310514_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

Type of Visit: Q'Com ce Inspection U Operation Review U Structure Evaluation Q Technical Assistance I
Reason for Visit: aRoutine O Complaint O Follow-up Q Referral O Emergency O Other O Denied Access Ij
Date of Visit:
Arrival Time: f�J Departure Time: p 4 County:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title:
/
Onsite Representative: { kf c Ic. ` 'c ( A,•r,-, S Integrator:
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Phone:
Region:
Certification Number: ? 1 0 0 0. I
Certification Number:
Longitude:
Design Current Design Current
Swipe CapacityW,Pap. Wet Poultry Capacity Pop. Cattle
Wean to Finish I iLayer Dairy Cow
Design Current
Capacity Pop.
Wean to Feeder
I
jNon-Layer
Dairy Calf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Design Current D Cow
D . Poultry Ca gcl Po . Non -Dairy
Layers Beef Stocker
Farrow to Finish
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
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 of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes [; Ko ❑ NA ❑ NE
❑ Yes ❑ No
[:]Yes []No
❑NA ❑NE
❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ETNo ❑ NA ❑ NE
❑ Yes No [] NA ❑ NE
Page I of 3 21412015 Continued

Facility umber: 'j l - S/Y Date of Inspection: o
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ICJ 110 ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: 3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 3 Zy0
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
[2 Flo ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
Fj 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 [ 110 ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes [fNo ❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes [;N ❑ 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 GEr o ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes NA
r'No
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes No NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes No ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes - No NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �lo , ❑ 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 E]-tta 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

Facili Number: jDate of Inspection: o
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No [:]NA [_]NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check �es ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
61Von-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No A ❑ 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?
S o -.'t. (%t'9 4 s t.. "C' e, 11% t/ r t
3-1
2o/ 4 z^ I 7A 4 I
3Y7q 31tTT
V&?? 11-TY
-4 ,Owl
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes L'J No ❑ NA ❑ NE
❑ Yes LCJ No ❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes E24 ❑ NA ❑ NE
❑ Yes w o
❑ Yes �No
❑ Yes No
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
Phone: `lo T Ij
Date: a(0 &7
21412015

IType of Visit: 4P Compliance Inspection U Operation Review U Structure Evaluation U Technical Assistance
Reason for Visit: ® Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: JZ� l � Arrival Time: r0 ] Departure Time: p ADO County: Region; 0
Farm Name: �f WI� 35Dt I , 3) 02-1 Owner Email:
Owner Name: � " l Lt~ :�6 ccJ� , uC Phone:
Mailing Address:
Physical Address:
Facility Contact: - M q4e Ajje&10PL.!r Title: Phone:
Onsite Representative: Integrator: Llie,0�j2F�u�i✓1
Certified Operator: u 1107— Certification Number: q-TOD07
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Swine
can to Finish
Design Current
Capacity Pop.
Wet Poultry
La er
Design
Capacity
Current
Pop.
Cattle
Dai Cow
Design
Capacity
C►urrent
Pop.
can to Feeder
Non -La er
Dai Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
7-00
000
Dai Heifer
Design Current
Dr, P,o iIL Ca aci P,o
Layers
D Cow
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Other
Other
Pullets
Turkeys
Turkey Poults
Other
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes [P No ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes
❑ No
NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page I of 3 21412011 Continued

Facili Number: IDate of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [] No NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ?.j 501-`1 3
Spillway?: _
Designed Freeboard (in): _
Observed Freeboard (in): I l
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes 0 No
❑ Yes b No
❑ NA ❑ NE
❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
8. Do any of the 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 Appl c� atioo
10. Are there any requut 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 �S No ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate ManurelSludge into Bare Soil
❑ Outside of Acc ptable Crop Window [] Evidenceof-Wind Drift 0 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?
❑ Yes
❑ Yes
❑ Yes
No
CP No
No
❑ NA
❑ NA
❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
❑ Waste Application ❑ 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 No
❑NA [3 NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: 97 Date of Inspection:
24,;Did.tha.facility fail to calibrate waste application equipment as required by the permit? ❑ Yes fV1 No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
[] No
permit? (i.e., discharge, freeboard problems, over -application)
3 I. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
T
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
(Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other torments. I
Use drawings of facility to better explain situations (use additional pages as'necessary).
3 5 01) Y %, 5 t `t�j CICOa e�_ .
r rn- 1 tj i�, r�e_Jh6da--, l 1 131 !o ' ° 4="' ,
Reviewer/Inspector Name: Phone:
Reviewer/Inspector Signature: Date:_gft� 4A Lb
( 4 3
Page 3 of 3 21412011

Type of visit: W compliance inspection U Vperation Review V atructure Evaluation V l echnical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: jZ Arrival Time: D : Departure Time: t :�I County: u L�
Farm Name: r 35221 f 31 a Z! Owner Email:
Owner Name: !4 Phone:
Mailing Address:
Physical Address:
Facility Contact: �� �+�nhto/7S Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Region:
Design C*urrent Design Current
Swine Capacity Pop. Wet Poultry C*apacity Pop.
Wean to Finish La er
Design Current
Cattle Capacity Pop.
DairyCow
Wean to Feeder
Non -Layer
DairyCalf
Feeder to Finish
Dairy Heifer
Farrow to Wean
Design C►urrent
D Cow
Farrow to Feeder
Farrow to Finish
Dr. P,ou1! C.a aclt P■o P.
Layers
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
rP.tlier Turke Poultsther HOther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes P No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
0 NA ❑ NE
MNA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No (&NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes [P No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes 7Y..,No ❑ NA ❑ NE
of the State other than from a discharge? TT
Page I of 3 21412011 Continued

r
Facility Number: 5f - S7q Date of Inspection: Z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 9 Structure 3 Structure 4 Structure 5
Identifier:
Q9 No ❑ NA ❑ NE
❑ No .CM NA ❑ NE
Structure 6
Spillway?:
Designed Freeboard (in):
b �
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 DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
® No
T®
❑ 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)
T
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Applicatio4
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
rM 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
rA No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[F] No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Vg No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
M No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
M No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
[P No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ YesNo
1
❑ NA
❑ NE
the appropriate box.
❑WUP El Checklists [3 Design ❑ Maps ❑ Lease Agreements []Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �9 No
❑ 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 Q9 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes `'P` No
❑ NA ❑ NE
[] Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: Date of inspection: Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Nan -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?
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? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[] No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes ❑ No
[:]Yes [:]No
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: pio33 �33�
Date: g �-
2/4/2011

H
Type of Visit Compliance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit P"'outine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access Date of Visit: 3 Arrival Time: �.�eparture Time: County: Region: A%IA
Farm Name: Q Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: C7fC4 Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: = o = =" Longitude: 0 0 "
Design Cnrrent
Design Current
Design Current
Swine Capacity Population
Wet Poultry Capacity Population
Cattle C•apaclty Population
❑ Wean to Finish
❑ La er
❑ Dairy Cow
❑ Wean to Feeder
IQ Non -Layer I I
❑ Dairy Calf
❑ Feeder to Finish
❑ Dairy Heifer
❑ Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
ElNon-Dairy
❑ Farrow to Finish
El Layers
El Beef Stocker
❑ Gilts
❑Non -La Non -Layers
❑ Beef Feeder
❑ Boars
❑ Pullets
❑ Beef Brood Cow
❑ Turke s
Qther
❑ Other
❑Turke Points
❑ Other
Dumber 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?
El Yes PNo El NA El NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes 0 No
❑ Yes )7No
❑ NA
❑ NE
❑ Yes )ZNo
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

,
Facility Number: — Date of Inspection 33
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Stntcture I Stnicture 2 Structure 3 Structure 4
l i �ntifter4 Z
c�
Spillway?:
Designed Freeboard (in):
Obsmed Freeboard (in):
❑ Yes ❑,No ❑ NA ❑ NE
❑ Yes f o ❑ NA ❑ NE
Structure . Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes Vio
❑ NA El NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ZNo
❑ 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 WNo
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes RTNo
❑ 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 L7No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [lo
❑ NA ❑ NE
maintenancelimprovement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes F,--'(No
❑ NA ❑ NE
❑ Excessive Pending ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes /No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
�Ao
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination i ❑ Yes
JZNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
eNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
VNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date:
121281041 tnnfimued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes oNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes PNo ❑ 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 I'ZNo [I NA ❑ NE
El Waste Application [I Weekly Freeboard [3 Waste Analysis El Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes ZffNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ZrNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�fNo
❑ 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
,VNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
[P-No
❑ NA
❑ NE
Other issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�ZNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
FNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑'No
El NA
❑ NE
If yes, contact a regional Air Quality representative immediately
!!
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[?No
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
o
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings:
cayC&
j';aera;',
AL
use %.
Page 3 of 3 12128104

FadfltyjlNumber..
0 's
C
p!�
�,
ion ofiWater Quality,-,, x.
iopsofiSoil and #Ater' "Conservation
, .t
r. Anrnev.,- ,k �.af
Type of Visit i2rfompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Q-Voutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region: "&
Farm Name: �l Z �� Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: r�iC4 L�Tr✓' Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: o � � = Longitude: 0 ° =1 =•«
< 1Ps rx c�, ffit z a y �a A A i•: x 1,,
{r Desi n Cur�eni! '` , $:pestgn ;current :83t9 F ,' U i n: ourre tj,
1: i z t;' an.eij S= _':ter �t'D eA s i � esg F-Currenty>
4Swore' t , f Capacityr'Population Wet Poultry (,Capacity Population ;Cattle �� Ca`pac�ty�I'opulation a
1R t 0i �i- 3i.1.i F� SY.. "-F J-.s-. k. b�
Pk FL k1
❑ Wean to Finish ❑ La er I i ❑ Dai Cow
❑ Wean to Feeder R 10 Non -Layer I ❑ Dai Calf
El Feeder to Finish f
k5T;L ) �;` ❑Dai Heifer
❑Farrow to Wean llrPoaltr �` ,.1' El Dry Cow
❑ Farrow to Feeder �y'`'" 'y''�' `}' ❑ Non-Dai
El Farrow to Finish El Beef Stocker
ElGilts [] Beef Feeder
❑ Boars 1-1BeefBrood Cow
❑ Other Number of Structures
k "s`:a�—`��T- t��a.t. ..f 4-, °.➢" -:2t-. :tiaSx�.tifl.i z;'v3w4�'*-;x`��i'�i:i€4��-s's-� .��,�a:��.;$.�
El
Layers
❑
Non -Layers
El
Pullets
El
Turkeys
❑
Turke Poults
❑
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field El 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?
Page 1 of 3
❑ Yes -4 No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[]No
❑ NA
❑ N E
[]NA
❑ NE
❑ Yes
Z3 No
❑ YesZJWNo
No
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
12/28/04 Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
St7cture I Struc re 2 Structure 3 Structure 4
❑ Yes R, No ❑ NA El NE
El Yes oNo ❑ NA ❑ NE
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ;�`No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 4�No
❑ NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes /LI 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 KNo
[]NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Z No
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes VNo
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 Ibs []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)
t4. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
21 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ICJ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
V No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
dNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
1�o
❑ NA
❑ NE
Commeiit`s refer`toquestion # Ex lam an YES°answers and/or an recammendati`
( ');'� p y y y ons or anyother comments. E
Use drawings of facility to better explain situations, use;additionapages as necessary.):'
G
Reviewer/Inspector Name P,;. �t:a,t1. w"
Phone: —T} --3
Reviewer/Inspector Signature:
Date:
Page 2 of 3 12128104 Continued

Facility Number: j Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Zo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ElYes tNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes Vlo ❑ 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 IdNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ZNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�KNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ZNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
Ro
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
V No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
VVo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
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
9"N o
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
El NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
7N o
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Division of Water Quality
Facility Number _ 0 Division of Soil and Water Conservation
Other Agency /I
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 ❑ Denied Access
Date of Visit: qt�yArrival Time: _ ,� Awlrture Time: �] County:,la ,6- Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: Title: �Phone No:
Onsite Representative: integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Back-up Certification Number:
Latitude: =e = I =1 Longitude: = ° ❑ d
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Daia Cow
❑
Dairy Calf
❑
Dairy Heifei
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocket
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures: E,
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ONo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
.fNo
❑ NA
❑ NE
❑ Yes
VNo
❑ NA
❑ NE
12128104 Continued

Facility, Number: ` — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Struct�}re 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 VrNo ❑ NA ❑ NE
❑ Yes N No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes [YNo ❑ NA ❑ NE
<
❑ Yes L No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes P.No El NA [I NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes P.
❑ 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 VfNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes �No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 Ibs ❑'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,PNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes 9No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes ONo ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes P�o ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes ❑Ao ❑ NA ❑ NE
Reviewer/InspectorName �, '>� i, t�'f' °.,� Phone:
Reviewer/Inspector Signatu e: Date: /Z
Page 2 of 3 12/28104 Continued

Facilify Number:,.?/ �` Date of Inspection
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes I 'No El NA El NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check El Yes l N�o ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps ❑ ether
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ["No [I NA El NE
El Waste Application El Weekly Freeboard El Waste Analysis El Soil Analysis ❑ Waste Transfers [I Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
0
7-1
❑ NA
ElNE
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
XNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
J No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
rNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
ENo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ONo
❑ 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
P(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
ZNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[�No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104
12128104

N Dwasion of Wter`Qua[ity
Fadlity<Number .� 0 Division of Soil and,Water Conservation
OtherAgency,
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 ❑ Denied Access
Date of Visit: -7 Arrival Time: Departure Time: County: Region: �-✓�/�
Farm Name: / /� Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude: = c
Phone:
Phon o•
Integrator:
Operator Certiti tion Number:
Back-up Certification Number:
❑ Longitude: ❑ ° ='
=
Design CurrentDesign ` Current Design Current
Swine, Capacity 'Population Wet`:Poultry Capacity Population Cattle' Capacity Population
❑
Wean to Finish
❑ Layer
❑
Wean to Feeder
❑ Non -La er
ElFeeder
to Finish
❑
Farrow to Wean
Dry Poultry.
El
Farrow to Feeder
El Lavers
- _ ..
Gilts
Other
�� ❑Other
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part ofthe operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Dairy Cow
Discharges & Stream Impacts
1. Is any discharge observed from any part ofthe operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
E]Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
Number of Structures:
r
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
12128104 Continued

Facility Number: J — L Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure 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 ❑ No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes ❑ No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ❑ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
❑ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name Phone: —
Reviewer/lnspector Signature: Date:
M
12128104 Continued

• Facility Number: — Date of Inspection '
Required Records &_ ocuments
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ AnnuaI 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
❑ No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or. Drawings:
�So� �'p✓�t.� ��e��T /i �Jee� C'a✓I/��d
_. �6GKd:&
Page 3 of 3 12.128104

Date of Visit:
Farm Name:
Owner Name: _
Mailing Address:
Physical Address:
Facility Contact:
Type of Visit compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Rtoutine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
i ``__
Region `L�''/
Arrival Time: .'k02parture Time: County:
4d` Owner Email:
Onsite Representative: 61 21
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Phone:
"Or-L
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = 1 = d Longitude: 0 ° = 1 = `l
Design Current Design C►urrent Design Current
Swine
C►apacity Population Wet Poultry Capacity Population C*attle Capacity Population
❑ Wean to Finish
10 Layer
❑ Dairy Cow
❑ Dairy Calf
❑ Wean to Feeder
❑Non -Layer
El Feeder to Finish
IDry Poultry
❑Dai Heifer
❑ Dry Cow
arrow to Wean
Farrow to Feeder
GVU ❑ Layers
ElNon-Dairy
lyrarrow to Finish
(J❑
❑Non -La Non -Layers
Beef Stocker
El Gilts
❑ Beef Feeder
❑ Boars
❑ pullets
❑ Beef Brood Cow
❑ Turkeys
Other
❑ Turkey Poults
❑ Other
JEJ Other
Number of Structures:
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
12128104 Continued

Nu—JV
Facility mber: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes ❑ No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
❑ NA
❑ NE
Strucfure 1 Structuure`2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes ❑ No
❑ NA
❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes ❑ No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes ❑ No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ❑ No ❑ NA ❑ NE
maintenance or improvement?
Waste Ap2lication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
t3. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Comments (refer to question ##): Explain any YES answers and/or any recommendations or any other comments.
Use drawings'of facility to better explain situations. (use additional pages as necessary):
lee GUr S arc
i
Reviewer/Inspector Name ( eft G D Phone: , - 7Q12/*
Reviewer/Inspector Signature: Date:
Page 2 of 3 12128104 Continued

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

IType of Vislt Ptompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for VisitJerlRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access I
Date of Visit: Arrival Time: Departure Time. County:
Farm Name: _Cr,_ /=g!-- / A. T!` Owner Email. -
Owner Name:
Mailing Address:
Physical Address:
Phone:
/lam— Region:
Facility Contact: Title: Phone No:
Onsite Representative: �d7 Integrator:._{ rii� eac rites..._,
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Back-up Certification Number:
Latitude: = 0 0 6 =16 Longitude: = ° a ` = "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer +
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
,;2-00
%
Farrow to Finish
40000
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑
La ers
❑
Non -Layers
❑
Pullets
❑
Turkeys
❑
Turkey Poults
❑
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifei
El
-pry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures: =i
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
12128104 Continued

Facility Numbeiz — Date of Inspection a
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes No
❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes )211r10
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: Q
Spillway?:
Designed Freeboard (in): r
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes ;allo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes �-No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes JIVo
❑ 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 .E3-&o
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes ErNo
❑ NA ❑ NE
maintenance/improvement?
I
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes e 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 Window ❑ Evidenceof Wind Drift ❑ Application Outside of Area
`Crop
1
12. Crop type(s)
13. Soil type(s)
14.
Do the receiving crops differ from those designated in the CAWMP?
Q,Xis e I No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes .fib
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'![:]
Yes �o
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes -8-T<o
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes to
❑ NA
❑ NE
A.Vf
—L.':.;2 :.' .,..., .: '-..' _I., . ' ... .::.... .... .:..I .
�-snxran'.n. ,:- a. ,s;ra...�,., v.ur ss _.:.., : . _'tw.,: „. .•e,,: :. .urr:. ., ,a. o-,.aa..u.. ..._.. �-e:�.. .,
S � �3. �',f��� /rea ms lP�e
Reviewer/inspector Name " r -} Phone:
Reviewer/inspector Signature: Date:
121281041 1 Continued

Facility Number: ' — Date of inspection 1 G
Requi fed Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropiiate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
❑ Yes ON ❑ NA ❑ NE
❑ Yes Ll No ❑ NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
[--]Yes
❑ No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ 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
ZNo
❑ 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?
El Yes
� No
[I NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
ElYes
No
El NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
ICJ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
0 No
❑ NA
❑ NE
Other Issues
2$.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
O No ❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Ko ❑ 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
ZNo ❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
0No
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative'?
❑ Yes
No NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No ❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104
12128104

i,i1'ii .I•l:li -i(- ty:. is#f(i31w,>t(•. -..'• ... y.,ier3<'lie?4aa,,.;rP9i+4,E 9. t ..i.'.. Eli.•. k 'q i _-€4..• 5 ! _ 3 }fa gg !+t •�lil:
a �R, ��€. � 1 } -. �'V p/. &e n � . t �P'7
, j y O DtVIS]on U SV0 k6d T. �tiR �QfLlG�8t1oY li �l ILA
j !
xiY is
yt
pia €n rf , Q(dt11eA$ei1Cj�, p f
Type of Visit JO Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ,,Vl!Routine O Complaint O Follow up O Emergency Notification O Other [] Denied Access
Facility Number I Date of Visit: U Time:
C Not Operational Q Below Threshold
Permitted Certified 13 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: .........................
FarmName:.............................................................................................................................. County:.....................................................................................
OwnerName: ................................................... ........................................................................ Phone No:.......................................................................................
MailingAddress: ..................................................................................................................... ..................................................................................... .....................
FacilityContact:.............................................................................. Title:................................................................ Phone No:...................................................
OnsiteRepresentative: Az..'..�.....!.1.................................................................. Integrator:......................................................................................
Certified Operator: ................................................... ............................................................. Operator Certification Number:..........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 4 64 Longitude • 6 44
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 ❑ Nq
2. Is there evidence of past discharge from any part of the operation? ❑ Yes 7No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure b
Identifier: ......... 1................... ....... Z...................................................................................................................... ...............................
Freeboard (inches): a
12112103 Continued

Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes En No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? /ye❑ Nq.
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑Yes [�J/No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes No
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type SkzO Br_""sA Ca
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
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
Air Quality representative immediately.
❑ Yes
❑ Yes �Nt7N_>'
El Yes
❑ Yes [ N
❑ Yes No
❑ Yes No
❑ Yes 7Np-'-
❑ Yes
❑ Yes No
❑ Yes No
❑ Field Copy ❑ Final Notes
-7,J rZc-A► w Cf 6 C�-� C ow S w A L K- `S%V ST V- r N c-CDs ��-�Qrt4vEv�n E►.rC'
otJ (;9_AeS COd OL, SC`""'C_ F Rvs3:ah+ , 1uC� DyK�
w (.; S E) 6ti)t-- b103
�.n1 JC t7oUG3LC ceof oV �
ouo wUP Am) -vS PPO NtV V36Q t46 50.
Reviewer/Ins ector Name'
1? 11"
Reviewer/Inspector Signature:
Date:
12/12M.1 Gonnnued

Facility Number: I —Nig
Date of Inspection O
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes /11�
FN
❑ Yes
❑ Yes
❑ Yes Z
❑ Yes
❑ Yes 7010F;q.,o
❑ Yes
❑ Yes
❑ Yes L/1 No
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
12112103

!'i!F'1 chss-..--r rs. - - . - �, - .w v - - . r" c �.•+'-.. +;fir ���..!',. .l 0':9 ;- y ,.
1Ln
a
a
u
z
¢ °
¢o
�m
.a
l66L ounf• 1008E wJoJ Sd
' ■ Complete items 1, 2, and 3. Also complete
A. R by (Plea6ie P nt Clewly)B.
D tsof D livery
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
C. gnature
■ Attach this card to the back of the mailpiece,
� &7
❑ Agent
or on the front if space permits.
❑Addressee
D. Is deliv address different from item 1?
i] Yes
1. Article Addressed to:
If YES, enter delivery address below:
❑ No
Mr. Jimmy Vinson
PO Box 487
Warsaw, NC 28398
3. Service
ertified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt
for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee)
Cl Yes
2. cle N mber!. f m ervice abe!
� �, ',
I PS Form 3811, July 1999 Domestic Return Receipt
102595•99•M-1789

Facility Number: 3t' —s� 1� Date of lu.spection 2 (b
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 JZ No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 2TNo
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 Ian belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ;"Yes ❑ No
Additional Comments and/or
Drawtn s:." "'„
a . ,L
l�keai 4e hAve
i7ewesa
Ge,4-4. `,-44 eV 6avcra5e
46erltrq)
3/23/99

MAR-29700 WED 1:32 PM BROWN S PAX NO. 9102961675 P. 2
BROWNS` Running Lagoon Level & Rainfall Report
OF CAROLINA Farr Name: 01
Date Lagoon Level Rainfall{Inches
33/990
0 6
1
19
1 Q130/99
19
0
1 1 /6/99
20
1.25
1 1 / 13/99
27
0
1 1 /20M
26
0
1 1 /27/99
26
0.84
12/4/99
26
0
12/ 1 1 /99
24
0.4
12/ l al99
24
1
12/25199
23
0.6
Wednesday. March 20. 2000 Page 1

MAR-29-00 WED 1:33 PM BROWN S FAX NO, 9102961675 P, 3
BRdWN'S
OF CAROLINA
Farm Narne: 01
Dato Lagoon Level Ralntall(Inches
1/1/00
23
0.5
118/00
20
0.5
1 / 15/00
20
1.5
1/22/00
21
0.5
1 /29/00
10
1
2/5/00
15
0.7
M NO
16
0
2/ 19/00
is
0.9
2/26/0O
16
0
314/00
20
0.1
3/ l 1/00
24
O
3/ 18/00
22
2.25
3/25/00
20
1.25
wedriosday. Mawh 29. 2000 Page 1

MAR-29-00 WED 1:33 PM BROWN S PAX N0, 9102961675 P, 4
`BROWN'S`, Runnjng Lagoon Level & Rainfall Report
OF CAROLINA Rarm Name: 02
Date Lagoon Level Rainfaii(inches
10/9/99
21
0.9
10/23/)9
13
0.65
10/30J99
21
O
1 1 /6M
22
1.25
1 1 / 13/99
20
O
1 1 /20/9A
22
0
1 1 /27/90
19
0.9
12/4199
21
O
12/ 1 1 /99
21
0,4
12/ 1 & 99
20
1
12125M
17
0.6
Wedwaday, March 29.2000 Page 2

MAR-29=pQ WED 1 33 QM BROWN S FAX NO, 9102961675 � F. 5
BROWN'S Running Lagoon Level & Rainfall Report
OF CAROLINA sarm Name: oz
Date Lagoon Level Rainfall(Inches
1/1/00
19
0.5
i/M
23
0.5
1 / 15/00
20
1.6
l /22/00
19
0.5
1 /29/00
14
1.7
2/5/00
is
0.8
2/ 12/00
24
0
2/ 19/00
23
0.9
2/26/00
19
0
3/4100
10
0.1
3/1 1 /00
20
O
3118/00
24
2.25
3/25100
22
1
;;PogPogo a
o March 29. 2000

0 Division of Sail and Water Conservation Operation Review �.
• l • !I 4� , ,� 4 l � l , r , -{ tia - - t nl,
Division of S41and Water=Conservat►on .Compliance Ittspect�oh�+ i �'l' , P i 1.
s Division of Water Quality Compliance Inspection '
_ ,
Other Agency - Operation Rev�ery ', d ik n
...,� ., ��.., �;���
IV Routine 0 Complaint 0 hollow -up of DWQ inspection 0 Follow-up of DSWC review 0 Other
IIIMN
Facility Number Date of Inspection
Time of Inspection 24 hr. (hh:mm)
19 Permitted 0 Certified © Conditionally Certified E] Registered 10 Not Operational I Date Last Operated:
Farm Name:i County: .......!!........................................
...................
..........................................tZ........................................................................:..
Owner Name: C �i Phone No ��
rn�.ac�.5...... ......... ....!........................................,..,...............1,60..........&7J.$�...............................................
`1
FacilityContact: ....... I'.In`!^1 .......l�l.[;tn`7 n.......... ........ ......... _Title:..................................r.............................. Phone No:...................................................
MailingAddress: ........'.Q,....,4.1.1......................................................................... .....lt!�?l aAlr±..�....�............................................... ........
�r
Onsite Representative: .............. .Ylnl}1n;.......Vivvwk................................. .. Integrator: �C�1tvYvS... t......................................................
Certified Operator: ................................................... .. Operator Certification Number:
Location of Farm:
�,...p......�...f.lfa... f...p....2... .. r�. (.. i, f........................................
.........................r......r.... ........ t[ .....e�... ..�.......Sa., ter....... Q:.... t
................... :.............. ................ .............. ............ ............................................................................. .... ... .......................
Latitude �' 0` �•� Longitude • 1
Design
Current ' Design' ' Current .
Design Cu'rirent ;§
Swine. '.: Capacity
Population' Poultry . Capacity' PoLulation Cattle
Capacity Population
❑ Wean to Feeder
❑Layer
❑Dairy
El Feeder to Finish
'[E]
Non -Layer
❑Non -Dairy
❑ Farrow to Wean
`
Farrow to Feeder
�p
❑ Other
Farrow to Finish
pp�
Total Design Capacity
Qp
❑ Gilts,
Boars
JOtat'SSL'W
�
Number of Lagoons' .
J❑ Subsurface Drains Present ❑ Lagoon Area
❑ Spray Field Area
.. T4 '"
g, P
Holdin Ponds / Solid Traps
I
� : i
No Liquid Waste Management System
❑ g g y
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: [ILagoon ElSpray Field . ❑ Other
a. If discharge is observed, was the conveyance man-made.?
h. If discharge is observed, did it reach Water of €hc Stale? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (Il'yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: Z
Freeboard(inches): Z.................3a.................................................................................... .............................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes ® No
❑ Yes
1,9 No
❑ Yes
No
N�
❑ Yes
[9 No
❑ Yes
( No
❑ Yes
No
❑ Yes 0 No
Structure 6
❑ Yes [VNo
Continued on back
3/23/99

Facility Number: — 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
52 No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
%3 Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
MNo
Waste Aimlication
10. Are there any buffers that need maintenance/improvement?
❑ Yes
L'Om No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
No
12. Crop type �pYYnif(f(� L� �� my-A1r• CGf�tl� �j'ulRPbw.�
--
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14, a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c} This facility is pended for a wettable acre determination?
( Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
No
16. Is there a lack of adequate waste application equipment?
❑ Yes
No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
[0 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
14 No
19, Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
9 Yes
❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
1`0 No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
IX 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 reviewlinspection with on -site representative?
❑ Yes
14 No
24. Does facility require a follow-up visit by same agency?
❑ Yes
14 No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
M No
No • , iol'atigris'or d�ficier><cies ��re pt�tetl 00-t°ifg 4his;Visit'. - ;Y:otit Will •teo+ ive Etta fui'thof • • '
correspoticience. ab' k this visit. . .
Comments {refer to question #};`'Explain any YES'answers and/or any -recommendations or anytotlier` comments '
UseArawin s of factht to better ex lain'situations us r
g, y p { ,� add�honal pages as necessary} 99 y i
x3t, r�
KoOltv grip S 0Y— to ��9ide 6� 0.o�cor W�9 ►-� CAIi ll- wa '.
�-00" + gYta��t� vts �AiCO G Ca C{�55;t-�.
>•� c� �r�t:'c �i 11� „ _.'Q.0 �Y �"�� �Q.fiGI/1M-iV1�T� 0/1 • J J
tai j1Z�" Z '�trr`.s s�not� ��, fn�e�� f�or (,oNvec�' i�A � 14.aai�-t a.V�a�SPz� c�a'i•eS
Reviewer/Inspector Name
ReviewertInspector Signature:
Date: $
3/23/99

Facility Number: -s
Date of Inspection
Odor .Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
Yes
No
liquid level of lagoon or storage pond with no agitation?
27,
Are there any dead animals not disposed 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
FNo
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
WYes
❑ No
[Additional omments'an or Drawings::,`
L1
3/23/99

:,..,.,„Mr,i,`w,:a.«'•«<saika.:,`,w',aa'ita`s�3.M-3k >....,.aa<i»:, sa�.a€� i f :
#$ i rl Division of Soil and Water Conservation Other Agency
_
'A ®D�vtsion of Water Quality
Routine O Coni laint O Follow-u of DW ins ection O F 61low-u of DSWC review O Other
Date of Inspection
Facility Number
Time of Inspection ; �24 hr. (hh:mm)
© Registered gl Certified [3 Applied for Permit 13 Permitted 113 Not Opera Date Last Operated: .................
Farm Name. rev k+........ w . . Count ...................
Owner Name: �r h� S .... Phone No:.......� fad.. �....1. ...
..........................aw.............� ....Carr..���.�a...........................................................................
Facility Contact: ............ J 1 ..........Y.. 0.�P.J:7 .................. Title: � } . Phone No:
MailingAddress: .................R.0.....&.1....4.31........................ ... ... .........N.C......................... ...... .2:2351".11.1.
Onrrte Representative: ............ .. ... Integrator :...,.�t!�Ny.ls..............................................................
Certified Operator;............................................................................................................... Operator Certification Number;
Location of Farm:
Q.......t^r....s..f...P....S�..li.,..t..A:....tha e+�S�......af....Si.t.c!w�..............................................................
......................................................... ... ............................ ............
Latitude 0=1 46 Longitude =• ° 94
Design ".Xurrent
Design Current
Design Current '
Swine
v
>.
Capacity Populations Poultry,
Capacity '9pulation,; ' Cattle ;; Capacity„ Pap6lati:
❑ Wean to Feeder
El Layer
❑Dairy
❑ Feeder to Finish
ID Non -Layer
JE3Non-Dairy
❑ Farrow to Wean
Feeder
❑ Other
.
Farrow to
Zpp
Farrow to Finish
oco
Tote! Design Capacity
E] Gilts
Total SSLW
❑Soars
,<'
y >
x.
Nu nl�er of L goons / ldmg Ponds
❑ Subsurface Drains Present ❑ Lagoon Area
-12
ID Spray E'ield Area
�'„
❑ No Liquid Waste Management System
k
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes No
2. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes No
b. If discharge is obsen ed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes M No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes M 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 91 Yes ❑ No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 0 No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes [A No
7/25/97

Facility Number: 3 — 1a l
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons tiolding Ponds, Flush Pits. etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2
Identifier: L L
Freeboard (ft): ................ ................................3................
10. Is seepage observed from any of the structures?
❑ Yes No
❑ Yes No
Structure 3 Structure 4 Structure 5 Structure 6
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. 'Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
.....................................................
❑ Yes
® No
❑ Yes
N No
Yes
❑ No
❑ Yes
® No
Waste ,Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type...........tXnhuck ............. SI 0 it......................�.C1.Y.iC\..... .................... .........................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0. No.vitilations°or d6f ciencies were iioted,during hKvisit'.' :You:will receive-ito'ftirther
eorrespQndeitce dtiout this;visit.,
❑ Yes q No
❑ Yes [)3No
❑ Yes ® No
® Yes P No
❑ Yes 'r"n No
❑ Yes D9 No
❑ Yes No
Yes ❑ No
❑ Yes tO No
Yes ❑ No
Yes ❑ No
'Gv lewd"( ;&. to gvestton #) E rlatn.ariy YEs ans ors en i/o any recammendatio s or any other comm
�Usediawi�tgs i wtty tn`� catplaanttuahn. fuse addttfoxaal pages as ricccsary}.
``s'�,�? ,ru mat "#ate] ��a// r,�' ta.. �F .d �:..
he4l txr- S Or. �rp, *Z ��r} be un [. yd 1-6 cd (v&) .. �VA1�naa Q- o � ��,r►►.._ �
1�c r, �or� S cau5eta [ caWs- c-vO� riser �aulJ be- F W , �,mde 7 awel m,_eAd.
Ot &OcL "e c ck t �o P�l� t l { - D�4��{. PrL�cY se� cKS
O%Sl iGe,t�x. A Con` kw\yhPC shtAx ```,6vl0 be boi 14-
�YetJnri �r acu t) Vltar wet Oro— CUC-11- C,- �f C�v�aivi o� Qa. ►-t.
22 . t r•�t a�o ;r`fierrna�,'or� S1.o�ld 6e- W; R, . r ccords y °�"'r
ZA.foVtAO 990QtJiVN o r.�kyeTL, C2,5 (bsl .
96Q 6e- r�tvt jt't i. GvesbK c.U� ;a� KGJC� 11U odd �Oe,
' uj 4--to !M4 nti a cor 4 17/25/97 '
E
wer/Inspector Namewer/Inspector Signature: Date:

T
p Division of Soil and 11'ater Cons c atitin L Operatiow RevtewrtM, o 01 , Y '
p Divhshon"of Soil and Water Conservation ,�Comphance,Inspectton4 �
Division of Water Quality Colttplta ce lnspectton"
p Oth
` er Abency - Operation Rev]e4y1 ;'pit gxti +4�� °�p w,^tar
.„.
p tt(oil ttile p lnnrlrtaun p [', , l "' mspecturn p hnYlow-up of ,� WC review 9 Other
Fneility Nunthcr. !"�r.lr r r Inslxtti"rl
;,t , l 1lavlrct'[ion� 24 hr. (hh:mm)
p Registered ■ Certifies! p Applicd for Pernhil ■ Permitted 13 Nol Offrational Date Last Operated:
Fni-m N:Erttc: F.airm.#1..•t.nd.tt2 .................................................................................... County: Duplin WIRO
Ownccr \ante :................................................... . ................. Phone No: 9.111-19.6--1800 ..........................................................
FacilityCowacl:................ ........................ .............................. ........."I'itic: ....................... :....................................... Phone No:
N'Irlili,r'• :lflrlr'c��: 'Q..I [],a.{.�7............................................................................................. arsam... NC.......................................................... 209'a..............
Onsifc.........................................................................................
Cerlificd0I1cr:rtnr:.V.irgil..L................................. kl urlilly.........................
Location of Fornh:
.. Integrator: Rrowa'.s.ja1.Camllna,.one..................................
Operator Certification Number:16285 .............................
rA .. _:d.'I!.^::::::::::................................................................. i
.......... :yx _
V
Latiludc ��®
Swine Capacity Populalion
❑ can to ee er
❑ Feeder to Pinish
p Farrow to can
® Farrow to Feeder
_ t
® Farrow to Finish
I 00t1
❑ Gi€ts
❑ Boars
!,ongiltid . ®f ®,
estgn u rrent 7 Desi
Poultry• Capacity Population,.,,Cattle!,,,.�� rCapa
❑ ayer p airy
p Non -Layer 113 on- airy
❑ ter
Total Design Capacity .4
Total SSLW .'�
Lam.
;Number of Lagoons / Holding Ponds acerasresenp goan
❑ o Liquid Waste anagement ystem
1. Are there any buffers that need muintcn:rticc; improvement?
2. Is any discharge observed from any p,,in of the operation?
Disch:hr�c c�riei, ,u�ii ❑ Lagoon ❑ Spray Field p Other
a. II'di.scharp r• „},,:', '.'c. -;I!; 4hc conveyance man-made''
b, li tlischarcc i• ,r.. rri. (!!d i, reach Surface 1k'arcr•? (If•ves• notify DWQ)
li;'.i !S the CStllllateCl !lo,Y IIl �itl!lllln?
Do,sSvstc.]tl? (Ifycs. notify DWQ)
3. Is there evidence of past discharge from miy hart 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 nimm :entent-Svstent (other than lagoons/holding ponds) require
zn
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 conified operator in responsible charge?
7/25/97
2,200
Z,043,400
Spray Field Area J.i
❑ Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No

JlFact ity Number; 31_514
8. Are there lagoons or storage ponds on Site which need to be properly closed?
tirrucrirre� (I.:��nnn�,Idulrlin� t���n�i�:_ ,'i�r!� .'a.,. r•fr•.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
ti!ruCIIt1.' ! `;:r:;1•1in'l, structurc Sll'tlCltll'C4
lclt�ntif ier:
Frcchnrird (1'Ii:
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(if any of questions 9-12 was answered yes, and the situation poses an
immediate public health or envir•ontnental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste A11lliv;t(km
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
Yes p No
p Yes p No
Structure 5 Structure 6
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
15. rop type.......................................................... ..................................................................................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? p Yes p No
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Cvr0fied or Permittt'rt F;rr;!i : °' '• ;`
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
q ... a_viu ttons.or a ncrenrtes -ivere.note . unng t is visit:. You willxeceive nofurther.*.
*mrvespo,n crie�e abut t�ti$ isit:: ; .:.
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
p Yes p No
Commenw(refer,to=question'#) Expla n n1t► S'ES;answers�andlor any.recomffiieridations or�anyattie �cotminerit :
des �,{sr Ls4'r S,xx-d+�'rR ,eds a P "` 3'M' � ,. - Y� yam' i,m9. it_.Il?'%'�" fy 1. - .
yU..s,e clrHwmgs of facility to better c�lt1. m sit+i.ttions: (useiraddthonaltpages as necessary):.
Visit was made to assess if facility is a likely candidate for State groundwater study. Observations of spray,feld borders were made w
from public roads.
Most of spray fields were wet and had ponded water (especially those fields closer to facility #2), Spray fields next'to facility #1; .
looked a little drier (some of these fields appear to be in Sampson County). F ,
Only one house on Duplin county side is close to spray fields. The house is on the east.side.of spray fieli_' Io'rdering'the state. -road.
This house has a well; however, there is another field (about 2 acres) between the. closest,sprayfeld and the house/well.
7/25/97
Reviewer/Inspector Name `Andre►s G. 1-1clnlrnger`` ��� ;i�'�' � r`t ° ;r `��F,�"'���"�`����� � MINIM,`
Reviewer/Inspector Signature: — Date: L

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I also wish to receive the
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■Print your name and address on the reverse of thls form so that we
can return this
following services (for an
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card to you.
•Attach thls fort to the front of the mailpiece, or on the bads if space does not
1. ❑ Addressee's Address
aWdle Retum Receipt Requestsd'on the mailpiece below the article number.
2. ❑ Restricted Delivery
■The Return Receipt will show to whom the amide was delivered and the date
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Consult postmaster for fee.
3. Article Addressed to: � �
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PS Form 3811, Decem 1994 102595-97-B-0179 Domestic Return Receipt
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STATE a
a
State of North Carolina
Department of Environment, Health, and Natural Resources
Wilmington Regional Office
James B. Hunt, Jr. Division of Water Quality Jonathan B. Howes
Governor Secretary
May ,19, 1997
Brown's of Carolina, Inc.
Farm #2
PO Box 487
Warsaw, North Carolina 28398
Dear Brown's of Carolina, Inc.:
Subject: NOTICE OF DEFICIENCY
Farm #2
Facility Number: 31-514
Duplin County
On May 14, 1997, staff from the Wilmington Office of the Division of Water Quality inspected
your animal operation and the lagoon(s) serving this operation. It was observed that wastewater was present
in an erosion path in one of the irrigation fields. While no discharge of waste was observed to waters of the
state at the time of inspection, any rainfall -event could likely result in the discharge of waste from the erosion
path into a nearby stream. A significant quantity of medical waste was also observed in the lagoon during
the inspection.
As was discussed, the remaining waste in the erosion path should be removed. The irrigation
field should be filled and revegetated with an appropriate cover crop. In addition, ail other bare areas in the
spray fields should be revegetated. Actions should also be taken to remove medical waste from the lagoon.
We suggest that you contact your local NRCS or Soil and Water District for any assistance they may be able
to provide to correct these problems.
To remain a deemed permitted facility, you must notify this office in writing within fourteen (14)
days of the receipt of this notice, what actions will be taken to comply with your waste management plan.
Failure to do so may result in the facility losing it's deemed permitted status, requiring it to obtain an
individual non discharge permit.
127 Cardinal Drive Extension, Wilmington, N.C. 28405-3845 6 Telephone [phone] • Fax [phone]
An Equal Opportunity Affirmative Action Employer

Brown's of Carolina, Inc.
May 19, 1997
Page 2
Please be aware it is a violation of North Carolina General Statutes to discharge wastewater to
the surface waters of the State without a permit. The Division of Water Quality has the authority to levy
a civil penalty of not more than $10,000 per day per violation.
If you have any questions concerning this matter, please call Andy Heminger, David Holsinger,
or Brian Wrenn at 910-395-3900.
Sincerely,
Andrew G. Heminger
Environmental Specialist
cc: Harold Jones, County Soil and Water Conservatioti-
Sandra Weitzel, NC Division of Soil and Water Conservation
Operations Branch
Wilmington Files
SAWQSWMYAU1-514.DEF

�r ❑DSWC Anitmal Fe: dlof-0 eration Review`
P
-
- :� ',. ..
®.DWQAnima! Feed�af;Operation Site.Iuspectzon"
r �„,.• _'
_..
r
' iRoutine O Complaint O Follow-up of DWQ inspection O Follow-uo of DSWC rcviciv O Other
Date of Inspection q
Facility dumber
Time of Inspection Use 24 hr. time
Total Time (in hours) Spent onRedew
Farm Status:..�.Kc�rS.�_ .__ -••--- or Inspection (includes travel and processing) `---�
Farm Name:.County:...cr-a4x
Owner Name: __.._ . _ $� S 1t. .a._ Phone No:. ! oo )Z9 S.— L.0,.Q ....._
Mailing Address: E Q-- R aIL-AA__— _ 1 r3 td.sd� T . »�r ... _ _ ».� g..3 9 k
Onsite Representative: So Certified Operator: Operator Certification Number:.1.ia...$ �. _...._ ..
Location of Farm:
.1) .
Latitude i s74 �•L �Il!` Z�" Longitude �' ��Z
❑ Not U eradonal Date Last Operated:
rype of Operation and Design Capacity
i:nF«:: s,"c '. �:a:i:.,r.;ie. '�`-. H :'"' `+"+ - •'.Rv, r},�:- .....`,�::
r
Latitude i s74 �•L �Il!` Z�" Longitude �' ��Z
❑ Not U eradonal Date Last Operated:
rype of Operation and Design Capacity
i:nF«:: s,"c '. �:a:i:.,r.;ie. '�`-. H :'"' `+"+ - •'.Rv, r},�:- .....`,�::
r
;ssn :e;.x:. .-"T'! :,°'�Sir;.:.�:.:: >«'t%.r:i.: .!Y::.,.v
r �YCattie���.>,�:�r.Auinber'.��_� �,�
.� . •-�
....�;'Nu�ber'. h'Y �� ,�:� \umber,
,.
❑ Wean to Feeder
❑Dairy
❑ Feeder to'Finish
'',",'Jo
Z❑ Non -Laver I
Beef
Farrow to Wean
::
w ,
L-y�,�. �7- - %r.� x •wt z K. r a°K.W,a .*„+K� �*ae r .�&r�;-�`t�"� �e a �
a�= yqr
Farrow to Feeder
12-00
PK
Farrow to Finish
❑ Other Type of Livestock
,.�•��i."',y"'".^'°",K.^r-1 �.,,.�
Number oELa6oaaslHbldutgPonds ❑Subsurface Drains Present
sw. �� x'�r-�mae'se3n x'a��ri�..�''4''xiie»��,�.�i�� s a'��i =.�t�a `"g�"'•w"� 'in•'c�" .
❑ Lagoon Area Spray Field Area `
General
1. Are there any bune-s that need maintenance/improvement? R-Yes ❑ No
2. Is any discharge observed from any part of the operation? ❑ Yes ENO
a. If discharge is observed, was the conveyance man-made? Yes No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notiry DWQ) ❑ Yes ® No
Is there evidence of past discharge from any part of the operation? Yes ❑ No
v4. Was 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 lagoonsiholding ponds) require 9 Yes ❑ No
rraintenanceimprovement?
Contirrrred on ack

6. Is facility not in compliance with any applicable setback criteria?
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/1/97)?
❑ Yes ®No
❑ Yes IS No '
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures fLanons and/or HoldiniPonds
9. Is structural freeboard less than adequate?
Freeboard (ft): Lagoon 1 Lagoon 2 Lagoon 3
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notifyDWQ)
13. Do any of the'stni&t res lack adquate markers to identify start and stop pumping levels?
Waste ARRUcation
I4. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type - -LAC •v. - e_,r r►-._<rr�-r1� - -- -
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
17. Does the facility have a Iack of adequate acreage for land application?
18. Does the cover crop need improvemmient?
19.. Is there a lack of available irrigation equipment?
For Certified Facilities Oniv
20. Does the facility fail to have a copy of the Animal Waste Management PIan readily available?
21. Does the facility fail to comply with the Animal. Waste Management Plan in any way?
22. Does record keeping nerd improvement?
23. Does facility require a follow-up visit by same agency?
24. Did Reviewer/Inspector fail to discuss reviewlinspection with owner or operator in charge?
❑ Yes allo
❑ Yes ® No
Lagoon 4
❑ Yes IN NO
❑ Yes RNo
® Yes ❑ No
❑ Yes RNo
,Yes ❑ No
❑ Yes a'o
❑ Yes ®No
]ryes ❑ No
❑ Yes &No
❑ Yes J�FNo
,Yes ❑ No
❑ Yes XLNo
J�[Yes ❑ No
❑ Yes J2r,,lo
I. A �r �e.r lbvi}e— area neeS Jk be b beiwt #t.e area Sf -+tom ar.d 1 t Q
WOed l;v.e-i pIOV� irtlpat�d.� -P4.1d-S. f
3 1 I ./ y 1. W a s t e =�r ,.., •i: G 1 rr i a i, a v, s y S t t w+ L, d r1 r v +� G i r► �O 0,— e-, S i 0 v�
ov\e 0t tkt S� �i4kkt. ! T�+e ruKo� vVdC du�A�O 01eve-0.I P1,�w� tl
� + , 0. V�, 0. r e.dL vj ti L k 0 V eL Y-" T f-I C. � � V G� � � 0. � ' GQ V t%✓'. r C I t L� Q' Ll p0.
0 -C Wade.,— wai vw ai,tQ-Y•v-P-d a� t- � e �T
S e r- E-+� r. I{ a Y p e o rrS `E ti`-a vJ d L E~R J e�,F" r-� + h a v C p a S S ill t-1.-R v tL
CL �V-U wa�pJ{ t V 1 v fir a„�-� 0} , C_i% 1 e�b -a. I E� G� je ar•n a1 fit. , U
S. O 1 n C vv O S I O ✓� R 1 w ih a s P >�y I 1 Cl Yl 5 �D I � a �� r e I N I,V ; a •4 a rro r ; �, e. [ o .r Cr,rp Q . 1 r}I a- +j- + i-+ o +n a 1 a vv- b tp- �r e a
Sprri ��etd5 (; cWdi.3 oo tcq¢ I-�c�lt� 5tiouta ��t r�V2ge a. .
lz �e�ve4t{ 0, 0.v-4-i bare 4m.re-4,4 6v, laa6d_vt LJ& V
Reviewer/Inspector Namez
Reviwer/InspectorSignature: p�„,. rp�f ,�+�p n Date:
cc: Division of Water Quality, Water Quality+Section, facility Assessment Unit . 11/I4/96

•
Site Requires Immediate Attenti : /VQ
1
Facility No. kj
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATION SITE VISITATION RECORD
DATE: �` , 1995
r Time:
Farm Name/Owner:
Mailing A
County: _
Integrator.
On Site Representative:
Physical Address/Location:
Phone:
Type of Operation: Swine V Poultry ' Cattle
Design Capacity: /0
00 S4212i
Number of Animals on Site:
DEM Certification Number: ACE DEMI Certification Number: ACNEW
Latitude:' �$' yJD" Longitude:Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have ffici t freeboard of 1 Foot + 25 ear 4 hour storm event
es (approximately 1 Foot + 7 inches) YActual Freeboard Ft. .49 Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes r N
Is adequate land available for ray. Ye r No Is the cover crop adequateor No
Crop(s) being utilized: Z_ /V_CiL
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwelling es r No'
100 Feet from Wellst Yes;br No
Is the animal waste stockpiled within 100 Feet ofUSGS Blue Line Stream? Ye-s or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes r N If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acr ge with cover crop) Vr No
Additional Comments: _e- op3-tf--l4 7D'
• U,41LL
Inspector Name
ature
cc: Facility Assessment Unit
Use Attacliments if Needed.

•
Site Requires Immediate Attention:
DIVISION OF ENVIRONMENTAL MANAGEMENTity No .14K
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE:. -7 a , 1995
Time: (e3 c.
Farm Name/Owner:
Mailing Address:
County --gip i
Integrator: rO & k Phone:
On Site Representative: Phone:
Physical Address/Location: _A. P SR_ 11 a t, „ t . J ,r,,, :lac c o✓fl !Z o.r-SR u o u
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity:
Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: " ' " Longitude: ° ' " 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)(9or No Actual Freeboard: a Ft. __fp_ Inches
0 Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes oro
Is adequate land available for spray? Yes or No Is the cover crop adequate? Yes or No
Crop(s) being utilized:
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 or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No
Additional Comments:
Inspector Name
r -
Si
tur
cc: Facility Assessment Unit Use Attachments if Needed.