710004_INSPECTIONS_20171231

NUH rH UAHULINA
Department of Environmental Qual

E
Visit Co (lance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: f D' Arrival Time: ® Departure'f ime: County: NDlR Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: 4_)&1z_ Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator: Backup Certification Number:
Location of Farm: Latitude: ❑ o = 1 = , Longitude:
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
E Layer
Non -La et
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish
Q D
192
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Cilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
i
❑ Turkey Poults
❑ Other
Discharees & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non-DaiEy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: =1
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
[--]No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
[]Yes
[ o
❑ NA
[:IN E
❑ Yes
,alto
❑ NA
❑ NE
12128104 Continued

I.Facility Number: -)I — Date of Inspection I W ! .1 LQr
'Waste Collection &Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑Yes
El No [I NA El NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No ❑ NA ❑ NE
Structur I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: M
Spillway?:
Designed Freeboard (in): 1q,
Observed Freeboard (in): 5
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ NA El NE
(ie/ large trees, severe erosion, seepage, etc.)
VNo
6. Are there structures on -site which are not properly addressed and/or managed
El Yes
❑ 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
environmentalt"at, notify DWQ
Do any of the structures need maintenance or improvement?
El7. YesVNo
❑ El NE
8. Do any of the stuctures lack adequate markers as required by the permit?
El Yes
❑ 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
[I Yes
,�/
L( No ❑ NA ❑ NE
maintenance or improvement?
Waste A1212lication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
L'J No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
[]Yes
E No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs []Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window` [I Evidence of Wind Driift El Application Outside
of Area
12. Croptype(s) �EA m01nh {. a) oC- C G ) 4�Gd
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes Zo
o ❑ NA El NE
15. Does the receiving crop and/or land application site need improvement? El Yes ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'![] Yes [Xo ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes rNo
o El NA El NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ❑ NA ❑ NE
(APB Ajj_9 zcc os LoaIL Gv, !,'
Reviewer/InspectorName pJ :f-�`
bl �s�, � �. - .•>
Phone:( //0
%�� �—. '""
Reviewer/Inspector Signature:
Date:
2%q 0 5`
12128104
Continued

Facility Number: Date of Inspection !w o$
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes E 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 ❑Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
C"I 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
[%No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
L/( No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
dbVN
❑ NA
[INE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ 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
IQ No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
LdNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ZI No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
_,/
l,4 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?
❑
ETNO No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
LJ/ No
❑ NA
❑ NE
Additional. Comments'andlor_Drawings:
12128104

1
IType of Visit 9F Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 9VRoutine O Complaint O Follow up O Emergency Notification O Other p Denied Access
Facility Number Date or visit:
Permitted Q Certified .©/CoonnditionaUy Certified ❑ Registered
Farm Name:
Owner Name:....»..
Time:
Date Last Operar Above Threshold: ... .... »»..
County: _ ..» »......._.......
PhoneNo: _....»..»�_.. _.....».....» .................. ........
MailingAddress: ..........._....... _._.......... _ ._....._.....»..._..............._.._..............._....._...»..._.».___._....................... .....».... » ...»....................
Facility Contact: . __ .». ». »»»._ .. .. _.._ Title:... �,� I .._ _.. .. .._._...» _. Phone No:
Onsite Representative:.„��LL SJ _�. !�» „,G�Integrator:
CertifiedOperator: . ......... . . . .... . . . ........... »»»__....»._.»...........»........... ..... _............... Operator Certification Number: ............... ....................
Location of Farm:
ASwine ❑ Poultry ❑ Cattle ❑ Norse Latitude • 1 66 Longitude • 4 49
Sine
Wean to Feeder
;yk:
❑ Layer
Feeder to Finish
; ❑ Non -Layer
Farrow to Wean
t
Other
Farrow to Feeder
i
'' ^ �' Total Des3
! k. k
Farrow to Finish
Celts"
Boars
..-M
`Hnldin
Discharges & Stream ImRacts
1. Is any discharge observed from any part of the operation?
Discharge originated au ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man -trade?
„M�❑ Non-Daiiy
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/rain?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
Desaga'J,Cnrrnt.
❑ Yes FrNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes gNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes A No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ZNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
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,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Excessive Ponding ❑I /PP�AN ❑ 1Hydraulic Overload ❑ Fro n Ground
12. Crop type ��SGsr/.� /(J Ze_' 1 . 664,9U+SO4 7�V..
❑ Yes �NO
❑ Yes [PNo
❑ Yes A No
❑ Yes YNo
❑ Yes �INo
❑ Yes )ZNo
El Yes ;ZfNo
Copper and/or Zinc
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? El Yes
14. a) Does the facility lack adequate acreage for land application? ❑ Yes
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attar below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
❑ Yes
ANo
OrNo
❑ No
❑ Yes ❑ No
❑ Yes XNO
❑ yes 70
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes �'No
' _—R.:.h`�.z'. -.:L''e' m:T:.: —' .+s;>'1; b.YY4"�''"•.'tlae"`�:G ""vir "'b:sC ' 4'-:y'4}ta4u,",.••'."�E1S:t�:r.YJ?�GtsRi:•yaY,',;i ^tRiilpHE%:Et::lP"'tir :Y°�:.:,:i a Ge. "�"°�"tr:' a.! it - t tt.:7s-A t �i:11sEp f� 'r E.rB -ws, s EL' §
(COmpaer t& iset'ar ta:quest�vn7#) Faeplt auty YES ansvrers and/ar anylrtcvmmendatfot sir attp other�oomments: dt'.;� , iy
'51'ra�.:`iii:: tl§ �:ii'lSi:•;4.�^ "'tip'..'+,Y"°:`°"°tl'"d�...u.3�i.=i:'<8i'4tt°v..a- ! -;C`.. J..a:._.G:.:s.tra:.w- a.aa:r�k
Use dra offactii , tabetter sstnatiioas. {osc addibanal as s ,s1
' w 9 i „ ti Pa fir]') >, ❑ Field Copy ❑ Final Notes w
{ E. h iA f •6�{t 3 { <s:q{�iah9a, (3��'�'}?t' 33 6 "6pp�d gy5s{ 's 4 y�1 §s•;'' - ( 1 ., } 4 �i �s}V{,? §y. j 9 i ku
S. Pf t➢?wL��'.�iiii�.l,:'.i�il�?Zf�'"') `et L 11�C.K�-41�, E1�
�k.41"Si�'�,3:S
..5. iL FEM!"M
�fu� Lv Af CG?9,O
Ito
�� 5 Gv� j C�v✓627s �i%�f�G p lcC=C�, sQo t",[lGf�7ZOn1
f e 44'_NT' �461 64 �15.
Reviewer/Inspector Name > ird ,: , ,. A a G ,s
Reviewer/Inspector Signature: Date: L
%4
12112103 Continued

Facility Number: — Date of Inspection
Required Records & Documentti
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/Impector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Stocking Form [:]Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ Yes u] No
❑ Yes No
❑ Yes No
❑ Yes R1 No
❑ Yes po
❑ Yes P No
❑ Yes 9No
❑ Yes PfNo
❑ Yes ONo
g(Yes ❑ No
❑ Yes ANo
❑ Yes 9No
❑ Yes J6 No
❑ Yes 0 No
❑ Yes ;dNo
© No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
PV
1
G
;/_/�f�a
12112103

Type of Visit 5D Compliance inspection Q Operation Review 0 Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number (late of Visit: D Time.
N t Operational Q Below Threshold
Permitted 0 Certified Q Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
//
Farm Name: ���E (�kv,LS Fi/lI County
Owner Name: _ /�/`� — tul��, _ Phone No:
Mailing Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Location of Farm:
Title:
Phone No:
Integrator: _f.Ag&u 4_
Operator Certification Number:
Swine ❑ Poultry ❑ cattle ❑ Horse Latitude �' �• u Longitude
:. Design'.",, Current Design Current': ":Design'Current
.Swine Ca kith' Population Poultry 'Capacity" Po ulation. Gaitle r. ''Ca acitv:°'.'Po ulation ,
❑ Wean to Feeder , ❑ Layer I ' : ❑ Dairy
Feeder to Finish ❑ Non -Layer ❑ Non-Dai
ID a:
Farrow to Wean _
r
❑ Farrow to Feeder ❑Other ,
,yiFinish I �{iE 33f i3 6. °saF s
Farrow to Finish
u : Total�; Uesign CapaCtt�
❑ Gilts
❑ Boars ,. 1- -
` r NatalS5W
Number of Lagoons 3 ' ❑Subsurface Drains Present J0 Lagoon Area ❑ S rav Field Area P
�Holding!Pend. I, Solid Traps' � � G ❑ No Liquid Waste Mana ement System
Discharges & atrearn 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 Collectim & 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): IV 93
05103101
❑ Yes VfNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
No
❑ Yes
No
❑ Yes
No
Structure 6
Continued

i
Facility Number: — Date of Inspection p
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ 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? ❑ Yes No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? Cl Yes No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence of over application? P Excessive Ponding p PAN ❑ Hyjraulic Ove�qad ❑ Yes �No
12. Crop type f
13.
Do the receiving crops differ with those de ' nated in the Certified Animal Waste anagement 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
Reguired
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?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
/ 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
VNo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
X,No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
X"No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
VNO
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
-.� ' e e rasc�,r,. y � :
/ora any recommendations or-�anyother comments
Camtrtents (refer to question;#f} ,Explain any YES an=Addf&','U�"i
_ Use drawiags of facrlity to befter explain situations (�,pyages as;neccssary): Field Copy ❑ Final Notes
Al
�.✓� �.��zz.E�
1�Q�7�°GC7",E111
Hy
'Al
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: DZ
05103101 Continued

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 drill 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 fi[I pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes �No
❑ Yes gc—/No
Yes [No
❑ Yes //❑ No
Additional Comments and/or Drawings:
l 31,- --- / Z74-( �d
/47
05103101

Facility Number Date of Visit: I 2. 0 Time:rO 1SZ 7
�? i
Not Operational O Below Threshold
0 Permitted 0 Certified © Conditionally Certified [3 Registered Date Last Operated or Above Threshold : ..........................
Farm Name:.........VenQ..,.�'.I`�.s8',�.rf�...�'��........ County:.....p rvjP.................................. ......... ........
OwnerName:........... G 6 Y-► C.... w e I ! :5................................................................... Phone No:.....................................................................................
FacilityContact: ............................................................................... Title:................................................................ Phone No:...................................................
MailingAddress: ...............n........................................................................................J..............................................................................................................................
Onsite Representative:... e.!'!e... �t? l l ...Cj..'.:s.....4r.!':.el..J r..... Integrator:... .�rfb..j...s.................................................
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location of Farm:
❑ Swine (] Poultry ❑ Cattle ❑ Horse Latitude ' ' " Longitude • 4 «
Design - Current
Swine. ;, ,, f'gn9e�t i Ponulatirin'
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design
Poultry Ca � aci Po p6liti6n Cattle Ca aci
❑ Layer I ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
C
IV ambei';o1'ILagoons ) :" ❑ Subsurface Drains Present ❑ Lagoon Area (] Spray Field Area
Holding PoemsI SolidTraps', ;i ❑ Na Liquid Waste Management System
Discharges & Stream ImlRacts
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: ................................................................................................
......... .................................... .............................
Freeboard (inches): q y
5100
❑ Yes XNo
❑ Yes Z No
❑ Yes 21No
-h la
❑ Yes j2rNo
❑ Yes )jNo
❑ Yes RNo
❑ Yes Jallo
Structure 6
Continued on back

Facility Number:171 —q Date of Inspection p
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/imptovement?
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 ❑rPAN • ❑ Hydraulic Overload
12. Crop hype Tas4vne
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Re uired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
Q YiAl�i rls:a �f eie��} •frn odd• aWW9 NsAgIt, • Yost :vst�-><ee�iye fl t'u h$r . .
coriesporideike: about: this visit:
&re &e;V1j
ww; >q4C.", the of in ah e_x Ge110 n4
❑ Yes ;2(No
❑ Yes J2'No
❑ Yes _Z(No
❑ Yes j•No
❑ Yes ,(No
❑ Yes 2(No
❑ Yes ONO
❑ Yes ONO
❑ Yes ,j� No
❑YesNo
❑ Yes XJ No
❑ Yes allo
❑ Yes f No
❑ Yes JZ No
❑ Yes jo No
❑ Yes XNo
❑ Yes No
❑ Yes ONO
❑ Yes ,TNo
❑ Yes ONO
❑ Yes ONO
❑ Yes <o
A.
-,. �,'Mi i
Reviewer/Inspector Name i� .S�Ylh P.. i,�aIvt i .S, ,, €at i
�
• •. „
Reviewer/Inspector Signature: n/'t.et;� Date: Zq O 5/00

Facility Number: 71 — I Hate of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below []Yes ;2(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 WNo
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 J!fNo
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 /d No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes dNo
Additional Comments an or,- Drawings;
3
al
Ml
5/00

O Routine O Complaint
O Follow-up of DWQ inspection
Q Follow-up of DSWC review
Q Other
Facility Number
Date of Inspection
FEE
Time of Inspection
24 hr. (hh:mm)
Permitted ❑4CU.fied
E3 Conditionally Certified ❑ Registered Not O era[ional
Date Last Operated:Farm
Name:......................C..rc/5........I�t'//`i
...................................
County:..............1...,e/V�!............�..,.........
..................
OwnerName:......rn............................
J....
..... 1/.!f...�ls................................................
Phone No:.................
FacilityContact: .5..]. ................... W(.) .S................... Title:................................................................
Phone No:...................................................
MailingAddress: .....................................................................................................................
Onsite Representative: 61r.-y,/Z ....... ... , ...... le. l Integrator: ......... j(9iYi'
Certified Operator: ................................................. ; . ............................................................. Operator Certification Number:
Location of Farm:
Latitude =•=' =•{ Longitude =• =' =11
< Design;',•Curregf;' '
`
D,esign Current �:: �il.�i'�R ��dDes�gn"Current
Swine, ; Ca act 1 Po ulation
Poultry Ca tact :Population ,Cattle t . {Ca aci Population
❑ Layer ❑Dairy
..
❑ Non -Layer ` ❑Non -Dairy -
❑Other. „ ,
Total D&i jgn Capacity;
Total'SSLVV
Number of Lagoons
.� ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps 1 0
❑ No Liquid Waste Management System
.,,
❑ Wean [o Feeder
[]Yes
�Feederto Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑Gilts
BoarsVNI
Discharges & Stream Impts
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'? (II' yes, notify DWQ)
c. If discharge is observed, what is the estimated Flow in gal/min'?
d. Does discharge bypass a lagoon system'? (II' 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: I� n -
Freeboard(inches): .............-13-�.................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
[No
❑ Yes ❑ No
❑ Yes ❑ No
— N'A—
❑ Yes
❑ No
❑ Yes
MNo
❑ Yes
9No
❑ Yes ffNo
Structure 6
❑ Yes ®No
Continued on back

Facility Number: — Date of Inspection
6. Are ther4tructures on -site which are not properly addressed and/or managed through a waste management or
cliosure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
13. Do the receiving crops differ ith hose designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Pail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. hail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
' 0 •yiQla�i4njs'oir• d�#ic�et�c;ie5 rv�re n+�te�• d�•>r°�ng •th#s;v�s�t; • Y:or>f ;w;i•�ee�iye tj<o; #'u>�thgr • ; •
corres{ 6fiden ' e' about: this visit:
Cl Yes A No
[:]Yes X No
❑ Yes [9.No
❑ Yes qNo
❑ Yes 19No
❑ Yes 'R No
❑ Yes 5�No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes XNo
❑ Yes qNo
❑ Yes ANo
❑ Yes [2(No
❑ Yes C&No
❑ Yes RNo
❑ Yes U No
❑ Yes WNo
❑ Yes 5jNo
❑ Yes qNo
❑ Yes C5�No
Commentsl(refer to,question #)': , Explain any YES,answers and/or any, recommendations or any other comments r' I
r n'I;t'�r
Use drawings of facility to betterjexplam sttuahons' (use additional pages as necessary)I i jt;,,���1 4 ,:j, ;ru •}a K rila'
1 L4 a is 3•:r"! .,. f �. 'JrW1 -t-�, �:.l, .,w r
Oliver C-1rppS 1 v` 2,�C�ME� Gur�•},�..
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:

_Facility Number: � j — 4 Date of litspection
Odor IssuesT
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below [:]Yes kNo
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
Ij No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
No
Additional Comments: and/or, Drawings:' �-� ,'iFi: i '
, .1.
}.
1
3/23/99

Revised January 22, 199,
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number '71 - L _ _L1.1"Operafion is flagged fora wettable
Farm Name: &, , !,Jells Fyn _ acre determination due to failure of
On -Site Representative: C / k PA Part 11 eligibility items) F1 F2 4"'F�
Inspector/Reviewer's Name:
Date of site visit: �lq5
Operation not required to secure WA
determination at this time based on
exemption E1 E2 E3 E4
Date of most recent WUP: -7 Annual farm PAN deficit: (azQ_3 pounds
Irrigation Systems) - circle #. . hard -Dose traveler• 2. center -pivot system; 3. linear -move system;
4. stationary sprinkler system w/permanen pipe; 5. stationary sprinkler system w/portable pipe;
6. stationary gun system w/permanent pipe; 7. stationary gun system wlportable pipe
PART 1. WA Determination Exemptions (Eligibility failure, Part II, overrides Part 1 exemption.)
E1 Adequate irrigation design, including map depicting wettable acres, is complete
and signed by an I or PE.
E2 Adequate D, and D)D3 irrigation operating parameter sheets, including map
depicting wettable acres, is complete and signed by an 1 or PE.
E3 Adequate D, irrigation operating parameter sheet, including map depicting
wettable acres, is complete and signed by a WUP.
E4 75% rule exemption as verified in Part Ill. (NOTE: 75 % exemption cannot be
applied to farms that fail the eligibility checklist in Part 11. Complete eligibility
checklist, Part 11- F1 F2 F3, before completing computational table in Part 111).
PART 1I. 75% Rule Eligibility Checklist and Documentation of WA Determination
Requirements. WA Determination required because operation fails one of the eligibility
requirements listed below:
F1 Lack of acreage which resulted in over application of wastewater (PAN) on spray
field(s) according to farm's last two years of irrigation records.
F2 Unclear, illegible, or lack of information/map.
F3 Obvious field limitations (numerous ditches; failure to deduct required
buffer/setback acreage; or 25% of total acreage identified in CAWMP includes
small, irregularly shaped fields - fields less than 5 acres for travelers or less than
2 acres for stationary sprinklers).
V//"F4 WA determination required because CAWMP credits field(s)'s acreage in excess
of 75% of the respective field's total 'acreage as noted in table in Part 111.

Revised January 22, 1,
Facility Number I_-L_
Part ill. Field by Field Determination of 75% Exemption Rule for WA Determination
TRACT
NUMBER
FIELD
NUMBER'z
TYPE OF
IRRIGATION
SYSTEM
TOTAL
ACRES
CAWMP
ACRES
FIELD
%
COMMENTS'
4
J^-�''-
�3
S3
1Cri
Z
I g
(00
E
J a�
1
I
l
i
I
f
I
C
�
�
FIELD NUMBER' - hydrant pull zone or point numbers may be used in place of field numbers
depending on CAWMP
and type of irrigation system. if pulls, etc. cross more than one field, inspector/reviewer will have to combine fields to
calculate 75% field by field determination for exemption if possible; otherwise operation will be subject to WA
determination.
FIELD NUMBER2 - must be clearly delineated on map.
COMMENTS' - back-up fields with CAWMP acreage exceeding 75% of its total acres and having received less than 50%
of its annual PAN as documented in the farm's previous two years' (1997 & 1998) of irrigation records, cannot serve as the
sole bzsis for requiring a WA Determination. Back-up fields must be noted in the comment section and must be accessibie
by irrigation system.

t
Dwision Of SOIL an'd WateC; COn9erVat3Un,-'Optratlori ROVIeWJ.
'�
i [3 Division of Soil and Water Conservation - Compliancelnspection i s
MADivision of Water.Qualityl'- Com ' ance;Inspection
0 Other Agency - Operation Review
EQ Routine Q Complaint Q Follow-up of DWQ inspection Q hollow -up of DS%VC review Q Other
Facility Number ')ate of Inspection 3 p
Time of Inspection p 24 hr. (hh:mm)
JOPermitted r Certified © Conditionally Certified 1] Registered JE3 Not Operaational Date Last Operated:
FarmName:..........G.r.N....... 14!.!.�......�.,�1'r............ ...................................I.......I........I..... County:.........4^r..............................................................
Owner Nance: ....................... ........... (,-�£.f1.�................................................. Phone No:4..............................................
.............
FacilityContact:..............................................................................•l'itle:................................................................ Phone No: ...................................................
Mailing; Address: ....... .......nat .,..,,. alb„t.,....,U.r............................................. ........ ............................................. .. $. Z�........,
OnsiteRepresentative: ��{�4 4!'e[,{.5.., Integrator: r .........................................................
Certified Operator: ................................................... ............................................. . .............. Operator Certilication Number:..........................................
Location of Farm:
....................... ....A:?.........�.......�,�,........................ ................ ........ ....... ... ........ ............... ............................................................................ .......................................
�
....................................................... ....... ...... ... ....................... .. ................
Latitude `' 44 Longitude ' 6 46
Swine Capacity Population
❑ Wean to Feeder
Feeder to Finish
7040
p
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 7 0
Total SSLW
Number of Lagoons 1 ❑ Snbsurtace Drains Present liqLagoon Area ❑Spray Field Area
Holding Ponds / Solid 'Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Discharge originated at: ❑ Lagoon ❑ Spray Field []Other
a. If discharge is observed, was the conveyance nian-made"
1). If discharge is observed. did it reach: ❑ Surface Waters ❑ Waters of the State
c. if discharge is observed. what is the estin)aled flow in galftnin?
d. Does discharge hypass a lagoim system?
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts to the waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structur 3 Structure 4
Identi f ter:
Structure 5
❑ Yes 4 No
❑ Yes 7' No
❑ Yes JR No
❑ Yes No
❑ Yes No
❑ Yes [ No
❑ Yes 0 No
Structure 6
Freeboard (inches): ...........3'�..
1/6/99 Continued on back

'aeilityNumber: -Zf — Date of Inspection 3 jo
5. Are there any immediate thrcats to the integrity oi' any of the structures observed? (ie/ trees, severe erosion, ❑ Yes (9 No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ® Yes ❑ No
8. Does any pai t of the waste management system other than waste structures require maintenance/unprovernent? ❑ Yes rQ No
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings?
❑ Yes
No
Waste Application
10,
Are there any buffers that need maintenance/improvement?
❑ Yes
No
11.
Is there evidence of ovcr application'? ❑ Ponding ❑ Nitrogen
❑ Yes
k9 No
12.
Crap type ............... .
4SctJ. ...f .9.................. .e xwl.,... ...................Sma. ....,Gi.r�.......................,.........................................................
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
(�j No
14.
Does the facility lack wettable acreage for land application? (footprint)
® Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
52 No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
No
Renuired .Records & Documents
17.
Pail to have Certificate of Coverage & General Permit readily available?
[:]Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
91 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
154No
21.
Did the facility fail to have a certified operator in responsible charge?
❑ Yes
'%6 No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard prohlems, over application)
❑ Yes
IN 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
No
:.1Vo:viaiationa.or. cieficiencit�s .were Hated during ttiiS.visit:: I'.ou vvi1l:reeeI e no further .::
eorrespandence: about: this :visit.: ::: ::: ::: :::::: :: .:... ...:: :::: : .
Comments (refer to question #): Explain any YES answers and/or any.recommendattons 6r any other, comments ,'`
t< =, <.
U'se drawings'of facility to better explain situations. (use add itiona] pages as necessary):;.E ,
7• G{OSicn PAS ati. innar a�iG ixtll 0� ittyta}oti o.roc�.� in�l �i11eS Stio��� �ell�� ��
ov� ttseeQ . j(
I�.�dLYM+� 10�Gh i�ld,gqyy@t� (�Y1r W �2�fIRY�iYLA�Dy�.'l`•
r� Jl
lq_ �cScuC Sr l �c b� Sr-tro.iC�tllf�� � �_ °WWr iry _jM_%4, CSeV� , A�eil,,, �,la+� Lwds
�ttr capte-% %1Uutd no �.A. �,���.; ,r` ��uJQ
O�ltDn �' t�J.��ir.. OV�q'iY\ol ' t�C�.
Reviewer/Inspector Name
Reviewer/Inspector Signature: �604__
Date:
1/6/99

Ej Division of Soil and Water Conservation E3Other Agency
Division of Water Quality
xxx
[®Routine 0 Cont laint O Follow-u 'of !i=ins cction O Follow-up of DSWC review 0 Other
Date of Inspection s 2
Facility Number Time of Inspection l : I S 24 hr. (hh:mm}
© Registered [3 Certified © Applied for Permit' ® Permitted 10 Not Operational Date Last Operated:
Farm Name:... ..... :......
��...S,Ai.�...�..�..5.....�.y-.w-�............................................... County. �?46,",4..a, r..---........................
Owner Name:........................a .�......... .,Es .1.1 S Phone No: $$..................
............................................. ............ t
FacilityContact: ......................................................... -..................... Title:....................-----....................................... Phone No:...................................................
Mailing Address: ....,�..� ..� ....... .. ... , t V-w!.�,,,....l..tl.. .............. iN..a...� rsb r ...�..�, ............................. ...�g.`�. �.[...
Onsitc Representative:... �,�,,....W.t.J.J.S...................... ... ....... Integrator:..... sa...x.,rx...U..i................................................. :..
Certified Operator; ................................................... ............................ ................................. Operator Certification Number:....................
Location of Farm:
0
Latitude
Longitude
1 ;Design Current
Design Current
"Design Current E
,.
Swore ,, Capacity 1Populatiod
'Poultry '
-,,Capacity ;Population Cattle „ "
Capacity Population
❑ Wean to Feeder,
JEI Layer
1
Dairy
to Finish
j0Q0
❑Non -Layer
"
❑ Non -Dairy
-Weeder
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
,
Elrr Faow to Finish
riTOfal. Design ;Capacity
U�
❑ Gilts
; TotaIVSSW
�❑
-
Boars
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes 0 No
2. Is any discharge observed from any part of the operation? ❑ Yes 0 No
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 gaUrnin?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
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 21 No
❑ Yes RNo
❑ Yes
&No
❑ Yes
B No
❑ Yes
0 No
❑ Yes
19 No
❑ Yes
IR No
❑ Yes
�!No
Continued on back

` Fa ility Number, -Tj — L)
8. Are there lagoons or storage ponds on site which need to be properly closed'? ❑ Yes 9 No
Structures (Lagoons,Haldijig fonds. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? R1 Yes ❑ No
Structure l Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
.,
Identifier: �:.�..�riP. � ...............................
...................................
Freeboard (ft): �.:..�... 3 �.,.,�
.......................
10. Is seepage observed from any of the structures'?
❑ Yes
CR No
11. Is erosion, or any other threats to the integrity of any of the structures observed'?
❑ Yes
R No
12.. Do any of the structures need maiotcnance/imhrovenient'?
SYcs.
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
®'Yes
❑ No
Waste Application
14. Is there physical evidence of over application'?
❑ Yes
Q No
(If in excess of WMP, or runoff entering waters. of the State, notify DWQ)
15. Croptype t..r,rrrnl...N............Ssncrd�....�.rtn�.,n-............:�...................
16. Do the receiving crops differ with those designated in the Animal Waste Management flan (AWMP)?
❑ Yes
RiNo
17. Does the facility have a lack of adequate acreage for land application'?
❑ Yes
IM No
18. Does the receiving crop need improvement?
i
❑ Yes
® No
19. Is there a lack of available waste application equipment?
❑ Yes
® No
20. Does facility require a follow-up visit by same agency?
Yes
❑ No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
fie] No
22. Does record keeping need improvement?
Yes
❑ No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste :Management Plan readily available?
❑ Yes
® No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
IR Yes
® No
25. Were any additional problems noted which cause noncompliance of the Permit'?
RYes
®,No
0 No violation's or def dencie's.were-noted during this:visit. Yoit.will receive no further
correspbbdence a4oitt this'. visit'.-'.',
Comments (refer to gttestnn #): rxplairi any YES answers andlor any r+Lcommendattons or any other comments v
Us6 drawings of facility to bciter'explain 'situations.'(ttse additional pages as necessary) y
9. Ga-,r.-� i t s. w'�-r Y-c.�r' r e-a- i i �'-'�-�►-� , 0 4 e.�ra- f a Q �v� .r �-, ,, i.�....N•e� ' i
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'4 x i_ @. S 1 +` q] 1r_ a ty i 1 c 0- -�;' d ,� ,� - 1 1 7/25/97
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viewerllnspector Name A-;,,%
Reviewer/Inspector Signature: o—
Tp
Date:

® Routine p omp a1nt p Follow-up of inspection p Follow-up of DSWC review p Other
Facility Number
Farm Status: Certified
Date of Inspection
Time of Inspection F-7775­1
24 hr. (hh:mm)
ti, k ota one m racttop 91
P ours 7.
(es125 far_L hr 15 min)) Spcnt on Review s
orins et'tian` inclti'destrnvcl and
ri�cessin' )�'"`:'° '
Farm Name: Gezte..Wells.Facm.......................................................................................... County: Pender WIRO
OwnerName: G.eae........................................ Wells ..................... ...... Phone No: 259.-.438B ....................................................................
Mailing Address: Rx.A..Rox.145 ............................................................... :......................... 1?1'.axh.a... .C............................................................. 284.7.1..............
Onsite Representative: Geua.Welbs.................................................................................. Integrator: Carrmll.'.s.Eaodslac... ..........................................
Certified Operator: G.eue.A.................................. W.2115 .................................................. Operator Certification Number:IMED.............................
Location of Farm:
112.miie..........................................................................................................................................................1^
Latitude ®• ®� ®�+ Longitude ©6 ®� ©`•
p Not Operationai Date Last Operated: .........................................................................................
Type of Operation and Design Capacity
General
I. Are there any buffers that need maintenance/improvement? p Yes ® No
2. Is any discharge observed from any part of the operation? p Yes ® No
a. If discharge is observed. was the conveyance man-made? p Yes ® No
b, If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) p Yes ® No
c. If discharge is observed, what is die estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ©Yes ®No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
4. Were there any adverse impacts to the waters of the State other than from a discharge? p Yes ® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require p Yes ® No
maintenance/improvement?
Continued on hack

6. Is facility not in compliance with any applicable setback criteria?
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/l/97)?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons and/or Holdinl; Ponds)
9. Is structural freeboard less than adequate?
Freeboard (ft): Lagoon 1 Lagoon 2 Lagoon 3
2.5
10. is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adquate markers to identify start and stop pumping levels?
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
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the cover crop need improvement?
19. Is there a lack of available irrigation equipment?
.For „Certified ,FacilitiesOnly
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal Waste Management Plan in any way?
22. Does record keeping need improvement?
D Yes ig No
D Yes ® No
D Yes ® No
p Yes ® No
Lagoon 4
D Yes Cl No
D Yes M No
D Yes ig No
D Yes M No
D Yes ® No
D Yes ® No
p Yes Ig No
i
D Yes ® No
D Yes ® No
D Yes Ig No
M Yes D No
D Yes ® No
23. Does facility require a follow-up visit by same agency? D Yes ig No
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge? D Yes M No
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 3
cc: Division of Water Utiality. Water Uttality .Section, Facilitv Assessment Unit
1 1 /14/96

Site Requires Immediate Attention: N J
Facility No. of -
DIVISION OF ENVIRONMENTAL MANAGEMENT, .4
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 0 0 , 1995
Time: D 0
Farm Name/Owner:_
Mailing Address: I�S
County:
Integrator: rx r v'o I IS Phone:
On Site Representative: CkPhone:
Physical Address/Location: 1 19 `S'�'`. , �eQ `f
Type of Operation: Swine Poultry Cattle
Design Capacity: 2' 6t)0 Number of Animals on Site: �3
DEM Certification Number: ACE DEM Certification Number: ACNEW
Lad tude:3�° JC �" Longitude: ' �� " Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) Yes or No A ual Freeboa4- Ft. Inch
Was any seepage observed from the lag8e'
oon(s)? Yes N Was any erosion observed? Yes or o
Is adequate land available for spray? orNo Is the cover crop adequate? 6a or No
Crop(s) being utilized: b A C _
Does the facility meet SCS minimum setback criteria?. 200 Feet from Dwellings? Jes No
100 Feet from W lls es r No
ham I�r�
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? or N4C-,J0V--
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state -by man-made ditch, flushing system, or other .
similar man-made devices? Yes or(s)
No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? es r No
Additional Comments: — J LJ / � Y - (ca �-- .l.► -_
Inspector Name
cc: Facility Assessment Unit
Signat e
Use Attachments if Needed.

�1�J�_�71Cy1
NYlat 20
•
i
Site Requires Immediate Attention
SITE VISITATION RECORD
DATE: juiv 17 , 1995
Facility Number:
Owner: Gene Wells ti Farm Name:
County: Eandar
Agent Visiting Site: _Sm & 85 - CES _ — Phone: [phone]
Openror: Phone: (sin.) mg-d-iA.
On Site Representative: unavailable Phone:'
Physical Address:
Mailing Address: 1195 Shady Lane Road-
Watha, N.C. 28471
Type of Operation: .'-Swine x Poultry. Cattle
Design Capacity: 7g,4o Finishing Number of Animals on Site: 7040 Finishing
Latitude' Longitude -
Type of Inspection: Ground x Aerial
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 75 year 24 hour storm event
(approximately 1 Foot + 7 inches) 9 or No ,Actual Freeboard: 3 Feet 6 Inches
For facilities with more than one Iagoon, please address the other lagoons' freeboard under the
comments section.
Was any seepage observed from the lagoon(s)? Yes o N Was there erosion of the dam? Ye or No
Is adequate land available for land application? ee or No Is the cover crop adequate? (e or No
., 4grg,2sion noted on interior _ side of dike - grater level. is at
Additional Comments: � r s„.
or sligUly above bottom Ripesybich are providiU 316" freeboard. T rary
storAge ;maximized - pumping at present. Good extablished cover for most part.
Erosion not a threat to dam integrity - spotty areas.
lynx (4) [phone]
Signature of Agent