710006_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qua

Type of Visit: 0 Compliance Inspection U Operation Review U Structluation Q Technical Assistance
ure
Reason for Visit: O Routine p Complaint p Follow-up 0 Referral Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: ® County: Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Owner Email:
Phone:
Facility Contact: ff Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
Design C►urgent Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish La er
Design
Cattle Capacity
Dairy Cow
Current
Pop.
.,
Wean to Feeder Non -La er
Dairy Calf
Feeder to Finish
Dairy heifer
Farrow to Wean Design Current
Dry Cow
Farrow to Feeder D , P,oultr. C•_a acit P,o .
Farrow to Finish Layers
Non -Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turke s
Other Turke Points
Other Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes F/JO O NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes eNo
❑ NA ❑ NE
❑ Yes ❑ NA 0 NE
Page I of 3 21412015 Continued

Facili 'Number: -06Date of Inspection: Z.
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? �es ❑ No ❑ NA ONE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
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
PNo
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify
DWR
7. Do any of the structures need maintenance or improvement?
❑Yes
❑ No
❑ NA
NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ No
❑ NA
,F5`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
[DNA
NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes
❑ No
❑ NA
NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground
❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure
to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift
❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
.
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
7NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes
❑ No
❑ NA
VN
acres determination?
17, Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
E.
r
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[] No
❑ NA
NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
[:]Yes
❑ No
❑ NA NE'
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ No
❑ NA FrNE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
❑ Sludge Surve
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
C] No
❑ NA NE
Page 2 of 3 21412015 Continued

ircili Number: - Date of Inspection: 77
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
[:]No
❑ NA
NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
❑ No
❑ NA
:6�NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
P<E
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
D. No
/�,NA
[
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? if yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ❑ No ❑ NA N E
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA /ZrNE
El Yes No
❑Yeso
❑ Yes o
❑ NA ❑ NE
❑NA ❑NE
D NA ❑ NE
J� ��
r�►�^e �� �1
!/av�c� �o�-C l�
CNG�r�1��
G-�.� Ira
ce-
ltx)Von,
—C
Co r,rww-I`c «
5ar%, t=— d rrrr{ciS — 1l0 7 7,9 21lp
Reviewer/Inspector Name: OWO [{ ,L-0
Reviewer/Inspector Signature:
Page 3 of 3
Phone: {��/.3_ 7
Date: `Z69
21412015

type of visit lJ t:ompuance inspection v operation review structure r,vaiunuon V iecnnicai P►ssistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up a Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: �i lt3% Arrival Time: ® Departure Time: ® County: 9._ 4, Region:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title: Phone:
Onsite Representative: B �i� M o or&a MC tii Integrator:
Certified Operator:
Certification Number: 99 q 3 a r
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine
Wean to Finish
Wean to Feeder
Design Current
Capacity Pop.
Wet Pouitry
Layer
Non -La er
Design
Capacity
Current
Pop.
Cattle
DairyCow
DairyCalf
Design C►arrest
Capacity Pop.
Feeder to Finish
`) 2¢
c6'�
DairyHeifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Dr, I;oult ,
La ers
Design
Ca aci
arrest
C►ON
P.o
D Cow
Non-Dairy
Beef Stocker
Gilts
I
INon-Layers
I Beef Feeder
Boars
I
Pullets
Beef Brood Cow
Other
OtherI
I
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:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes ErNo ❑ NA ❑ NE
❑ Yes [5No ❑ NA ❑ NE
Page I of 3 21412014 Continued

Facility -Number: - Date of Inspection: 10 5
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 7 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LA�,� �I cjcc_oz.iZ. LACbot
Spillway?: TTI&O TO &C-1rAfbIL
Designed Freeboard (in):
Observed Freeboard (in): 3
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. O No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes dNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [3/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 Z(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 �No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [_0"N' o ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑`16 ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes Ej, o ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[]lo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
W4o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
E�No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. Zyes ❑ No ❑ A ❑ NE
❑ Waste Application ❑ Weekly Freeboar ❑ Waste Analysis ❑ Soil Analysis ❑Waste Transfers [Weather Code
E�ainfall E] Stocking ❑ Crop Yield 20 Minute Inspections ❑ Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes � ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes VNoo ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Fpeility Number: - Date of Inspection: 'S•
2:' `Did the facility fail to calibrate waste application equipment as required by the permit ❑ Yes 2/No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [:]No ❑ NA dNE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
[] Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? 0 Yes �No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
dNo
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[3"No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
No
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
[]
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
/No
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[2
❑ NA
[] NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[!(No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑Yes
[3/No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
6/N o
❑ NA
❑ NE
Comments (refer to question#):;Ezplain:ariy YES answers and/or any additionaLrecommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessa
HAS <ALTBa.RT1_L0fj ENE) cow E)crt(_/V5± J , SL✓JCYE Wks o6o(-
(3e,tQ G VOLE .
��� Ito �►�-u aa� w Cz a-t4i c-sz c,oD C_ r�cE05 iZ) f6C Z�b�lE. _Z(Zg ,
u n -D ALL Ot 1 E� T.N Fa
vmee CidAdZ) 1, -v6L-� Cam* Irv\ TjjTrcmrvR AST f o s Wc-fZE CUAI . ,
AFL.. Co P y TO D k
3S) 5LUIDC,-t-- SutiVE V DolvE ?APC.R-Wc>K*-- HAS 06F (3C_l') co Pc-�rEa
S A M Gb w A RP-S AND J " [ P-1)(--C � AT' sZTC
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Page 3 of 3
�Jd i•I N tom! RIB E
Phone: {Q���'l (9 3 00
Date: 0 1 2.0 ,
21412015

a
e
Type of Visit: � f7 Compliance Inspection 00 tion Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Q Routine O Complaint Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: goeh7- MWTG-dMiC!�k _
Certified Operator:
Phone:
Integrator:
Certification Number: 9 91 3 Oq
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop. Wet Poultry
Layer
0012ewsig—nIff@urrent
Capacity Pop.
Design Current
Cattle Capacity P.
Dairy Cow
can to Feeder
Non -Layer
Dairy Calf
Feeder to Finish
115
Dairy Heifer
Farrow to Wean
Farrow to Feeder
Farrow to Finish
QRYI P,oultr,
Layers
Design Current
Ca aci P,o ,
Dry Cow
Non-Dairy
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
10ther
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:
a. Was the conveyance man-made?
❑ Yes
[]No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
0 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
❑ N
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
�] Yes
VNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
C3140
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili, Number: - to jDateof Inspection:
7.
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No [DNA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):� _ 0
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes dt4o ❑ 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 environmen l threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes 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 WNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes o ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [%%No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[/f o
❑ 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
0 No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
o
❑ NA]
NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ YesVNo
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other: 1.
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes eNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections []Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑*o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes F3/No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

lFacilt Number: - Date of lns ectiorr
24. the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No ❑ NA YNE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes eNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? [:]Yes %"No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes �No ❑ NA ❑ NE
and report mortality rates that were higher than normal'?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ffNo
❑ Yes No
❑NA ❑NE
❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
[:]Yes 2 No NA ❑ NE
❑ Yes ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additionaLrecommendations or any.'other comments;:;, s
Use drawings of facility to better explain situations (use additional=pages aspecessary)i
203,0
.V0A) .
z e i CS T ?E l 4G"/L°#JvtA15`� �AS LOM
Reviewer/] ns pector Name: Vo� N /i,(/[-�(� Phont.90 O
Reviewer/Inspector Signature: Date:
Page 3 of 3 2/4/20 1

Type of Visit (D Coompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit L.,� Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 10 G 6 Arrival Time: a Departure Time: County: Region:
Farm Name:
Owner Name: _
Mailing Address:
Physical Address:
Facility Contact:
Owner Email:
Phone:
r _ Title: Phone No:
Onsite Representative: LL VJA`?NE �L, Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Operator Certification Number:
Back-up Certification Number:
Latitude: = Q 0 4 Longitude: = o= 1
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Cattle
Design Current
Capacity Population
E]Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
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 dNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes [I NA ❑ NE
El Yes 1N,o El NA El NE
12128104 Continued

Facility Number: — Date of Inspection 0 �a
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes ro ❑ 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: LA 6 OK) �A%0 rJ 7— C1 "OA/ 3
Spillway`?:
Designed Freeboard (in):
Observed Freeboard (in): — 39 3e 39,
5. Are there any immediate threats to the integrity of any of the structures observed?
El 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 ZNo ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? El Yes ,2� o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes LJ No [I NA [I NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) Er
4. Does any part of the waste management system other than the waste structures require El Yes E No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes E No ❑ NA ❑ NE
maintenance/improvement? ,,,�
11, Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes Li No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s) Ci") S
13. Soil type(s) L /Oa191fM&' I
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes LJ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
[LXo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,[:] Yes
[2,15Lo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application`? ❑ Yes
ElNA
[INE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
,2-No
Ea o
El NA
❑ NE
2A) (A e,'rp A &Lf0 A LCCS
Reviewer/inspector Name .. jz .) &(( Y,,, ;u aS
11
Reviewer/Inspector Signature: Date: L6G
12128104 Continued

i %r
Facility Number: Date of Inspection 0 8
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If es, check 2(y/es El No ❑ NA ❑ NE
the appropirate box. ❑ WUP El Checklists El Design ❑Maps Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22,
Did the facility fail to install and maintain a rain gauge?
❑ Yes
D o
❑ NA
❑ NE
23,
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
EKO
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
9No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
;W6
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
J2 o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
0- o
❑ NA
❑ NE
Other Issues
28,
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑Ko
❑ NA
❑ NE
29,
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Q l� o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[1- o
❑ 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
❑-N-o
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
91?Co
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
D Nii —
❑ NA
❑ NE
Additional Comments and/or Drawings: 4 a t
12128104

Type of Visit JZ Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other p Denied Access
Facility Number
Date of Visit:F0=NotO
'Time: D /
erational Q Below Threshold
Permitted 13Ceriified 0 Conditionally Certified 13 Registered Date Last Opera r Above Threshold: .» .........._._ ..
Farm Name: » . ». 1 `Pel� »..AZ�... rCounty:
......
O...... PhoneNo:Owner Name: _W!L....__»_..F.ri3�Q„�'�..»...».»...».»...» ..»...__._
»»»» »__..........»»............._........ » .
Mailing Address:
FacilityContact: ..--------------- /.�.... W .. _ .__ Title: ................... ............. _.».. .._ ...._�.2,P�hone No:
OnsiteRepresentative:Q� .�!!�T_ . ,!.7! Integrator: L�1.._e....__ ......._. _.....».
Certified Operator:.�...._.�._...��..�....� ....».. ».. _�.._ .».__......._....._ ....... Operator Certification Number:__.__.._--_
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Home Latitude �• �` �"
Design l C1urrent f7' i Cnrrenl
Swine Po''Yiilation' °Paultr3: ;Ga Po' tic
Wean to Feeder
❑Layer
Feeder to Finish
(J
3 .
❑ Non -Layer
Farrow to Wean
�t� '•
y_: Other
❑ Farrow to Feeder
Farrow to Finish
�n ti. s l� Toffil DeS't)
r '^
Gilts
Boats
Longitude �• �` ��<
r ` L Des�ga � <Cnrreut
Cattle :Ca act 'Pn tian
�rg,a Dairy L
❑ Non -Dairy
1�R I s
ca
Discbaraes & Streams 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 gaUmin?
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
❑ Yes JWfNo
❑ Yes ❑ No
❑ Yes ❑ No
Q Yes ❑ No
❑ Yes 2No
❑ Yes Ja No
❑ Yes ZNo
Structure 6
Identifier: _w. _._................ _..
Freeboard (inches): 3L
12112103
Continued

JT_flity;lYumber: '71 — (., Date of Inspection D
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
ONO
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
0 No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
A No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
❑ Yes
A No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
No
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. ^..top type eew^)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
VNo
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
P No
16. Is there a lack of adequate waste application equipment?
❑ Yes
No
Odor hisues
17. 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
ONO
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
gNo
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
Air Quality representative immediately.
'P°No
`f} G A-,7— A,ge�
4�4�'Cm or) g
Field Copy ❑ Final Notes
�lolj.'Oc 5 �'j LS:4) N-01816+70-a-14
�}Ll�r�- �k ��Rrn��►�} T�v� �%Fo�'D. [�frsrf. �c.�� /�9
Puu1'491 ,r7 Ajo /Z,
1 !VFj-Q C' �02 l �f cJ (�crJc+%,fQj LC �� NG�F
to- 0147W.4 9/740/1pi/
nl�EnF� , Gilt— NE � vr,1J c.1 1=iG�
�:4e n
SZPZ/e x 7�C1LGfr0 :gitl7'
p� . .,�7 . z u, !p: , ru1€fti0g:� ���iti +<,ji�lir#!it.�€iis{
Reviewer ector ame ,r
Reviewer/Inspector Signature: _ Date:
12/12V3 Continued

faciptyrNumber: — Date of Inspection
Reauired Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ❑ No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ;Z No
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes JZj No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes RrNo
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ZNo
28. Does facility require a follow-up visit by same agency? ❑ Yes Q(No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 2rNo
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) 01 Yes ❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes O No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes 21 No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes aTNo
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 JTNo
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112/03

Type of Visit 0 Compliance Inspection O Operation Review goon Evaluation
Reason for Visit Cf Routine o Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: Time:
Facility Number
Not O crationaf 0 Below Threshold
Permitted 0 Certified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: r CU r / County: _ . � r ( ✓
Owner Name: / r v JJ Phone No:
Mailing Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Location of Farm:
Title:
Phone No:
Integrator:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' 04 « Longitude • 1 Du
Design Current ' Design Current Design' `' Current
Swine Capacity Population P ultry CaDacity Po" ulation Cattle-
CaDRCUY P01DUldtiOn
❑ W n to Feeder ID Layer I JE1 Dairy
eeder to Finish I 1 11 10 Non -Layer I I❑Non-Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity
❑Gilts
❑ Boars TotaI..SSLW
x;
,� . umber of L ig 0
�N -� goons '� , ❑Subsurface Drains Present ❑ l.a goon Area ❑ Spray Field Area
Holdtng Ponds /Solid Traps ❑ No Liquid Waste Management System
«. ,
Discharges Se Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b, if discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min"?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: q I
Freeboard(inches):
05/03/01 Continued

Facility Number: Date of Inspection T7
5. Are there any immediate threats to the integrity of any of the structures observed? (iel 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?
(If any of questions 4-6 was answered yes, and the situation poses an
❑ Yes
❑ No
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 anv stuctures lack adequate. gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
'Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
❑ 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?
(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?
❑ Yes
❑ No
(ie. discharge. freeboard problems, over application)
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
No violations or deficiencies were noted during this visit. You will receive no further correspondence about tliis visit.
.u'w+"a^'.Sy..Yr�r� "1
Camments,(refer to gdespon : EzplsiriAny YES'aaswers andlo�r any recommen+datsoaas cr am otller�mmmeats..�I��t°���y
Use drawing of facility to better explain situations< (use addltianal pages as nece�si_s_ary) ;1`' ❑Field Gopv ❑Final Notes
.
w....�.k�i,„y/n�. t.ar..a..M.$.,..::+�.t.:�:I.'�.'i�aid.�a:.{.Y°-�./3.�,•::z�..�a3.it...r.::.�:::.a: �]i�`�'�+...i�:zc.,,.:�,.�.�,.�ia;i�� ,.:`.._: a*:.a'�r�J4 _.+i:>...�.,-,..m ..4_�..�rs�.i�'
wvi C 7c'-
ss :fR.- .N- .� x �3' ,M - e .ai ps... - •......°"a+ei^"�e..� \j -,+#
Reviewer/Inspector Name �r� yw`' � ;
Reviewer/Inspector Signature: r Date:
05103101 t-Condinued

7
TA�.ne -9 } i� i 3.1 E i�' �'. E� iiiF'"5...°� 't a 1 4A93 i S d 3 3 dd 8 ' 93 6 d oIE
di, d i. tta���
`�
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit j6Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Bate ol` Visit: O Time:
Not O erati nal $eloKThreshold
Permitted ❑ Certified © Conditionally Certified 0 Registered Date Last Operatopr Above Threshold:
Farm Name: County:
Owner Name: ALLER Phone No:
Mailing Address:
Facility Contact: rn� Title: Phone No:
Onsite Representative: :{CF_ i1 s kL F_! — _ et, -��OR� Integrator: f co al M�
1
Certified Operator: Operator Certification Number:
Location of Farm:
Swine ❑ Poultry ❑ Cattle
❑ Horse Latitude 0' �• u Longitude
.
Design
Swine _.' , , . ;'�Ca acitv:�
Current 3. ' design P.,", Current ;' Design ,� Current
Pu `ulation Poultry , . « Cap ii8ty '. Eowatian`. Cattle;; . , e°Ca actri - i Po` ulation
❑Wean to Feeder
❑ La er
; ,;
❑ Dairy1,
Feeder to Finish
ZD
t.,
E3 -
❑ Non-Laye
�' ,.
❑Nan -Dairy I
i.
Farrow to Wean
' -
I
; ❑Other€E'i`!�' '
Farrow to Feeder
, ii ' E �i'�f I : E '
3'E
Farrow to Finish
' €
i Tpt Design Cif
❑ Gilts
IEk i l Se
i ! _
i � E , ''T4s1 SSI,W
❑Boars
Number, of Lagoons
i' ❑Subsurface Drains Present ❑ Lagoon Area ❑ S rsv Field Area•`
Holding ;Ponds'1,Sofld,Tra s . '
�` p
No Liquid Waste Management System
❑ 1
Discharees & Stream impacts
1. Is any discharge observed from any pan 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 pan 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 t Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
05103101
❑ Yes 0 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
X No
❑ Yes
X No
❑ Yes
ONo
Structure 6
Continued

f
Facility Number: Date of Inspection / t7
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?
(If any of questions 4-6 was answered yes, and the situation poses an
❑ Yes
No
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑
� No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
(Yeses,
�Yes W No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
No
Waste Anplication
10. Are there any buffers that need maintenance/improvement?
❑ Yes
ANo
11, Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
)ZN0
l2..Crop type _ Rij, � ®ygepkoS. W%A]' � d NutALJ
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
-
❑ Yes
14. a) Does the facility lack adequate acreage for land application?
El Yes
15No
VNo
b) Does the facility need a wettable acre determination?
❑ Yes
0 No
c) This facility is pended for a wettable acre determination?
❑ Yes
VNo
15. Does the receiving crop need improvement?
❑ Yes
No
16. Is there a lack of adequate waste application equipment?
❑ Yes
No
Required RecgEdL& Dpeuments
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)
A 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
VNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
O No
(iel discharge, freeboard problems, over application)
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
�dNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
;dNo
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Corriments prefer #o questeon'�#) �Explatn any YES answers�andlor,:itp� romme�datians or anv other,coromen[s of
-
[Fse drawtn � i , �
gs.of fac7ity to better explain sttnattons. (usc additton�l pages as necessary) �,',❑ Feld C onv ❑ Final Notes j
E— �A i51-L CIRASs Dry PDU1Rr NEAS ARV Lk Py-1 oo J.
�j2�G F S .r && (�2C,—A- 6E W"J
NG LJ [Acc, t4oLts ems,
C'ooOC-cr�o,�
PLI M,P,
w
j W
Reviewer/InspectorName
Reviewer/Inspector Signature: Date:
05103101 vl Continued

• .)
N
Facility lumber: — slate of Inspection O'Z
dor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there anv 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? 0 Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i,e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters. etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes XNO
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? []Yes ❑ No
Additional Comments and/or Dra%�ings
L A C'O AS ! 6 EEO14,101
5
(or Tip KFtJ U)�F,�r R6za �A7zon! y57F�
Lr �yq'SaT L)sFO R
vFiL IV yF ��r Fog-
rJ-arza � �aooa o � °�r Ut2c.z au ��� {��-r-6I�c . .. F3u-
17iu,E 5 4 Aa 1J �' r, R e
gw-VT r S�-rF uP ��� � Z>'T�p POPU'A'
SEE, fl �F— FP
OCv) `� [_ � S? RF-Pr>P,-r- �j Swpp-7v rRkE
O0 F
05103101
�,e� VF_L : *1'e" 50 Aw4

of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Jr Routine O Complaint, O Follow up Q Emergency ]Notification O Other ❑ Denied Access
Facility Number Date of Visit: � D Time:
Q Not Operational Q Below Threshold
Q Permitted 13 Certified [3 Conditionally Certified 13 Registered Date Last Operated Above Threshold: ............
Farm Name: ....�...�.�!..!...,..'7ti%Z �.5......f �t^..... ........................... county: ........ F F�..............................
Owner Name:
PhoneNo:........................................................................................
FacilityContact: .....................:........................................................ Title:................................................................ Phone No:...................................................
MailingAddress: ............./�......................./.�............................................................ ...........................
Onsite Representative:...1.f...!.GrY........•..I...`.d:3V/ .................................... Integrator:../..!�f�Y1......w...............................
Certified Operator:
Location of Farm:
................................. ................. I.......... Operator Certification Number:..........................................
U1 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 " Longitude 64
Design . Current' Design Current Design Current ,
.tSwine Ca aci Pa elation PoulCai Catty aCalad Po elation .
❑ Wean to Feeder ❑ Layer ❑ Dairy'
Feeder to Finish ❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Other
❑ Farrow to Feeder
„ ❑ Farrow to Finish Total'Design Capacity
❑ Gilts
❑ Boars 'Total gstw
.-
Narnber.of Lagoon ❑ Subsurface Drains Present ❑ Lagoon Area . Spray Field Area
f' Holdin . Ponds / Solid�Tra s.. ❑ No Liquid Waste Management System _ `
S P. , 9 B Y .. .k
Discharges & Stream ImRaaets
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
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
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes XNo
❑ Yes XNo
❑ Yes No
Structure
Identifier:
Freeboard (inches):
5100
r�
r
Continued on back

L.
Facility Number: 77 — 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?
B. 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 ov_er application? 0 Excessive
12. Crop type Colf, . OY6'tw5" .1)
❑ Yes � No
❑ Yes No
❑ Yes X No
❑ Yes XNo
❑ Yes No
❑ Yes A No
❑ PAN ❑ Hydraulic Overload ❑ Yes 0 No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ,EfNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes QNo
b) Does the facility need a wettabie acre determination'? ❑Yes j No
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. 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?
' •¢tjs;o� cier�cies •vt�re p�te�• g ��js'w�s�t;- Y;o� Wa�i•�ee�i�e too #'ui-t��r .
.. co*r4 cien& abotif this visit.
❑ Yes ❑ No.
❑ Yes No
❑ Yes �&
❑ Yes �No
❑ Yes �No
❑ Yes OJ No
❑ Yes No
❑ Yes O(No
❑ Yes No
❑ Yes No
❑ Yes QJ/ No
❑ Yes.XNo
1 � I F 15p ro 'F Fp 960 ol_05-
S��p�Fs ��-��� ,�y sou-ff�� �✓IS��T�s,-
1Z AV
Reviewer/Inspector Name 1�r,, _. ���.t. E_ t
Reviewer/Inspector Signature A41 i Date: p S/pp

Facility Number: — Date of Inspection
Odor Issues ko
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30, Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes No
Additional ornments"an
or ravings• . ..
: , E ` t` ` ,
AL
5100

r i
`' ;�: � � Dtvtsion of Water Quality '
Q Division of Soil and Water Consewatton
Q,Other'Agency�
Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit XRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date of Visit: �'fime: Qu Q Printed on: 7/21/2000
�-•�
Q Nat —operational Q Below Threshold
Pf1permitted j3 Certified E3 Conditionally Certified (] Registered Date Last Operated or Above Threshold:
.........................
FarmName: .......................................................................................................... County:.. ��2t.................................... .......................
OwnerName: ................................................... ........................
FacilityContact: .....................................................................
:Mailing Address:...................................•.............................,..
Onsite Representative: ,k .8' zw;tQ��... ....
CertifiedOperator : ................................................... .............
Location of Farm:
I ...... I........ Phone No:.............................................................................
Title:................................................................ Phone No:......................................
.................................................................................................... I...................... ..........................
........................ Integrator; ......W. 57
...................................... Operator Certification Number:..........................................
IT
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �� �° ��� Longitude •
Design Current A k\-bo Design Current Design Current
Swine Capacity Po ulatiooultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
`7'1-;�p
❑ Farrow to Wcan
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gifts
❑ Boars
❑ Layer ❑ Dairy I I ----d
❑ Non -Layer JEI Non -Dairy
❑ Other
Total Design Capacity
Total SSLW--�
Number of Lagoons ❑ Subsurface Drains Present IFM 17ignon Area ❑ Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharaes & Stream Impact;
1. Is any discharge observed from any part of the operation?
Discharge ori'ina€ed aC ❑ Lagoon ❑ Spray Field [:]Other
a. If discharge is observed, was the conveyance man-madc'r
h. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. ll' dischar�,c is observed, what is the c5timated How in gal/ruin`?
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 ucturc Structure 4 Structure S
F............ .................................... .............................
Freeboard (inches): 34�
5100
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ZNo
❑ Yes RNo
❑ Yes )�No
Structure 6
Continued on back

- Facility Number: `) — C I Date of Inspection 0 Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes *0
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes 0No
(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 NrNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes gNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes KNo
Waste A polication
10. Are there any buffers that need maintenance/improvement? ,Yes ❑ No
Is there evidence of over application'? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes MNo
12. Crop type C I �j15%Y
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)'? ❑ Yes ONo
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
9No
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
b�No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
,WNo
Reuuired Records & DocumenLS
17.
Fail to have Certificate of Coverage & General Permit readily available'?
❑ Yes
XNo
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
XNo
19.
Does record keeping need improvement'? (ic/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
kf 'No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design'?
❑ Yes
hj['No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
N�No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
ONO
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
19rNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
ONo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
XYes
❑ No
:: �Vo yiglafticjris;ojr iie�ieiencies ►��re n6tecl• during •this:visit; • Yoit' W,ilfreedV;e Rio fui•thgr
C0 resporid6C' e. a1bout. thfs '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):
/ �[ U �-- 4-1�3 ..�. 1 �•.Q.,� ��►-+'2'i �`^�'.I � • �� � G1 K: L.,�� �/Y�s-�.�\c� Gi'•<'rS� '� VIY-Ct.Qr
Ae
,3 �o�� t„iv�r moo, �c��''�-� aa.� tl5 ha� l�(-.�� �.�
p �r � I
es��,� ��- pe►rt�► ��� A(17c72-o vs . RHO, Ai
Reviewerlinspector Name
Reviewer/inspectorSignature: Date: — _60 5100

Fatility Number: — Date of Isispection GU Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below �M Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28, Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a peimanent/temporary cover? ❑ Yes No
'Additional -Comments and/or rawinp:
CG C-
s�< < s��
ugz�j
'�c G
5100

Revised January 22, t 99;
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number -11 - G —L--operation is'flagged for a wettable
Farm Name: 5q-M Frr, acre determination due to failure of
On -Site Representative: K%'lA MLUw Part ll eligibility item(s) . F1 F2 F3 4
Inspector/Reviewer's Name: r
Date of site visit: _ 3 / 1 01 j
Operation not required to secure WA
determination at this time based on
exemption El E2 E3 E4
5-7Q3.97
Date of most recent WUP: S c ff AnnvaTfarm PAN deficit: = ;° pounds
Irrigation System(s) - circle 1. hard -hose traveler 2. center -pivot system; 3. linear -move system;
4. stationary sprinkler system w perm pipe;.stationary sprinkler system w/portable pipe;
6. stationary gun system wlpbrmanent pipe; 7, stationary gun system w/portable pipe
PART 1. WA Determination Exemptions (Eligibility failure, Part ll, 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 I 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 II - F1 F2 F3, before completing computational table in Part 111).
PART 11. 75% Rule Eligibility Checklist and Documentation of WA Determination
Requirements. VITA 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
feld(s) according to farm's last two years of irrigation records.
F2 Unclear, illegible, or lack of inform ationlmap.
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).
F4 WA determination required because CAWMP credits feld(s)'s acreage in excess
of 75% of the respective field's total acreage as noted in table in Part 111.

Revised January 22, i
Facility Number_. is
Part 111. Field by Field Determination of 75% Exemption Rule for WA Determination
TRACT
NUMBER
FIELD
NUMBER'.2
TYPE OF
IRRIGATION
SYSTEM
TOTAL
ACRES
CAWMP
ACRES
FIELD
%
COMMENTS3
1061
2
3.(Y7
3
91. Lz
T_ ZI
c
q.qQ
'K.7
9Z.'s
to
_4 4ft—
8
0.3
is
li_DD
I6.73
�7�
) 6
q A
I. a-s'
q-7•s
a
rs. roz
jS,I-7
it
15.03
1 11.11
17.1
13
7-
S.S z
-7I.5
1
I
I
I
FIELD NUMBER'
i
- 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 NUMBER - 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 zs the
sole basis for requiring a WA Determination. Back-up fields must be noted in the comment section and must be accessible
by irrigation system.

Division of Soil and water Conservatlop-'`Operatlotr Revlewl
Q'Dlvlslon Uf Soil and Water COnSL'CVatlon - Compliance Iltspeetloni . '�� �� �r ,'�
, f
_ Water Quality Com Iiance�Ins Inspection
g
Dw�sion ol'„
Q Y'=' P P A ;
Other A ency --Operation Review
�ty Routine Q Complaint 0 Follow-up of DWQ inspection Q hollow -up of DSWC review Q Other
Facility Nuinber � Date of Inspection
'Dime of Inspection : L0 24 hr. (hh:mm)
Permitted 'M Certified Q Conditionally Certified 13 Registered Q Not Op erational Date Last Operated:
s F County:......1 !:�'`$. ....,
Farm Name: . $. 1^I �......................................... I ..... .......................
Phi `U Z
Owner Name: ........................- .1<11y�1r�:cr............ ...4'.li�:!�-1.,..,......................................... one No:......1.....1...�.. ...q.Pgti......................................
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
NlailingAddress::A00....... ........ s.......................................................... ........ifY,G....................................... ..4 V?......
OnsiteRepresentative: ....%A� 1"l?.hv...... Intel;rator:........."a.S............................................................
`.................................,..............................,
Certified Operator : ...... ......................... I ...... ...1.1....... ...... .... ................................................... Operator Certification Number:..........................................
Location of Farm:
..................... on ....... 674/a,...... �.� ....01 �IZ..,..i ?$.�.. Q- SInxY r
........................................................ .. .................
J.-
Latitude 0 9 46 Longitude • 1 64
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer I 1 1[] Dairy
Feeder to Finish � ❑Non -Layer ❑ Non -Dairy
Farrow to Wean �
❑ Farrow to Feeder ❑Other
[]Farrow to Finish Total Design Capacity •'7qw
❑Gilts
❑ Boars Total SSLW
Number of Lagoons JE1 Subsurface Drains Present I ❑ Lagoon Area I0 Spray Field Area.
Holding Ponds / Solid Traps JE1 No Liquid Waste Management System
DischaEg!js & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Discharge originated al: [-]Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance m:1n-made'?
h. II' discharge is observed. did it reach: ❑ Surface Waters ❑ Waters of the State
c. II' discharge is observed. what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon 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
Identifier:
Freeboard (inches): ...........
Structure 3 Structure 4 Structure 5
❑ Yes 0 No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes 0 No
Stnicture 6
1/6/99 Continued on hack

1
. Facility Number: — Date of Inspection j �}
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 10No
(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 1�5 No
8. Does any pact of the waste management system other than waste structures require maintenance/improvement? ❑ Yes 52 No
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings?
❑ Yes
2DNo
Waste Application
10.
Are there any buffers that need nr3intenance/improvctncnt?
❑ Yes
59 No
11.
Is there evidence of over application? ❑ Ponding ❑ Nitrogen
❑Yes
U.,No
12.
Crop type ..(>` %V ...........�....+,...............................
13.
Do -the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
OdNo
14.
Does the facility lack wettable acreage for land application'? (footprint)
Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
EPo
16.
Is there a lack of adequate waste application equipment?
❑ Yes
P No
Required .records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
Wo
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
j8 No
19.
Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)
❑Yes
rd 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 certified operator in responsible charge?
❑ Yes
,�] No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(icl discharge, freeboard problems, over application) ❑'Yes lyNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes W No
24. Does facility require a follow-up visit by same agency? ❑ Yes Po No
:1VA:vi4la'pons:6r. deficiencies :were hated: during .t iiss.visit.: You �ilfretceive nn fiirtlie'r
io6fr.esptmidehee; about; this ;visit.: ; ; . . ::: .
Comments.(refe"r to question #): ,Explain any YES answers and/or any recommendations or any. otliter,comments�
Use drawiris of facilityto,better ex` lain situations. use additional, a es as necessary):i°3
14. F[Arrn l.h11 raj jFt� `�r wA fij. Ge,+A 6 ?o d 1�y
- WV J� �A
Reviewerllnspector Name �ri� ` n ' , ,'`,
Reviewer/Inspector Signature: x _ Date: s j ]I I jig
1 /6/99

` Division of Soil and Water Conservation �. � ❑Other Agency
ae
® Division of Water Quality
Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other J
Date of Inspection 4
Facility Number � L
Time of Inspection =tSD24 hr. (hh:mm)
© Registered M Certified [] Applied for Permit © Permitted 113 Not Operational I Date Last Operated:
FarmName: S �. �Wrs ll^- Countv:.....P414r.................:..............................................
.......{..„.1..-.... ...fv ... e ...+.....................................................................
Owner Name :.......V.�.r-.`.Sy............. .,?.. .......................................................... Phone No: ����..���:..��� �...........................................
Facility Contact: ...tl ..............Mo..!1�. Title:.......... ........... Phone No:...................................................
MailingAddress:...... 3G.b�...... ►h�...........:......................................................... ..... .i1�v'i tM.t.Ajf;........................................... I....... ... 1. 7ti........
Onsite Representative:.......1+1 t~ l^1J. d` Tlo:�.i. ................
... t.i(.o,......!.: W�P�lA1.............................................................. Integrator: .. .......
Certified Operator; ............................. ..................... ...... :................... ................................... Operator Certification Number;...... U,..,.
Location of Farm:
r4 !e...ak.....: 04.1if.
.. .... .. 9F
Latitude
{ Design Current
5wute :' z Capacity Pbpulatia
❑ Wean to Feeder
W] Feeder to Finish
`1 J10
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
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 gaUmin?
L
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
mai ntenancelimprovement?
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 �a No
❑ Yes to No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes No
M Yes ❑ No
❑ Yes No
❑ Yes No
Continued on back

rj
Facility Numbvr:
• 8. Are there lagoons or storage ponds on site which need to be properly closed'? ❑ Yes No
Structures (La Loons,Ifolding Ponds, Flush Pits, ete.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure.5 Structure 6
Identifier: (4Z_
..................I................ ....................... ...................................... ....... ,.............,................. ...... ...................,........ ,...... ....... ..................... I ......
Freeboard(ft):........................................................
10. is seepage observed from any of the structures? ❑ Yes fA No
11. Is erosion, or any ollte.r threats to the integrity of any of the structures observed'? ❑ Yes M No
12.
Do any of the structures need ni:rintenance/insl-)rovenient'?
M Yes
El No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
i
Do any of the structures lack adequate: minimum or rnaxitnunt liquid level markers?
❑ Yes
W No
Waste Application '
14.
Is there physical evidence of over application'?
Yes
❑ No
(If in excess of W(�MP, or runoff entering waters of the State, notify DWQ)
15.
Crop type ................ x,...........................U!..........................................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
ig Yes
❑ No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
In No
18.
Does the receiving crop need improvement?
❑ Yes
21 No
19.
,ls there a lack of available waste application equipment'?
❑ Yes
M No
N.
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 ONo
t
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 AW,MP? ❑ Yes 93 No
25. Were any additional problems noted which cause noncompliance of the Permit'? ❑ Yes ❑ No
0 No. violations or deficiencies were noted during this. visit.:You 4ill receive no further
correspondence about this visit..,
Comments,(i•efei to:question#). 'Explain any..VES answers and/or'any recorninendattons or any other comments '' f
Usc drawi;n�s of facility to better ex: plain situations, (use additional pubes as necessary)
. L4..,aoV1_ %\slay �-; Li b� 9e4.� . aptl �A U�if S}Ld VI� W �+c.t8t! `dWt h o frJ014{ i �t
M, ��hv
12, { �� sl�ct� �-rseeti'
u4w S. 4 5 .
(4. ?,04k! wat.% oA�er�e
v f is. W04 Ll' , t;�V,\ Ic., t V5
Lz , r S1� O 14yat L � 11
U sej tv w n� tl�., �1 k eY— WLW%;;vv�� l:,r,.�� �agg)w s CLA � � !� ��
:1a.W%LNk I a v..&L co-& S �a ln¢ VAN 1 1 r 7125197Vl
Reviewer/Inspecior Name ✓ .
Reviewer/Inspector Signature: Date:23%�
T------------ .............._._....__._--

Routine O Com laint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection 3127197
Facility Number 71 6
Time of Inspection 15:311 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: ftiat=d......................................................................... (ea:1.25 for I hr 15 min)) Spent on Review 2
I or InspectiQn (includes travel and processing)
FarmName: 5.A.M.F amduc................................................................................... County: PeackE..................................... I......... WiRo.........
OwnerName: 13wfeX.................................... B.Cdchlaad................................................. I Phone No: 235-46.59 ...................................................................
MailingAddress: 3S}Q0..L=h.Rd.................................................................................... WAlArd..Nc........................................................... 28.47.8 ..............
OnsiteRepresentative: MAc.L!9hky.............................................................................. Integrator: L.A.S ..........................................................................
Certified Operator: Michael R............................ Mobley ............................................. Operator Certiflcation Number:17.009 .............................
Location of Farm:
f'=t. aff.thc.irna1.......................................................................... .
Latitude 34 » 24 6 36 Longitude 78 • 31 6 48 u
13 Not Operational 1 Date Last Operated:.........................................................................................................................................................
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
2. Is any discharge observed from any part of the operation?
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?
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 Iagoons/holding ponds) require
maintenance/improvement?
❑ Yes H No
❑ Yes ® No
❑ Yes ® No
N/A
❑ Yes 0 No
❑ Yes No
❑ Yes ® No
® Yes ❑ No

6. Is facility not in compliance with any applicable setback criteria?
❑ Yes
® No
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1 /1 /97)?
❑ Yes
® No
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
0 No
Strurtures_¢,agoons and/or_Holdln.Z.Popds)
9. Is structural freeboard less than adequate?
❑ Yes
9 No
Freeboard (ft): Lagoon 1 Lagoon 2 Lagoon 3
Lagoon 4
.................1.9............................................................................................
......................................
10. Is seepage observed from any of the structures?
❑ Yes
IN 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 adquate markers to identify start and stop pumping levels?
❑ Yes
® No
Waste.Apprq ti9n
14. Is there physical evidence of over application?
❑ Yes
® No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type...............................FOry ie...............................................................4A.................................
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
❑ Yes
(R No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
® No
18. Does the cover crop need improvement?
❑ Yes
®.No
19. Is there a lack of available irrigation equipment?
❑ Yes
® No
For Certified_ Facilities_ Only.
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
®No
21. Does the facility fail to comply with the Animal Waste Management Plan in any way?
❑ Yes
® No
22; Does record keeping need improvement?
❑ Yes
® No
23. Does facility require a follow-up visit by same agency?
❑ Yes
®No
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
❑ Yes
® No
' )�: 7a ' r:a�r ':recopi cep ai ii s i ;ai ': t ei :coa iep ::... : ; : �� �¢::::.;.;:;
k�. x.. X.
.? .
use tlia '' :off66il f�i: titter ''sd�ia€ibii : rile aclr f d 'a es> i e'
5. A berm needs to be built around the header at the lagoon to prevent runoff into field ditch.
• .
I L/12. Minor erosion and bare spots need to be filled and seeded to prevent further erosion of lagoon walls. Erosion in spray fields
along field ditches needs to be repaired to prevent possible run off from waste application. Erosion at storm water drainage pipe near
lagoon wall needs to be repaired. Needs to keep inner wall of new lagoon mowed.
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: ' I

•
Site Requires Immediate Attention:
Facility No. '7 J
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANiMAL.FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
Time: •� 3 JT
Farm Name/Owner::�`L—Fa fim_S
Mailing Ad ess: )& L , 1z, X- L3 Q P & l 7 "f 4-r r R—
County: I
Integrator:
On Site Representative: I )
Physical Address/Location:
r
Type of Operation:
Design Capacity:/i
DEM Certification Number: ACE
Phone:
Phone: .9 = v Y
DEM Certification Number: ACNEW
Latitude:i? Longitude: 7" , Elevation:' Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour storm event
(approximately' l Foot + 7 inches) Y or No Actual Freeboard: Ft. Inches
Was any seepage observed from the Ia oon(s)? Yes okl�g)Was any erosion observed? ONTO
Is adequate land, available for spray? e or No Is the cover crop adequate? et�r No
Crop(s) being utilized: _/47'i_ fi ery S -- F` 60 ua _�o_ %
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings?(D� or No
100 Feet from Wells? 6e or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes <:NE"'
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes
Is animal waste discharged into waters of. the state by man-made ditch, flushing system,. or other
r
similar man-made devices? Yes No If Yes, Please Explain.
Does the facility maintain adequate was a management records (volumes of manure, land applied,
spray irrigated on specific
Additional Comments: %. .
Inspector Name
with cover crop)? Yes or No
ignature
04
cc: Facility Assessment Unit
Use Attachments if Needed.

OPERATIONS BRANCH - WQ Fax:[phone] Jul 18 '95 12:13 P.21/23
Site Requires lr=ediate AUntioa —,_,•'
•
is
•
Facility Number. IL-4
SM VISITATION RECORD
DATE, July 17 ► 1995
Owner: Farm Name: S&M Farm
County: rgndgr
Agent Visiting Site; k Pender SWCD Phone: L91=59-4=
Operator: waster Strickland Phone: [phone] •�
On Site Representative: same Phone: same
Physical Address: Farm road is on the left at the intersection of SR 1328 and SR 1325.
Mailing Address: 000 Laub Road
Willard, N.C. ' 28478
Type of Operation: .Swine —2L Poultry Cattle
Design Capacity: 10 560 Finishi19umber of Animals on Site:
Latitude: 0 Longitcide: o
Type of Inspection: Cround x Aerial
Circle 'Yes or No
6160 FizUshing
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) S� or No Actual Freeboard: 3 Feet 0 Inches
For facilities with mere than one Iagooa, please address the other lagoons' freeboard under the
COM=ents section.
Was any seepage observed from the lagoon(s)? Yes on to Was there erosion of the'dam?: Yes o N10
Is adequate land available for land application?Xe or No Is the cover crop adequate? Yes oro
Additional Commeats:
2
Fax to [phone] Signature of Agent

OPERATIONS BRANCH - WQ Fax : [phone] Jul 18 ' 95 12:14 F, 23/2Z
Site Requires Enmediate Attention
Facility Number. 7
SITE VISITATION RECORD
DATE: Jul ,17,
Owner. •• Farm Name: Tate Town Farm
County: Pgandar
Agent Visiting Site: teeth Cook Pender SWCD Mae: _(21A)2§9-4305 -- -
Operator: Walter Strickland Phone: [phone]
Oa Site Representative: Sam Phone:
Physical Address: .7 miles NE of the intersection of SR 1324 and INC 11. Farm road
is on the right,
Mailing Address: 3000 Lamb Road
Willard, N.C. 28478
Type of Operation: Swine x Poultry � Cattle
DesiPn Capacity: 6200 Finishing Number of Animals on Site: 4250 Finishing
Latitude: Longitude. rYw
Type of Inspection: Ground X Aerial
0 Circle Yes or No
Does the A iimal Waste I,agaont have sufficicat freeboard of 1 Foot + 2$ year 24 hour sto= evcut
(approximately 1 Face +7 inches) es or No Actual Freeboard: _ 3 Feet -0- Inches
For facilities with more than one lagoon, please address the other lagQOns' freeboard under the
comments section.
Was any seepage observed from the lagoon(s)? Yes on Was there erosion of the dam?: Yes o No
Is adequate land available for land application? DOor Na IS the cover crop adequate? or No
Additional Comments:
.c.
Fax to [phone] Signamic of Agent