310561_INSPECTIONS_20171231

NORTH CAROLINA J
Department of Environmental Quaff

Type of Visit: Compliance inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: [Ch. ' Arrival Time: Departure Time: County: Region:
Farm Name: jnj L Q2Q7 H`cQ S Fin R IVl Owner Email:
Owner Name: — (W t2i,-N h 14 1 L! Phone:
Mailing Address: FS'D S / Y C Ot `�� E � �J\/ / S U! u E , A/C
Physical Address:
Facility Contact:
Title:
Onsite Representative:
Certified Operator: VAA.A L EDWR eta DA I L-, Sv-.
Phone:
Integrator:
p` 01 %
Certification Number:
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Design Current
Swine Capacity Pop.
01
Wet Poultry
Design
Capacity
Current
Pop.
Cattle
Design
Capacity
Current
Pop.
Wean to Finish
[Layer
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dr, P,oul
Layers
Design
C+_a aci_
C►urrent
P,o ,
Dry Cow
Non-Dai
Beef Stocker
Gilts
Boars
Non -Layers
Beef Feeder
Pullets
Beef Brood Cow
OtherrH1
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
rr
a. Was the conveyance man-made?
[:]Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (if yes, notify DWQ)
❑ Yes
No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
ANo
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: - (p Date of Inspection: P715
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes *No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ]
Spillway?: [�
Designed Freeboard (in): l q . )9. S � %. s
Observed Freeboard (in): 3 a �p
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
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes j 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
pt
12. Crop Type(s): ,wlic- A rt S y -�
13. Soil Type(s): / `lNLf-6(- K CgA0eVj ^
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Rewired Records & Documents
19, Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
Q WUP ❑Checklists E] Design 0 Maps ❑ Lease Agreements
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No
❑ Waste Application 0 Weekly Freeboard Q Waste Analysis 0 Soil Analysis [:]Waste Transfers
❑ Rainfall ❑ Stocking E] Crop Yield ❑ 120 Minute Inspections Q 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 N
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
o
Page 2 of 3 21412011 Continued

Facility Number: - (pJ Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �{j No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes i%TT No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey [] Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? 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?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes A
No ❑ NA ❑ NE
❑Yes ❑ No )4 NA ❑ NE
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone:
Date: �7
21412011

Facti>tty Number; � j � `j(Q j
)SDrvrseon of Water Quality.
.0.Drvis on of Soil and Water Conservatroi
.. ..Q Other„:A�encv -��
Type of Visit ACompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ix Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit:T f/D� Arrival Time: r Departure Time: County: Region:
Farm Name: 1 At C Q�O� N�eeS V�A2m Owner Email:
Owner Name:Phone:
Mailing Address: ,Q5 11VC Dy E Kc,,,%Aw S U1LL[ /VC_ a g3 y9
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: To Integratq�:
Certified Operator: �aL � Z � At J� • _ OperattorrCCertification Number: l �S
Back-up Operator:
Location of Farm:
` Design 'Cl
�w me Capacity Pop
_] Wean to Finish _
] Wean to Feeder
] Feeder to Finish
Farrow to Wean QC)
Farrow to Feeder
] Farrow toTinish
] Gilts
71 Boars
Other
❑ Other
E, .�
Back-up Certification Number:
Latitude: c = 6 Longitude: = ° = =
Wet°Poultry- C
❑ Layer
❑ Non -Layer
`Dry Poultry a`
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouets
❑ Other
Dairy Cow
Dairy Calf
Dairy Heifer
Da Cow
_Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes x No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes tNo
o ElNA ElNE
ElYes ❑ NA ❑ NE
Page 1 of 3 12178104 Continued

Faciity nmber:'31 — 5Zp/ Date of Inspection 1 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes XNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: L 3
Spillway?:
Designed Freeboard (in): r n�j . _ 19.5
_
Observed Freeboard (in): y
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes XNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes allo ❑ 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
ElNE
maintenance/improvement?
11.
Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
4 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
t2.
Crop type(s)
13.
Soil type(s) NnQ-&(.K. CjAua ,/
14.
Do the receiving crops differ from those designated in the CAWMP?
-
❑ Yes
4No ❑ 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
9 No ❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
o ❑ NA
to
El NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
❑ NA
❑ NE
r, - �
Comm°ents (refer to question #) :Explain any YES; answers and/or any recommendations or a nyotherAcomment§ r
Use drawingsaof fac�Eity to bettei=explain situahans (use additional pagesjas neeessarS) k ti
toGi IVAS/4 OUT OF- 7-46 C,19-000/6
dT5 C� E-WS 1 oN o N, [_"aoN 4-- 1 17 c 1 SE
Reviewer/Inspector Name' (� % . :• �� Phone: t/U'l`�O-��
Reviewer/Inspector Signature: Date: S f /3//� _ __
Page 2 of 3 12128104 Continued

Y r f
Facility Number: 31 — Date of Inspection r U
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
X"No
❑ NA ElNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
XNo
❑ NA ❑ NE
the appropriate box. 0 WUP ❑ Checklists El Design [l Maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
D(No
❑ NA ❑ NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis ❑ Soil Analysis ❑ VXste Transfers
❑ �Aual Certification
Rainfall ❑ Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and V
Rain Inspections E]
Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Lp" No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes DkNo ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
h�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
gNo
❑ 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
0 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
1� No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
V No
❑ NA
❑ NE
t.
AddhOnalCOmments.andfor DraWmg3 .; d ""w�;.2. "�"�' _y .t�`,��
dL
a11�1�a o ,F3
/as/oci a . cog
C A(�.4 e�wvow C>1�� 0
I H
12/2&04

i ype of visit QkCompliance Inspection U Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit *Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: O Departure Time: County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: Title: Phone No:
(�
Onsite Representative: 1.�1 L-LLA 1wu% ON Integrator:
Certified Operator: %�l �- ��Operator Certification Number:
Back-up Operator:
Location of Farm:
Latitude: E__1 o
Back-up Certification Number:
Longitude: = n = i = «
Design Current
Swine Capacity Population
Design Current Design Current
Wet Poultry Capacity Population C+attle C*apacity Population
❑ an to Finish
airy Cow
❑ an to Feeder
airy Calf
❑ Feeder to Finish
❑ Dairy Heifer
Farrow to Wean
Dry Poultry ❑ Dry Cow
ElNon-Dairy
❑ Layers
❑ Beef Stocker
❑Non -La Non -Layers
❑ Pullets ❑ Beef Feeder
❑ Beef Brood Co
El Turkeys
❑ Turkey Poults
❑ Other Number of Structures:
❑ Farrow to Feeder
El Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ 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?
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 p(No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[:]'No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
PLNo
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility Number: —s(p
Date of inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
14 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier: A*r!,,,
Spillway?:
Designed Freeboard (in): CS 1q. S . S
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No ❑ NA ❑ NE
(ic/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No ❑ NA ❑ NE
through a waste management or closure plan?
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
D(No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No ElNA ❑ 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
[A No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs [:]Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
(q No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
Sj�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
PNo
❑ NA
❑ NE
�-aC-; 60A1 S E� � oar SUS o�V — !ry S I D S c c�7r ► S u �2u�
1 L,Pc R (_t-,T Lf-- l&L.as l C>N pq C,%_x� D �_k\ ko (.A) 6�
Reviewer/inspector Name I.HWA&CA Phone:
Reviewer/Inspector Signature: Date: 5.11
Page 2 of 3 12128104 Continued

facility -Number: , —5(p Date of Inspection
Reauired 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 appropirate box.
❑ WUP El Checklists El Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
C�No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
UfNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
PqNo
❑ 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
15ZNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
ONo
❑ 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
Ja 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
KINo
❑ 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
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
O -No
❑ NA
❑ NE
Page 3 of 3 12128104

Facility NumberE4D
S�
ODivision of Water Quality
O Division of Soil and Water Conservation
O Other Agency
Type of Visit A Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
i
Date of Visit: ! ! Arrival Time: yT Departure Time:, �jF County: Region:
Farm Name: _ q.ZZ_ /1`/�`iQ �/� Owner Email:
Owner Name: Fig e'&*eo _ � �— Phone:
Mailing Address:
Physical Address:
Facility Contact: / Title: Phone No:
Onsite Representative: G� �L' ��5�4� Integrator:
Certified Operator: Llefiz G Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine --
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
El Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
`' ❑ Boars
Other'
❑ Other
Back-up Certification Number:
Latitude: = o = i Longitude: = ° = 1 =
Design Current, Design Current Design Giirre
Capacity Population Wet Poultry. CapacityPopulation Cattle Capacity Po.pulati
•JU Non -Layer
Off �
l r V DryPoultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
ElTurkey Poults
❑ Other
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cod
I
:k �2
Numberof 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?
Page 1 of 3
❑ Yes VNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
El NA
El NE
❑Yes El No
❑ Yes.No
El NA
El NE
,,,���ctt,,,
ElYes ,LJ No
❑ 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?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: 1-0-11-W 0/xx
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?
El yes No ❑NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Yes ElNo ElNA ElNE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes gNo ❑ 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 es No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? if yes, check the appropriate box below. 16
Yes ❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground gHeavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptabl rop 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?
❑ YesA 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 XNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ YesNo
El NA
El NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes dNo
❑ NA
❑ NE
Reviewer/Inspector Name %� d p <j Phone: O 796 ` 32-7
Reviewer/Inspector Signature: Date: S
12127104 Continued

Facility Number: 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 appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps [I Other ,�/ ❑ El21. Does record keeping need improvement? If yes, check the appropriate box below. El/
Yes 2 No NA NE
❑ Waste Application ElWeekly Freeboard ElWaste Analysis ❑ Soil Analysis ElWaste 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 A No
El NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El 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
PfNo
❑ 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/dNo
ElNA
[INE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes�No
❑ NA
El NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El 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
X
ElNA
❑ 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
A No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
,_,(
32.
Did Reviewer/Inspector fail to discuss reviewlinspection with an on -site representative?
❑ Yes
0I No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
[ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
25 7-� S�uo�� SCR ✓F� � 2. S�' ��� -� F,�r -,-;:1 4
`
12128104

Division of Water Quality
Facility Number O Division of Soil and Water Conservation
—.._ _ .. Other Agency
Type of Visit P Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit P Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 'L Arrival Time: ' S eparture Time: 2%� County: U IZ Region: t
Farm Name: O-rR(n Owner Email:
owner Name: l= Ott ARp Z)A-_-CL Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator: Z
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
❑ Wean to Feeder
=" ❑ Feeder to Finish
Farrow to Wean
T El Farrow to Feeder
❑ Farrow to Finish
Gilts
Boars
Other
❑ Other
Phone No:
Integrator: 4d 114 f/ _'Aan(A
Operator Certification Number:
Back-up Certification Number:
Latitude: [= o = a Longitude: 0 ° =1 0 "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
i1.❑ Layer
jI ❑ Non -Layer
211200 1 Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ TurkeX 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 Cur
Cattle CapacityPopul
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Col
i
Number of Structures.
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes XNo ❑ NA ❑ NE
❑Yes
El No
El NA
El NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
7'No
❑ NA
❑ NE
❑ Yes
:VNo
❑ NA
❑ NE
12/2&104 Continued

Facility Numbers EKRI
Date of Inspection I �/
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes VNo ❑ 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: 40- r L) d 2 �M (1101-
Spillway?: D
Designed Freeboard (in): 19.5
Observed Freeboard (in): t'�j� _ 261
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes VNo ❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes VNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? I[J Yes El No El NA El NE
S. Do any of the stuctures lack adequate markers as required by the permit? /❑ Yes �No El NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
4. Does any part of the waste management system other than the waste structures require ❑ Yes 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 El NE
❑ Excessive Ponding El Hydraulic Overload El Frozen Ground El Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
�No ❑ NA ❑ NE
�No ❑ NA ❑ NE
No ❑ NA ❑ NE
XNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
�Ji>�i� Lt%r�Sh�D u T /fiij5 Q�C�.Paf.� �> %�iP�=���P.Cs ��.✓�. �>o
ReviewertInspector Name
Reviewer/Inspector Signature:
Page 2 of 3
Phone: of/a — Ft9l `
Date: 3 s' d 'r,
12128104 Continued

Facili ty Number:—s (p Date of Inspection Z D
Reauired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ yes gNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes VNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. )Z Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
ainfall 9 Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ElWeather Code
R�
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes VfNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
PrNo
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
PNo
❑ NA
❑ NE
❑ Yes
[:]No
f9NA
❑ NE
❑ Yes
X.No
X.
El NA
El NE
❑ Yes
/PNo
❑ NA
❑ NE
❑ Yes
❑ NA
❑ NE
❑ Yes
�&
❑ NA
❑ NE
❑ Yes
No
X
❑ NA
ElNE
❑ Yes
�No
❑ NA
❑ NE
Additional Comments and/or Drawings:
15) /�5oz4
�/�i(.� ��
-77
Page 3 of 3 12/28/04

Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 30 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Q p Arrival Time: Agly-)
Departure Time: County: �>GZ/+� Region:
I lA-7��
Farm Name: Owner Email:
Owner Name: FQLr .F,tf /t%a�✓. / /L! 2L Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: U LOIntegrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
Farrow to Wean
Farrow to Finisl
Ir❑ Gilts
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 0 = 4 Longitude: = ° ❑ 6
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
I0 Non -La et
Other
❑ Other — - -- - — -
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turke Points
❑ 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
❑ DaityCalf
❑ DairyHeifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Coyd
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes VNo ❑ NA ❑ NE
El Yes
- El No
El NA
El NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ NA
❑ NE
❑ Yes
'0
/No
❑ NA
❑ NE
12128104
Continued

Facility NIUmber; 11Y
Date of Inspection 2 5
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?
El NA El NE
El NA El NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 70Y _
Spillway?: /VO NoAlo
Designed Freeboard (in): ,� 5
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?
❑ Yes VNo
❑ Yes ❑ No
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 )n 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) 110
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 0 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box l�e�w. El Yes0 No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground CWeavy 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) f'd.QN G�f�AT SON B�-R�s
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
JO No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
O No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination:
❑ Yes
VrNo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
21No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Z No
❑ NA
❑ NE
I�`-'� "�.�:�t'--_-�a3.ri-�:,� _ u�`��.>..,.,. _tom• n, :�:.=, �- -w ._-z.°:w� �ir�:`�''.�'�s� _" � y
7v : N �y
L'o tip ©AI NCYo, gla-1, 2ooy Grsa /.�oC rFX..,o'!
Q,P,,/e I'v-v
Reviewer/Inspector Name r Phone: 2
Reviewer/Inspector Signature: Date: 25 5
i2128/O Continued

Facility Number.:Date of Inspection ! '
Required Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
evNo
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
ONo
❑ NA
❑ NE
the appropiiate box. ❑ WUP ❑ Checklists ❑ Design
g El Maps El Other
ti�/i�DS
M
21.
Does record keeping need improvement? If yes, check the appropriate box below.
gfYes
❑ No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking 0 Crop Yield ❑ 120 Minute Inspections 10 Monthly and 1"
Rain Inspections ❑
Weather Code
22,
Did the facility fail to install and maintain a rain gauge?
❑ Yes
XNo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[;dNo
❑ 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
'0
�No
El NA
[I NE
26.
Did the facility fail to have an actively certified operator in charge?
El Yes
VNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
NA
❑ NE
Other Issues
'0
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
El NA
El NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
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
r�� SdzG ��5-i FZF S �IBn%f l,�,✓,o %,�n/Gc� �%R % ` �� t Z.✓
� 3 �13.
100 PUM At, Ar"010 AD -f) r c, A P 1 E�
21y1V4,qa C406V KA4,,o 4�0042,4>3
- /vim 0
oarr4_
12128104

Type of Visit f�Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ,/Routine Q Complaint O Follow up O Emergency Notification Q Other ❑ Denied Access
Facility Number Date of Visit: Tune: `'_l.L1_ VJ
Q Not Operational Q Below Threshold
00i'ermitted�Certiified p3Conddiitionally Certified D Registered Date Last Operated
'olrpA7!;3
Threshold: ... ..
Farm Name: .... L._._1] '- _.. ............................... County: ».». fe ll.. ._................. .._ ...
OwnerName:.._..,........................._................._............. ......................... ........ Phone No: ..................... ._................................ ... _.
MailingAddress: .................................................................
_..... _ ��. .. - •.... ............ __ . _ ._
Facility Contact:
Onsite Representative:
................................. Phone No:
o_ ._� �» �. _ .. y- -- •...
Integratr:........1� 1� N—LA 5
Certified Operator: --................... ..............._.............................................. ..... Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 " Longitude �• �4 «
Discharges R Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes o
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)0 yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes Bl o
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes R<o
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes [ fo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ............. I................... Z. .� . 3 .......................... .... ...........
Freeboard (inches): 3
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 dNo
seepage, etc.) MI
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes J[T 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 maintenancelimprovement? Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenancefimprovement? ❑ Yes [�o
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 maintenancefunprovement? ❑ Yes ZN
11. Is there evidence of over application? If yes, check the appropriate box below. El Yes �N/o
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type C<,Vj
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes 0 No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
b) Does the facility need a wettable acre determination?
❑ Yes
c) This facility is pended for a wettable acre determination?
❑ Yes INN
7Nq
15. Does the receiving crop need improvement?
❑ Yes
16. Is there a lack of adequate waste application equipment?
El Yes No
Odor Issues
IT Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes No
Air Quality representative immediately.
:comments (iefe to.griesteon #) Ezplaia any, Y a sw s a jar any=recamaienaa ons nr =any other comments. a
� ."+a _...�'t ��t+i�xd
Use drawings of factiity4to better expiau� sitaat.oas.�(aseddittunal pageas eery)Field Copy ❑ Final Notes
�.) G t,VL 5aw(>5 6-OW 4 E
T
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: '"7 p
121I2103 Continued

Facility Number: 3�
Date of Inspection ? C
Rerruired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 3I-35)
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?
❑ Yes En No
❑ Yes [1 N
❑ Yes No
❑ Yes O/Na
❑ Yes
to
❑ Yes
INp
❑ Yes
7No
❑ Yes
❑ Yes
No
❑ Yes
ZNO
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

M
Type of Visit compliance Inspection 0 Operation Review /" Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Fallow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit: S % ® Time:
Not O erational 0 Below Threshold
yj Permitted Li Ce fled 0 Conditionally Certified �LJ Registered Date Last Operated jor Above Threshold:
Farm Name: /��L �Q_DT/-FF.rQs / f}� County: _ 0C/u)0GlV
Owner Name: % , �i3'Z!i Phone No:
Mailing Address:
Facility Contact: Title:
Onsite Representative:[ -
Certified Operator:
Location of Farm:
Phone No:
Integrator: 2&,V_ CL 5
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 04 " Longitude 0 6
Current
Nwme
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feedei
El Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Ca' acity Population Cattle Capacity Population
❑ Layer ❑ Dai
❑ Non -Layer I ILJ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of.Lagovns _ '� I L❑ Subsurface Drains Present J10 Lagoon Area 10 Spray Field Area
�Holdi g'Pon 1 Solid Traps
❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ill ty Z d
❑ Yes 0 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
No
❑ Yes
❑ No
❑ YesldNo
Structure
Freeboard (inches): !i -P 3 -33
05103101 Continued

Facility Number: —W j Date of Inspection V 3
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes El 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 Cl No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? El Yes ❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
,RfNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
µ sedraw�ngs
�Gomments_(refer to.queshoa #I) Eaplarn any YES answers andlor,aay reeommendatronIL
to Better explaEn�•.\s�itirattons:=(use addhorial neces
of�facibty pages as Sary) ❑Field Copy ❑Final Notes
�tG�G- ff f
Reviewer/Inspector Name j
Reviewer/Inspector Signature: Date: D
05103101 Continued

of Visit 0 Compliance Inspection O Operation Review Q Lagoon Evaluation
for Visit O Rouutine O Complaint ,0 Follow up O Emergency Notification O Other © Denied Access
Facility Number Date of Visit
Permitted [3 Certified Condition y Certified i3 Registered
Farm Name:
Owner Name :.. .......... .. -'1%�. a ...._._.......r��
MailingAddress- ........ —......... -..... ............... -.....................
Time: L
O Not O erational O Below Threshold
Date Last Operat:MWz.;:-7x)
Above Threshold: .........................
County:...... ................__
Phone Na:
FacilityContact: .................. ..... .............................. Title:.............................. ........................ ...... hone No:..................... ..... ........................
OnsiteAepresentative:... L .!Q -Zi✓ Integrator: GL ......._................... .. .........................................>�i..
Certified Operator: •--........ ........................... ........... ...................................................... Operator Certification Number:
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 Longitude • 6
Wean to Feeder
Feeder to Finish
?< ❑ Layer
= ❑Non -I
Farrow to Wean
` `❑ Other
Farrow to Feeder
Farrow to Finish
Subsurface Drains Present 110 Lagoon Area 10 Spray Field
No Liquid Waste Management Svstem _
Discharges & Stream bnpacts
1. Is any discharge observed from any part of the operation? D 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 D WQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? j] Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4- Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes [ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ................................................ ................................... ..................................... ...•--•-
Freeboard (inches): ................................... ............................... ........

Facility Number. — Date of Inspection 02
5. Are there any immediate threats to the integrity of am' of the strucoires observed? (ie/ trees, severe erosion, D Yes D No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? f D Yes D 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 structw= need maintenance/improvement? 1D Yes D No
8. Does any part of the waste management system other than waste structures require maintenancef=provement? D Yes D No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? D Yes ❑ No
Waste Application
10. Are there any buffers that need maintmanceiinmrovement? ❑ Yes D No
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload D Yes ❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? D Yes D No
14. a) Does the facility lack adequate acreage for land application? D Yes D No
b) Does the facility need a wettable acre determination? D Yes ❑ No
c) This facility is pended for a wettable acre determination? D Yes D No
15. Does the receiving crop need improvement?
16. 1s there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily -available?
19. Does the facility fail -to have all components of the Certified Animal Waste ManagementPlan n readily available?
( of WUP, checklists, design, maps, -etc.)
19. Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)
20_ Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21.. Did the facility fail to' -have a actively certified operator in charge?
22..Fail to notifyregional DWQ of emergeney.situations as required by General Permit?
(ie/.discharge, freeboard problems, over application)
23. Did Reviewerdnspector fail to discuss reviewfinspection with on -site representative?
24. Does facility require a follow-up visit by. same agency?
_ 5_ :Were any additional. problems noted which cause noncompliance of the Certified AWMP? -
D Yes ❑ No
D Yes D No
0 Yes ❑ No
D Yes D No
❑ Yes D No
D Yes ❑ No
D Yes .D No
0 Yes D No
D Yes No
:D Yes YNo
E'Yes :[]No
E3 No violaiions:or.deficiencies-weremated,during.this visit. Youm ll-receive no further.correspondenceabout ami -visit.
kt.r< S f
2...iii�a
+9CO.,.:.:.w-:,ss,
In— #zME
qr+>...w..::2>:
;--........ Fie1dC "YJ
-
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i
'
T
ra`s:.. - _ .e.:r:.v.�ti,..:;wscc-::;i:<c:;c.::,;!;S:r::...:..:t^.:s.nY.,?^::r::-as.:r:•
Reviewer s ame
1�
.ReviewerAnspector Signature: Date:

Facility Number: — Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation? -
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Additional Comments and/or. Drawings: „; ,;
>�o O� y � � 7747��0,J
r/&4 ���
ALOFFS
Loa •
Z(OF& —rW= 77zA-,< r+.
0 Ur s �
f fig 1014V-)
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©PtRik-702 FZGLrp z� Ac>rzr')�
O Uis N'))o 5 `fA y z (JC-�D C D rJ7 L
`� -� aF �op� � �5 . Sz � F U� �4cL 5 d % l✓ �-c--Do u, ►'�o �v,�
�o10,
j�v � fll✓L � � �7D2 - - S I��► � !� R O G-ASS C�""azprxe
"
-:T�i .GpF arts. �FFP OP T6E �JUORk,
05103101

Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit g Routine ()Complaint O Follow up O Emergency Notification. O Other ❑ Denied Access
e
Facility Number Datof Visit:
- ---------------
#Permitted Q Certified Q Conditionally Certified 1 Registered
Farm Name: �� ........�'��.?//L S R _
'Owner Name:........... �W( - ..... ......�./.azg .
Mailing Address:
Not
ional O Below Threshold
Date Last Operated or Above Threshold: ........ ................
County: ....... O.Y L2iJ... ,_ .........
Phone No:
Facility Contact : ............................................................. Title: ............... Phone No:
• a %..............................,
Onsite Representative:....!Q---...... ��zL Integrator....LRdL t- S.....................................
...............................................................................................
Certified Operator........................................................................_...................................... Operator Certification Number:
Location of Farm:
U(5wine ❑ Poultry ❑ Cattle ❑ Horse Latitude 10 ` u Longitude 0 6
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWt)
2. Is there evidence of past discharge from any part of the operation?
❑ Yes ❑ No
D Yes P(No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? 0 Yes JNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? 0 Spillway 0 Yes 0No
S ucture 1 Stru ttu�ure 2 S tore 3 Structure 4 Structure 5 Structure 6
Identifier. •----...��....2."�I.ih,P3 ....... .
r- - ----------------------•.........................------------.....---....---...........
Freeboard(inches): ........ ....��.. ...........................13..1.................. Z�.............. ................................ ..: .......................

Facility Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6.was answered yes, and tiie situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancerimprovement?
8- Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic
n i - 1) r
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA
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?
Re uired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19, Does record keeping need improvement? (ieJ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
.21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(id discharge, freeboard problems, over application)
23, Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24, Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? .
❑ Yes
jgNo
❑ Yes
;dNo
XYes
❑ No
❑ Yes
PfNo
❑ Yes
XNO
❑ Yes IV,
❑ Yes No
❑ Yes Q"No
[I Yes /❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes eNo
• Yes /No
❑ Yes /No
❑ Yes o
Xyes ❑ No
0 Yes - ( 40
❑ Yes YNo
❑ Yes No
0 Yes 0No
❑ Yes Ao
❑ Yes �KNO
LE3 .No -violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
„<•.. } . ,,,,}„R .22: -r}s \'-,: {-:1 Y s. „zz ..Y Y } zt" vgC+C{`.,}
ez iP3BE; 'w>z a9lEllf►1' $IIS�H .btBl'E
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..<;,:Y.,<:<.;:;•:�_::.,<>'reld CopyFinal
::.::....::.:<;-:::-:.,_'._-....,,............-:.t- .t.,�
.:�:. ,}. d.�c - ,.2�?:-> f`.tcz`:c:. %�:}?.::• -sr:a:x.•<.:.: ::m::^::ccrct<:uett;x neca�•n:<ttMc^t^:^- fG.i`.;kSt:
rEF� �;_4 1�s�nF I-c Z4600Ns E�� �,�
l�i?O // F �o T�o/rl SG oP�' -�O G-•E, C.�DO,o 11E�"Tig-T�
6 c­ i ? of -r e O C E�o . /�'�C�O/Yl /nr:;,v �E
1f�zaxz�o�
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v� Cam" O� �DuoG S oze- l tJ��F2 25 .-e T > -D e s �
- :uo::• •.:r.^. :cu^ r.�x-:�>-.�^c;•a:.::�::ar^.:. ::xc^. ::.:ra:�- ^.i:c<�: - :cox::
- ox.< -
evrewerllnP actor Name.......:-::':..........
Reviewer/Inspector Signature: Date:
r
is

Facility Number:
Date of InspectionGY (�
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31, Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes PNo
oYes
❑ Yes No
❑ Yes Z, o
El Yes 7o
❑ Yes ❑ No
Additional Comments and/or,Drawings:
p � t�R' POP Fn) C �'/t0 L I�I�' F�O ��pa � a0 'RODGr9�-`
( nvF0
FR0N\ C-Qo—
Co
3 2.
-ro �6tP
tPEPf"-T-OP S2f�R7r---
(jA ��EjP2�� �+leuCt� t' bb
11 F L. � i<<.J � \ �2 (�•Q2 �Cs--S p v`� � �J f F� r I � �(�� SAS 1 v � � �1.�
NJJ,- ro Co ffR.
(pd `,Dgy5 ° D up--orvc,- CRDPe2-k- Sr f:1\So10-
ivC7trE 4- X L
Cro � C) , � 0 SS � �r N �c-�t�T� � NN o -i�s u P#-
05103101

Date of Visit: Time: 6 v
Facility Number
Not O erational Q Below Threshold
Permitted © Certified [3Conditionally Certified 0 Registered Date Last Operated or A ove Threshold: .........................
�G .1.. �l dS , SOL., County: ..... �....... ,.... ..................................................
Farm Name: ... .............................................................
Owner Name:................................................... .... ...... Phone No:
.....................................................................................................................................................
FacilityContact:.........................----................................................. Title:................................................................ Phone No:
MailingAddress:......................................._.........`............................................................................................................ ........... .................... ..........................
�
Onsite Re resentative• . �w A- .............................................................. Integrator: �
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �� �� 0`< Longitude
T" T Dein .CDesign Current . e CDaesaign
Swine Capacity ulabonPoultty Ca aci ,,Po ulati_on_Catd-
city
r _Current
_= ❑ Wean to Feeder ❑ Layer ❑ Dairy
❑ Feeder to Finish IEJ Non -Layer ❑ Non -Dairy _-
❑ Farrow to Wean
Farrow to Feeder QOO ❑Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars total,SSL- W
Nfimber,of Lagoons - ❑ Subsurface Drains Present ❑Lagoon Area [:]Spray Field Area
"olding.Ponds'/ Solid Traps ❑ No Liquid Waste Management System -
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: .................................................................
Freeboard (inches):
S/00
❑ Yes 8fNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes J�fNo
❑ Yes P�No
❑ Yes KNo
Structure 6
Continned on back

Facility Number: i Date of Inspection Printed on: 10126/2000
5" Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 9No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes X(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? MYes ❑ No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes 2(No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? J9Yes ❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes KNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload El Yes VNo
12. Crop type � LJ l so V �Q S c iz- _
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes �"7'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 JqNo
16. Is there a lack of adequate waste application equipment? ❑ Yes XNo
Reouired 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?
Yes
t�No
(ie/ WUP, checklists, design, maps, etc.)
❑
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
%Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
b(No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
U'No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes No
24. Does facility require a follow-up visit by same agency? ❑ Yes )kNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes P No
�46-yiolatigiis ©r- di f ciencies -mere poted• during �bis:visit; - Y:oie will-t. eeeiye Rio further -
correspondence: about this visit. :::
Comments (refer to question #): _ Explain any YES answers and/or any recommendations or -any otter comitnents:
Use drawings of facilityto better explain situations. (use,additional pages as.nec_essary)
ajC C CGiS\I
t� J
U���11G`� �S- �VGct✓dl��� �[S-2 ujcoc�
qFF
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: g/pp

Faellfty Number: 3 — Date of Inspection t--�=1"" Printed on: 1/9/2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below xYes ❑ 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 XNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ff 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 PNo
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 PINo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes
RNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes J'9No
._.�ditionat.Comments-and/orDraw�.
Sly A. 43��,1�r
1� C.c��,`s
1
s s •ems
psi .
ti �1
t 1
o�►-�.t h-�,-,e s ro�,�c etc �..,, -- raei}�S e ►'�c� s
C jz CL
5 5
5100

i Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency.
Type of Visit ikCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: - jD•-jJt7 Time: ; pp Printed on: 7/21/2000
5
0 Not operational 0 Below Threshold
Pj Permitted 0 Certified rj Conditionally Certified ❑ Registered Date Last Operated or Above Threshold: .........................
Farm Name: i f vtn County: k .1..t ...............................
.... �Pr.................re.5...........5pvv......Fra..................................... ..... �...........-.............. C.
Owner Name: 4 } [ �. r ...
d.........Edwd.................................................... Phone No: .... . .....ZJ.U1'7.......k. :.r ..
3...
I
Facility Contact: .H.Lh.vy....... .1i0.�! 4, ....... rd.....a...i.1.........Title• +N t Phone No:
MailingAddress: ............................ I ....... ............... - ............................. ..........................
Onsite Representative: �'tI......................Du;( . ...... Integrator: .... ........................-.Yf.�.1.l..'.5...............................
Certified Operator:......�to.y,%I.............................tA.►!Jp4...........DP.L.jJ............ Operator Certification Number:..............
Location of Farm: i
FIR
17
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer ❑ Dairy
❑ Feeder to Finish ❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons 1 19Subsurface Drains Present 110 Lag—n Area Spray Field Area
Holding Ponds / Solid Traps JE1 No Liquid Waste Management System
Discharges & Stream Impacks
1. Is any discharge observed from any part of the operation?
❑ Yes
[SKNo
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/tnin?
d- Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
❑ No
2. is there evidence of past discharge from any part of the operation?
❑ Yes
5(No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes
C,No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
RNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
L4 O.I.... �?, I 'I
Identifier: ...............:�.. fi ........ ... ................... ........................`.............. ............ ....................... .........-............... ........ .... ....................................
Frechoard (inches):
5100 Continued on back

Facility Number: .3 (— Date of luspection 10 A Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ic/ trees, severe erosion, El Yes ('No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes qNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? . ❑ Yes 5kNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes I�No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes Pq No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes Q(No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes 0 No
12. Crop type 5
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? El Yes ENo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes D(No
b) Does the facility need a wettable acre determination? ❑ Yes V No
c) This facility is pended for a wettable acre determination? ❑ Yes [gNo
15. Does the receiving crop need improvement? ❑ Yes QkNo
16. Is there a lack of adequate waste application equipment? ❑ Yes j(No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes %,,No
Cr
18- Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.) ❑ Yes N(No
19- Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) 5dYes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes XNo
21. Did the facility fail to have a actively certified operator in charge'? ❑ Yes XNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes j4io
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes gNo
24. Does facility require a follow-up visit by same agency? [-]Yes XNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes A No
0: pia viglations:or delrcienc&_5 were h6 ed- during this:visit: • Y:oir will-reeeiW J6 farther -
• .' correspondence: ahout this Visit. . . . . . . . . . . . . . . . .
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
VVDtSt-t 6,.A(yS:s
� P
ReviewerlInspector Name L l r ce V M e-V t
Reviewer/Inspector 5ignature�,� N }, ;5 /,� �/1l1 r,{/,tiA,/ p_ Date: S 1 /D/O'o 5100

Facility Np mber: — Date of Iwspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes RNO
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 VNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes R No ,
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes -ONo
Additional omments and/or Drawings::, -
i
7

13 Division of Soil and=Water:Conservation - Operation Review r
0"Division of Soil and Water Conservation -:Compliance Inspection 'i
ivision of Water Quaitty Compliance Itispecttvn ,
�
Other Agency ration-'RevierY g Y -. O eP
tine 0 Complaint 0 Follow-up of
Follow-up of DSWC review 0 Other
Facility Number j Date of Inspection 7 �q
Time of Inspection a' 24 hr. (hh:mm)
,ep"ermitted'Certified Q Conditionally Certified 0 Registered 10 Not O erational Date Last Operated .
Farm Name: �. Irt------.... County:..----.--- �.�?... �-`_�............................................
.............
OwnerName: ................ ........_.... _ ._..... Phone No: .......................................................................................
FacilityContact: ......................... ............................................................ Title :....................................................... ......... Phone No:................................--..
MailingAddress: .......................................................................................................................................................................................................... ..........................
Onsite Representative: p -rkCLo D L Integrator:....... CA.RA?�?.l'`.'s.........................................
.............................. ..........
Certified Operator: ........................................................................................................... Operator Certification Number: / C)
......z..............
Location of Farm:
............... ....................................... ..... ................................................................................................................................................................................................. V
Latitude, 0 ° •4 Longitude • 4 C.
Swine
Design Current -Design.' Current Design Ciirrerit
Capacity Population - Poultry :.Capacity .Population Ca£tle Capacity Population
❑ We to Feeder
eeder to Finish
576p
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Soars
-Number of Lagoons.:-. J❑ Subsurface Drains Present ❑Lagoon Area ❑ Spray Field Area _
Holding PondsY.Solid Traps " El No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
h. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: F
Freeboard (inches):
tl.............
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes 0No
❑ Yes R�No
❑ Yes O No
❑ Yes No
❑ Yes I No
❑ Yes V No
❑ Yes ❑ wo
Structure 6
...................................
❑ Yes P "o
Continued on back

Facility Number: j / — 576 fl Date ol• lnspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes 0 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 0
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes �No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes 1;Ao
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes VNo
11,
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes P(No
12_
Crop type " W tAV_,,X C' S , �;? l
13.
Do the receiving crops dif r with those des gnated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes XNO
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes k -No
b) Does the facility need a.wettable acre determination?
❑ Yes P!rNo
c) This facility is pended for a wettable acre determination?
0Yes ,�V o
15.
Does the receiving crop need improvement?/Jpves
ONO
16.
Is there a lack of adequate waste application equipment?
Yes P410
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes gfNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
❑ Yes No
(ie/ WUP, checklists, design, maps, etc.)
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes ONO
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes �No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes erNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes AN
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes No
24.
Does facility require a follow-up visit by same agency?
❑ Yes �No
25,
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes �No
0: �4,6.*Mhtidris'ok- deficiencies -were noted• d&ift �bis'visit; • Yoi} wiil•rebt Mi iiti further
;correspondence. abouir this visit. . .
Comments (refer.to question #):r Explain any YES answers and/or any recommendations or any other comments -
Use -drawings of facility W,,better explain situations. (use additional pages as necessary) -
?IfC_-) �� ca�w,.�►�-:a�s jAe,,t: nf� AC.�GIi` IBcz;G+�` s�€sL Q< t
S-3C.
Reviewer/Inspector Name -'
Reviewer/Inspector Signature:
Date: 7% Z
3/23/99

Facility Number: [)ate of Inspection
7--7—`'T
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?
2T 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 ,ZNO
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 XNO
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 ZNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes , "No
[Additional Comments _and/orravings
3/23/99

Division of Soil and Water Conservation [3 Other Agency
Division of Water Quality
„ems e ��e� . �-z- �.:. :. A .m. �..:�.��, ;. , � �•.x.� �n :� �,�� �`'°h`w � �.
Routine 0 Complaint O Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number
Date of Inspection i i o115�
1 Sir.+
Time of Inspection EKinU hr. (hh:mm)
© Registered Cerrtiifed © A� `pplied for Permit 10 Permitted 0 Not Opera Date Last Operated:
. W
Farm Name: ...............''i+V
...... &fit Yba r.S....._-G�rnn................................................. County: ........ �1�rk�ilw...................._......................................
Owner Name:.... ..................... E..4�waj........... ail....................................................... Phone No: �!14 ...........................................
Facility Contact:... ............................................... ........ ... Title:................... ....... Phone No:
MailingAddress ......i ZS....N L. -4... ............................................................. ....... x'"",x.Y.paL...f.,N..C................................... I?.41.........
Onsite Representative: ............. .ksr-... I ,, ............................ ................. Integrator:......... ds.............................. .
Certified Operator..................................1.............................................................................. Operator Certification Number .....
Location of Farm:
.......lAf1. .......St 4......Lt........ y....Z...r...:.��....Nn�.�.S.....9.tlQ........a...........Z�.r..................................................�
.. ........................... ............................................. .............................. .
Latitude =0 ' " Longitude • =' ="
Design Current �_ Design Currenu Destgn Cur eint
Swore Capacity ;Population Poultry Capacity Population° Cattle Capactty' Population
:. ..
❑ Wean to Feeder ID Layer I I 1z"..❑ Dairy
❑ Feeder to Finish 10 Non -Layer El Non -Dairy
RrFarrow to Wean 49*_9 u
Farrow to Feeder p (.00 ❑ Other ,
El Farrow to Finish w Total Design Capacity`w
` ❑ Gilts
❑Boars Total SSLW
Number df oons / Holding 1'6nds Subsurface Drains Present ❑Lagoon Area KSpray Field Area
❑ No Liquid Waste Management System �
General
1. Are there any buffers that need maintenancetimprovement?
❑ Yes
99 No
2. Is any discharge observed from any part of the operation?
❑ Yes
-r7I No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
® No
c. If discharge is observed, what is the estimated flow in gal/min?
�
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
EP No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
IP No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
9I No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
In No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
ICI No
7/25/97

Fa4Mj Number: l — 9
S. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes No
Structures (LagoonsZolding Ponds,Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (ft): .............4. ...........................Z.......................Z..............._..................................... .................................... 10. Is seepage observed from any of the structures? ❑ Yes Q No
11. is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes 1A No
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-I2 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?
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 .............. ........... ............. Q2.1�........................ I ...... I..... .
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AVVW)?
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.violutioiissor. de' it:iencies.were-noted-during this.visit'._ Yoi14ill rece'i've n' 6Airther
: ctirrespandence about this. Visit.,','.
X Yes ❑ No
❑ Yes 18 No
❑ Yes EO No
❑ Yes No
❑ Yes No
❑ Yes C9 No
❑ Yes tB No
❑ Yes (J No
❑ Yes U3 No
❑ Yes ® No
❑ Yes 9 No
❑ Yes 0 No
❑ Yes 18 No
t 7-. _[," S 6r. -�L 00�W a`Y�. 0,9 k. o (P:SDC.zS �- J1,-U13 iv - �. cy. n( V'etnevej .
-0�*rr►d g; : + "Atr 4v- c.ss k� e� l r.�et P; � s : w Ujwr` � z s k,16 Le eo-it« J,
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: fV1Z_,/ / Date:

❑ Division of Soil and Water Conservation 0 Other Agency
® Division of Water Quality
19 Routine O Complaint O Follow- u of DNVQ inspection O Follow-up of I)SWC review O Other
Facility Number 31 Date of Inspection 1b/aij4 1
Time of Inspection I =t'c 24 hr. (hh:mm)
® Registered 0 Certified © Applied for Permit © Permitted 113 Not O erational Date Last Operated: .............
Farm Name: ....�iaFti ll...... a........�TnriN.......................... County: %p,�.................. ............
OwnerName:... MAu,4.......haj................................................................................... Phone No: NO-24k:7.0,377.1 .................................................
Facility Contact: .... r1x1�.......�� �.................I....'..................... Title:...." ....................................... Phone No: I-II(OVIL—JaU ...............
Mailing Address: Uir Air..... Itay ... 14......�as..................................................Kxnayas�,ll�. N...L.................................... ....11- 1 1...........
�....
Onsite Representative:.... r . ,.' ....... . �.......................................................................... Integrator:........ .. Y:O�.�.S�..................... ......................................
Certified Operator:.......�-{LY .... �?.:. 4�i�.... .............................. I .............................. Operator Certification Number:...... IYU?......................
Location of Farm:
...z!i...M5�:.....: . a ........arx.......LIS.......:L...MdA.!... ........ 5.......;!.!......cx,.!fi�.............
�.srk•..... j J v...i�............................................................................................................................................................................................................ .
Latitude Longitude �• �� �°
Design`" Current ,Design Current> .' Design Current
Somme`""' Capacity P©pulahon Poultry Capac►ty PopulatidnF Cattle Ca act Po ula on ''
w.
❑ Wean to Feeder I0 Layer � ❑ Dairy
[� Feeder to Finish ❑Non -Layer ❑ Non Dairy
® Farrow to Wean 00
Farrow to Feeder pp�
❑ Other
El Farrow to Finish Total Design Capacity ��
❑ Gilts
❑ Boars _ Total SSLW
�Nutml>er of Lagoons fHoldrngPondS', .3 Subsurface Drains Present ❑Lagoon Area Pl Spray Field Area
77.
t : r ❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Surface Water? (if yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
A Does discharge bypass a lagoon system'? (if yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes W No
❑ Yes 1P No
❑ Yes
0 No
❑ Yes
EZ No
N
❑ Yes
[W No
❑ Yes
tO No
❑ Yes
R No
❑ Yes
0 No
❑ Yes 14•No
❑ Yes (&No
Continued on back

•r
Facility Number: ]f - � .
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
9 No
Structures (La2oon5,Holdil3!Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
V1 No
Structure I Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: ............ ............................. �.........................................
Freeboard(ft): 1. .... -............................AA...........................................................................................................................
10. Is seepage observed from any of the structures?
❑ Yes
10 No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
® Yes
❑ No
12. Do any of the structures need maintenance/improvement?
Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
0 No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
WO
(If in excess of WMP, or runoff entering waters of the State``, notify DWQ)
15.
Crop type ........S6►Pw,S............. C.!#:oN..................... ....�k�t�►. .... ...........
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
® No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
W No
18.
Does the receiving crop need improvement?
❑ Yes
O No
19.
Is there a lack of available waste application equipment? '
❑ Yes
No
20.
Does facility require a follow-up visit by same agency?
Yes
❑ No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
iNNo
22.
Does record keeping need improvement?
1A Yes
❑ No
For Certified; or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
91 No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
IS No
[] No'violations-or. deficiencies were -noted -during this:visit:-:You:+will reCeiv`n`fiiriher:
Ofrespondebce AWA this.visit.,'-:
11V17. Evos;co, area Ara:js,a Smv�kj Pow �,pC in karP . #f 4kcv)d W*_ ahoy uJ yK1ieeJcd. �
lnLty P;y ec is, jq_VOns -}4L 4-3 5kwld 6e eX4'U1Jj 064 4. eto5%ovk W(xs b�,ckA f uJ ,a�'�- t-6,1
'a tested. G��Aj tow ptpc ro, ltyor, #-I s�,w b � or fu �16o hla-4J
�j ` Yt� �,r'47-.A.Ir' LVl"�1 1 � to (GI�GGtI • did �,pO�iY D�tcS ar. oi� WG-t� SV+au+u �pe cSYeOttJ A+`�
t-eseeae�- `ruts er �µ.,� ►,.r+.�r�av�Cr t�}skltiSJslocltd bal fetvavF.d� All }po,,�e a.:-eE.S Should foe. r-tseed�.
ZZ-4INS actitay_ Aa e. s�roj,,3 o, SkoA be ��W5 n,6jld be
4cor�.bt..c� Tr��IRn �,er
CM4aiCykm 1rr r P4 iL�et1K C mLA- `�rt�c��t} PW� `� tiers s6M IgQ �O h,-4 ! n
C bv-m i t c v-ds. 7/25/97
Reviewer/Inspector lame ti
Reviewer/Inspector Signature: fjt"
Date:

State of North Carolina
Department of Environment,
Health and Natural Resources
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
November 13, 1996
Edward Dail
Edward Dail Farm
805 NC 24 East
Kenansville NC 28349
SUBJECT: Operator In Charge Designation
Facility: Edward Dail Farm
Facility ID#: 31-561
Duplin County
Dear Mr. Dail:
Senate Bill 1217, An Act to Implement Recommendations of the Blue Ribbon Study
Commission on Agricultural Waste, enacted by the 1996 North Carolina General Assembly,
requires a certified operator for each animal waste management system that serves 250 or more
swine by January 1, 1997. The owner of each animal waste management system must submit a
designation form to the Technical Assistance and Certification Group which designates an
Operator in Charge and is countersigned by the certified operator. The enclosed form must be
submitted by January 1, 1997 for all facilities in operation as of that date. Failure to designate a
certified operator for your animal waste management system is a violation of 15A NCAC 2H
.0224 and may result in the assessment of a civil penalty.
If you have questions concerning operator training or examinations for certification, please
contact your local North Carolina Cooperative Extension Service agent or our office.
Examinations have been offered on an on -going basis in many counties throughout the state for
the past several months and will continue to be offered through December 31, 1996.
Thank you for your cooperation. If you have any questions concerning this requirement please
call Beth Buffington or Barry Huneycutt of our staff at 919/733-0026.
Sincere y,
A. Preston Howard, Jr., P.E., Director
Division of Water Quality.
Enclosure
cc: Wilmington Regional Office
Water Quality Files
P.O. Box 27687. NK *
Raleigh, North Carolina 27611-7687 An Equal Opportunity/Affirmative Action Employer
Voice 919-715-4100 - 50% recycled/ 10% post -consumer paper

:�) 1_-6�'l
Site Requires Immediate Attention:
Facility No:
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL: FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 1995
Time: l
r
Farm Name/Owner: P/rl(L, D cz,,'
Mailing Address: _ii_ ") vL �{ L,� Ke VAr -1A j L Ila C. �ir3 Al 9
CountyT I ! vt _ _ _ _ _J s
Integrator: a-2 C ro l �5 _ _ _ Phone:
On Site Representative: / /� _ _�T_ _ _ _ Phone: A ?& 13 7Z
Physical Address/Location :n „J %(nr ��_ '!_ i-IL12y.T 4, 0!j_ `l,N. a... , i } lip
Type of Operation:. Swine Poultry Cattle
Design Capacity: 4Poo �u3s Number of Animals on Site: % 000SAA4Q PIVA
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 3 / �S ' _ Longitude:_° Elevation: Feet
i
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) (9 or T�o Actual Freeboard: _,2--Ft. 4_ Inches
. Was any seepage observed from the iagoon(s)? Yes or& Was any erosion observed? e or No
Is adequate land available for spray? or No Is the cover crop adequate? Us or No
Crop(s) being utilized: �n
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? O or No
100 Feet from Wells? Oe or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes oo
Is animal waste discharged into waters of the state by man-made. ditch, flushing system, or other
similar man-made devices? Yes oz'�_,91 If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, Iand applied,
spray irrigated on specific acreage with cover crop)? Yes or No
Inspector Name
L
Signabre
cc: Facility Assessment Unit
Use Attachments if Needed.