered by Bette Rose
Reviewer/Inspector Signature: Date:

0AOM, Continued
'Facility Number: 3l - 503 Date of Inspection 11-14-2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ® No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ®No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Add bona . C ommen ts°an or` raw ngs. E aE:
25. Parts of pulls 6 & 8 are on Bermuda and part on row crops. Need to have technical specialist evaluate the acreage for each crop
in each pull and label the portions differently to aid in record keeping. The waste plan should be modified as necessary and records
kept accordingly. The application windows in the waste plan need to be followed.
The Bermuda fields and the area arould the houses and lagoon are neatly kept.

'4
r. .
Facility Number d Date of Visit. 'Circe: Fi 3 _ 1POnled on: 7/21/2000
,,,,, .. Q Not Operational O Below Threshold
Permitted Certified 13 Conditionally Certified © Registered Date Last Operated or Above Threshold:
Sv �G � /V d >r'VI P (-G ✓"� County: u �.................................2.0...
Farm Name. ............................... ...........�'1.......... %.. ..
OwnerName: ................. Ev*'..... ? .! .Cf !'4................................................ Phone No:......�1..0r.....................................................................
FacilityContact:.............................................................................. Title:...................................................... Phone No.
MailingAddress: ..................................................................................................................... .............................,......./..../......................�.............. ..........................
Onsite Representative: ........ &V4A '..'! .....�`C.........................................I Integrator:.........'..!......r.`.................................................
Certified Operator: ............... ...... �„!' oy-'-,Cv✓1 ..... Operator Certification Number:......(,.? .5�....
Location of Farm:
rN
swine [I Poultry []Cattle [I Horse
Latitude �' �� �i° Longitude �• �0°°
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer ❑ Dairy
eeder to Finish Z/ ❑ Non -Layer JCI Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons JE1 Subsurface Drains Present ❑Loorea ❑ 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? Cl Yes r
o
Dischargeoriginatedat: ❑Lagoon ❑SprayField ❑Other
a. If discharge is observed, was the conveyance nian-made? ❑ Yes [:]No
h. ff discharge is observed. did it reach Water of the State'? (Iryes, notify i.DWQ) ❑ Yes o
C. If discharge is observed. what is the estimated flow in gal/trtin? / /❑
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 KNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes �o
Structure I Strucluru 2 Struclurc 3 Structure 4 Structure 5 Structure 6
Identifier: ....................................................................... .................
Freehoard (inches):
5100
Continued on back

Farility Number:3 I— 03 Date of Inspection 74 0o Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑Yes Vo
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 VNo
(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 V0
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yeso
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ' No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes *No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes o
12. Crop type W 4
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes o
14. a) Does the facility lack adequate acreage for land application? ❑ Yes -gNo
b) Does the facility need a wettable acre determination? El Yes
1
c) This facility is pended for a wettable acre determination? ❑ Yes
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?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, reaps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge'?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
24. Does facility require a follow-up visit by same agency'?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
yiolations:or deficiencies were noted during Ibis;visit: • Yoti <fl. - �eeeiye fio: f'urthgr ,
icorresporidetrce. Acrut. 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):
r4 rr J
n► f o o k5 5 & cj. 0 4e-./ 4 4s
;,, "-c, .-'t e-
❑ Yes �(No
❑ Yes Nc
❑ Yes No
❑ Yes o
❑ Yes No
❑ Yes �.No
❑ Yes o
❑ Yes o
❑ Yes No
a
u

Facility Number-31 Date of Inspection r'� Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or brlow ❑ Yes CN
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes o
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes o
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes o
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 0
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes / o
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
I'AdditionaUComments and/or Drawings:
❑ Yes( No
A
5100

sion of Soil andnservataon�-, perafion
iru.
(] Division of Soil andWater, Conservation'- `Co`mn liance1iispectron
Division of Water Quality Compliance Inspection
,-.
is [ Other Agency Operabon.Revi-e
Routine Q Complaint Q Follow-up of DWQ inspection Q Follow -tip of DSWC review Q Other
Facility Number Date of Inspection �-
Time of Inspection 9WF 24 hr. (hh:mm)
Permitted 19 Certifieed/ © Conditionally Certified © Registered 113 Not 00crationall Date Last Operated:
lf�Xla^ .t........................ Y County: k�li- /...�...........
FarmName: .....f�:rN. a ..................... ....... •............�.,.........Y...�:..............._.......... �-.Q,,............
Owner Name:......... .41"!`C...................................................... Phone Not ....... Mjo-) ..... :''!''!#....
Facility Contact: ......EJW:te,.�.......... ......Title:........ L?WW.✓................. Phonl o t...q ... .-."p"v-1
Mailing Address: ...... R, P.: ...... Sox .......... im ......................................................... ........... J�y ......... ) ..... 1/, ... f ... / ... 6 .......... . wx� ....
Onsite Representative: . r�r:�..... —flog ........ Integrator: ............ ........,............................................
Certified Operator: ........&, C'.k..................... Operator Certification Number:..... �..7 .............,
Location of Farm:
A
................................ .... ... ......................................................... ................. ..... .. Y
Latitude ' ° " Longitude • ° ig
Design Current Design '-Current Design Current
Swine Capacity Population Poultry '.Capacity Population Cattle Capacity.Population
❑ Wean to Feeder ❑ Layer ❑ Dairy
„0
Feeder to Finish 1E] Non -Layer '`' ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
Farrow to Finish Total Design Capacity
❑Gilts
❑ soars " Total'SSLW
i :. „ Number dLagoons,, ❑ Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area
HoldingPonds / Solid Traps p. . ❑ Na Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes [� No
Discharge originated at: [3 Lagoon ❑ Spray Field ❑ Other `
a. If discharge is observed, was the conveyance man-made.'? ❑ Yes (W`No
h. Irdischargc is observed, did it reach Water cif the State? (If yes, notil'y DWQ) ❑ Yes /[.No
c. if discharge is observed, what is the estimated flow in gal/ruin?
d. Dues discharge bypass a lagoon system? (If ycs, notify DWQ) ❑ Ye %.No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ENo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes /19 No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 9 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure b
Identifier:
Freeboard(inches): ....... 4.....................................................................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes A No
seepage, etc.)
3/23/99 Continued on back

Facilit'J41Vuntber: 3 t �p 3 Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
[�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
4No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
)9�'No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
KNo
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
KNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
[(No
12. Crop type S S
ll
13, Do the receiving crops differ with those esignated 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?
KYes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
ANo
16. Is there a lack of adequate waste application equipment?
❑ Yes
No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
[ No
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
OdNo
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
PdNo
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
F No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
9 No
23. Did Reviewer/Inspector fail to discuss'review/inspection with on -site representative?
❑ Yes
X No
24. Does facility require a follow-up visit by same agency?
❑ Yes
qNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
/V No .
.. . . yi. . tion-s;oT .l Qciertd�l * re Noted• 00t ng tbisMS.R: • Y:oo wifl•reboiye fio furthot
icorres�ondence. vut. this .visit. .... . . • • • • . . . • • • . '
C.omnents (refer to question #)• Explaan any. Y.ES answers and/or any. recommendations orany otlherrcoinments
,, ...t z s
Use drawings of faaciltty=toi better' explain situati"ons (use additional tsages as necessary.) ' �,'
7,14141/c�
Gy`� z7aYzaor�S'S /�derl) akp"!
►� Gr`l ` Goo tea!
��� w i�tl gam-. ��riz zll
J
e � e
G'�o�tu rc ;fin i s / A /tcpr11S . —
Reviewer/Inspector Name i ' Gi��� ry Y✓ n , .art'° r " °„ " .,n
Reviewer/Inspector Signatu Date:
3/23199

F. cilitj Number: 3 Sb 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
N0
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
�NQ
30.
Were any major maintenance problems with the ventilation fan(s) noted? (Le. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
JWNo
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
A(No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
ANo
itlolld .p.,� 4Il1IiEClltS and/or Dra*iggs � , i,',, 1 , . t
3/23/99

❑ DSIVC Animal Feedlot Operation Review
m DNN'Q Animal Feedlot Operation Site Inspection
Routine O Com iaint ' O Follow-u of b%N,*( ins cction O Follow-up of I)SWC review O Other
Date of inspection .1 EUK—R
Facility Number a Time of Inspection 2 = 24.hr. (hh:mm)
©Registered PLCertified © Applied for Permit 0 Permitted JE3 Not O erational Date Last Operated:
FarmName: .....................N.0. 11!u„I............S .................................................... Cduntr:.........��..............................................
Owner Name: ............................... ........N.Qry ,.&r......................... ...... Phone No:....��i.Q� M. --:a
Facility, Contact: ..... Title Phone No:
MailingAddress: .................2........�lk�... �.................................................................. ...... 9AS&.... �.t.�.�.. lhrC..................................... ..�-?4'a.�.....
w p Onsite Representative:- ..............�u. lNArl�fl�r- ...... Inte«rator: l"
Ai
����............_..................
Certified Operator;............................................................................................................... Operator Certification Number ...........
Location of Farm:
A�.....Jt�A.....WC...C.....C.....t,i {�:...nat,..S...5R1i. 1aJ�.5�...Q......%kt 5
.... ....... ...... .... ... .............................................. .. .. ... ..
Latitude Longitude �• �' �"
a Design ; - , Current
; zzDesign .` . Current .. Design } Cu ents, `
$wine r,r s ,9 .Capacity. "Population
..Poultry
Capacity :Population , CattlePopulation
r-;
El Wean to Feeder
❑ Layer
❑Dairy
:
..
Feeder to Finish
I0 Non -Layer I
ElNon-Dairy"'
Farrow to Wean
❑Other
t
❑ Farrow to Feeder
❑ Farrow to Finish
Total Design Capacttjr
:
❑ Gilts
ElBoars
Total SSLW
Al
VNumber.of Lagouas,/-HoldingPonds Z� ' ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spra} Field Area
❑ No Liquid Waste Mana-ement System KKr ` 4y
General
,or I. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge ori6nated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. [f discharge is observed, wac the conveyance man-made'.
b. If dischar�,e is observed, did it reach Surface Water? (if yes, notify. DWQ)
c. If discharge is observed, what is the estimated flo«• in gal/min?
d. Does discharge bypassa. 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 manacement system (other than ]agoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7I25/97
❑ Yes *No
❑ Yes rd No
❑ Yes No
❑ Yes No
[I Yes' T No
❑ Yes No
❑ Yes [� No
❑ Yes No
❑ Yes No
❑ Yes No
Continu doh back

Facility Number: —
8. Are there lagoons or storage ponds on site which need to be properly closed? (� Yes No
Strucitire, (Lagoons,Ilolding Ponds, Pits, etc.i
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...0_0.............. tJ1.),W.
Freeboard {ft : 3 4.. .... ....... 1....
10. Is seepage observed from any of the structures? ❑ Yes Art 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? 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 CRNo
Wastp Application
14. Is there physical evidence of over application? ❑ Yes jj No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type .................. 6yshULL ................ s2ftll...... A.11n.................... . h............. .a.........................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? EgfYes ❑ No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes M No
18. Does the receiving crop need improvement? ❑ Yes Z No
19. Is there a lack of available waste application equipment? ❑ Yes 10 No
20. Does facility require a follow-up visit by same agency? ❑ Yes fO No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes No
22. Does record keeping need improvement? Yes ❑ No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available? El Yes O No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? Yes ❑ No
-01 25. Were any additional problems noted which cause noncompliance of the Permit? Yes ❑ No
No.vioEations or deficiencies were noted during this,' visit. Yo'u.r�iil receive no further
correspondence Ah:out this:
1.eOd �, K Ss64 IC_ �orr.p�Ct'�y �fl5e� dJ ; C�o� ���' old � p�001ti SkNid
ki f )2. 04- f N LJ � �L5 i In 00 1w ° VON S�U 6 Log- rtaY�1tlVltU. � � OS?ovx aArc Or, i t 1r11r�
OUJ U— a* e wo 0�
�o� S�oc�icl be. tt�u� a�� G �CScep�C�. gAt�c
o+.�c,� s �) b� rtvet.. , 04OAc (,Wad( ,t &ceX 4 old (cooly Stw,))c1
b.i e� [,e.a,sc� l Stull i lac. � i�ita� '�"%,r W UP k/ ,
I L .I zz. �Il c�rr7 � S � b e-11'� 1 - , �
pA rj (oo d 1+\ rt�S . 5q�i M— 2 S�oU [� b, �e r L,,C Ck7/25/97 T
Reviewer/Inspector Name
Reviewer/Inspector Signature
Date:

Facility Number: ..... I L .... . .. Date of Inspection: 2 �
7-4' Jos .
O vty r,. -, w4tav, tr- ry EY Cr-- I ^J
�7,Q -IL 4 70 7 0
) 9L.-3#
1bs�tQ e-
I Q-6
{d
5 hrU �U 5 U bT7'Q x►n t'!N
1`C 0 kJ' n� CYt�
If l �j-8 A pa,--
Cii, �, Y►c-e ,
4/30197

.t • M.
;�.; 5 �.S '. yy e R - q;}07� �;z� � : �`"Qs {�`
�L Y� k � {4
❑DSWC °Animal Feedlo_ t Operat[on Rvlew {
MR
j�DWQ =Animal FeMot Qperat[on Site Inspection
Y.K
O Routine O Complaint O Follow-u of :[)W inspection O Follow-up of DSWC review O Other
Facility Number Date of Inspection
Time of Inspections 1 I El 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: Registered ❑ Applied for Permit (ex:1.25 for 1 hr .15 min)) Spent on Review
❑ Certified ❑ Permitted or Inspection includes travel andprocessing)
❑ Not Operational Date Last Operated: .... . ..... . .. ...............
FarmName: ........ 11V.1.� ....... ........................ .........................
Land Owner Name:.... v!��:A........1....Y.zKr 'CAM .......................................
County:.1Lida.: ............................... .# ."
Phone No: ...... �i©.-..`..—.�?>.................................
FacilityConctact:...........................................................-..................... Title: ........................................... ....(Phone No: ..... ............... ........ _...... .........p.......
er
Mailing Address :.:.(,...B.............. ».......... ................. .............................�bSC:...i:,..l��.............................................gi;?......
Onsite Representative:.. Y1 Q... .�a.. ........................ . ..............................................
Certified Operator: .3"'tcrk.... Yv............. �$l �t�.......................... Operator Certification Number: ..... 1.12S-2............. ....
Location of Farm:
Latitude • SO 3°-" Longitude ©• ©` �`
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes I& No
2. Is any discharge observed from any part of the operation? ❑ Yes 09 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 gaUmin? I.
In
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 9[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 V,No
4/30/97 maintenance/improvement?
Continued on back

Facility Nauiber:...... —.. .!?.
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
RNo
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
ffNo
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
99 No
Structures (Lagoons andLar__Iloldiag Ponds
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
IgNo
Freeboard (ft): Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
b.... ............ _..... ........ ....... ..-................. ............................ ............................
..........................
-
10. Is seepage observed from any of the structures?
❑ Yes
9No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
I4Yes
❑ No
12. Do any of the structures need maintenance/improvement?
E4 Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
I3. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
Iallo
Waste Application
14. Is there physical evidence of over application?
❑ Yes
KNo
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type . h !:- ........ ... �tio -..r��r►..1.r�..............................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
R1No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
9 No
18. Does the receiving crop need improvement?
9 Yes
❑ No
19. Is there a lack of available waste application equipment?
❑ Yes
® No
20. Does facility require a follow-up visit by same agency?
❑ Yes
9 No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
19 No
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
9No
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
ILNo
24. Does record keeping need improvement?
® Yes
❑ No
Comments jrefer to„questton #) Explain any YES.answers'and/or;any recommendations of any other camzrtents
Use drawings;of facility�to better explain situattonsr (use additional pages..as necessary) u
11. r 1 Z• $, • , . t 1 t .�v 3 ; .� c l� o ,.. rwtS �--vwe S v {r� t� •�, c v. ¢ i a c c4 0 >,. o
w a l l. T� e- C'-ti-e-wd "�^ t b E } UL.L a 'Ar v g e E a L Q.d. 4 v a I- c
t'- e e. S bn, V t b C_ v e- -c V-XA (-w W" l 1 0 0 w n. M' A is a� t, --o v-e A-o w
V_ r W0.
L 1}. C K t enti a v t +r `a L `
j 1a i p Qd O vl , "� , rn t. e_ w. 1 +
d t ti` i ri.,+ a l l w e-o�,.- //t'`-o u141-S w•—d i! I ;.,.
by f e u Ic C" v I.v. r' v .•,.. P k a f Q C-v �.. v� a tCr d 1'.r .
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Reviewer/Inspector Name
Reviewer/Inspector Signature: aX1-1 , o , r_ , M _ Date:
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit . 4/30/97

Site Requires Immediate Attention:
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: '�f 3 , 1995
Time: 4' • DO ►r!
Farm Name/Owner: Buf6n Mormon
Mailing Address: iD P_ 0 X _ f�U52
County: 1
Integrator: Krobje Phone:
On Site Representative: Phone: Zgq- 00 4-
Physical Address/Location:
P I
Type of Operation: Swine _V�' Poultry v Cattle r Sh
Design Capacity: Number of Animals on Site: 46 1 &
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: "'21 _° _,dL_'1" Longitude: _21 ° S3 + {O Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Ye or No Actual Freeboard; 3 Ft. Inches
Was any seepage observed from the lagoon(s)? Yes o No Y Was any erosion observed? e r No i / 0r^
• Is adequate land available for spray? Ye or No Is the cover crop adequate? Yes or NoG{J�
Crop(s) being utilized:
al_rO
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Yes or No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? 'Yes o No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes o No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes o No If Yes, Please Explain.,
b;
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? s No
Additional Comments:
rid -a
Inspector Name Signature
cc: Facility Assessment Unit Use Attachments if Needed.

•
Site Requires Immediate Attention: _
Facility No. 1- r.0612
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPER.ATIONS SITE VISITATION RECORD
DATE: 10 - cf , 1995
Time:
Farm Name/Owner: or—m ?r►'LF--;ny 551 i5ufc i korn 2n
Mailing Address:
Country: _ Oyto1;/1 — - -
Integrator: luryh� _ Phone: -ZnS!l
On Site Representative: Phone: R89 -4-500
Physical Address/Location: 59 lq53 m,, fr) orrn f� _
. arm Oil �hf� U
Type of Operation: Swine Poultry Cattle
Design Capacity: 45060 Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
1.,atitude: 3�' ' Sv �'' Longitude: -22_' 53 ' TZ�j!' Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches)&orNo Actual Freeboard; Ft. Inches
Was any seepage observed from the lagoon(s)? Yes o No Was any erosion observed? Yes or No
Is adequate land available for spray? es or No Is the cover crop adequate? Ye or No 5Qe
Crop(s) being utilized: 2S — — 5om� -we �i�e - S ou�� /ICE+ IJ2 Sb►'?+�1 C'1
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? es r No �j
v 8>
100 Feet from Wells? . Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system. or other
simalar man-made devices? Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acrea.ge with cover crop)? Yes or No .
L L ew i'f _
. Inspector Name Signature
cc: Facility Assessment Unit
t'se Attachments if Needed.