710007_INSPECTIONS_20171231

2 VR
NORTH CAROLINA
Department of Environmental Qua'

Type of Visit 7Routine
pliance Inspection Q Operation Review Q Structure Evaluation O Technical Assistance
ReasonforVisit Q Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 1 o aJ Arrival Time: Departure Time: County: Peen t? L —Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: 24.zi-f zo Pou'lsao
Certified Operator:
Back-up Operator:
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = o = 0 Longitude: 0 ° = 6 =
o11211 WOM_n_E_N I K I I I 1
ign Current.
DeswA
Design 111 in Current Design Current ''
Swine Capacity Popullatio�nt
P- �oultr�Y
Capacity Population Cattle
Capacity Popuiaon
❑ Wean to Finish
Later _ _
_ _ _
'
❑ Dai Cow
❑ Wean to Feeder
❑Non -La et
❑ Daia Calf
❑ Feeder to Finish
$2SO
❑ Dairy Heifei
❑ Farrow to Wean
Dry Poultry
❑ D Cow
❑ Farrow to Feeder
❑ Non -Dairy
❑ Farrow to Finish
❑ Layers
El Beef Stocker
Gilts
❑Non -La Non -Layers
❑ Beef Feeder
So Boars
❑ Pullets
❑ Beef Brood Cow
❑ Turkeys
Other
❑ TurkeX Pouets
❑ Other
ILI Other I
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
2No
❑ 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
❑ No
❑ NA
❑ NE
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)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
o
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
ElYes
No
❑ NA
❑ NE
other than from a discharge?
12128104
Continued

Facility Number: — Date of Inspection
V1;iste Collection & Treatment �,,�
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 2 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 6A C v ot,) I
Spillway?:
Designed Freeboard (in): ,
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed El Yes
,,,��
CR No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environ
tal threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Yes
❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
2j'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
❑2Qo ❑ NA ❑ NE
maintenance or improvement?
✓
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
No El NA ❑ NE
maintenance/improvement?
1 l . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑Yes
No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Croptype(s) Q�121N1�1�Y-� CCY ) F6,, c- CG') 5" 0
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
1140
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`
❑ Yes
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
,L3No
LdN
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
o
❑ NA
❑ NE
,7,Nrt fi d�E („-� , I C. o kl G "--tbS cola m- °1 i?,r a W b u- -
[5,ESGt/(- r.1�[AS,
Reviewer/inspector Name . 3 a , r, :�, { C . �, _*• Phone I is
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility dumber: — Date of Inspection v '
Re - ired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
❑ Yes �ONo El NA El NE
❑ Yes O No ❑ NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
EINo
❑ 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 El Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
0 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
N
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
El Yes
,['--'],, !!
t,d'wo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
�No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
L. - o
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
No
❑ NA
❑ NE
Other Issues 28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes Q-15o ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
Q 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?
El,., Yes
L'�"No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Pen -nit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
ElYes
/
El-Ko
❑ NA
ElNE
33. Does facility require a follow-up visit by same agency?
❑ Yes
E No
❑ NA
❑ NE
Additional Comments and/or Drawings.
12128104

Facility Number
Date of yis� : Time:
JS�Dc�
O Not O erationa[ 0 Below Threshold
Permitted © Ce ` ed 0 Condition y Certified © Registered
FarmName: ...... „.... 0 .!0........1.6......_.................................
Owner Name:... _.... Ir!Qrl........ �./..................................
Mailing Address:
Date Last Operatefipr
_�Above Threshold: ......... „.». .....
County:....,�`^lGr„.....„...........» ..........„..........
PhoneNo: ».................. �. _.....».. „„»„.....„.».......... .
Facility Contact: ..__ .__ _ . .. _ ._». W- Tiitle:.. W. .W.W . » » .___• Phone No:
Onsite Representative:. 71j. Integrator:
CertifiedOperator:_...._...... . ..... . . . . ........... »».. ».„».„.„.».»............_............_... Operator Certification Number: »... ...... ................... »„........
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 4 " Longitude • 6 «
Discharges & Stream Impacts
i. Is any discharge observed from any part of the operation? ❑ Yes P 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) 0 Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes �No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes Z No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes eNo
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,
[] Yes
seepage, etc.)
;11No
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses as
00
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
VNo
S. Does any part of the waste management system other than waste structures require maintenancerimprovement?
❑ Yes
2j No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
VNo
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
/0 No
11. is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
[(No
❑ Excessive Ponding ❑ P ❑ Hy ulic Overload ❑ Frozen Grou d ❑ Cop and/or Zinc
I2. Crop typeF
13. Do the receiving crops differ with those designated in the Certified Animal Waste Managemjnt Plan (CAWMP)?
❑ Yes
w No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
JZ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
XNo
16. Is there a lack of adequate waste application equipment?
❑ Yes
;6 No
Odor Lssues
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 A No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes XNO
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 ❑ Yes0
Air Quality representative immediately.
ire auutnaaat in
�>��lask „ec�sa rY x❑ Field- Copy .wd _ ,:❑ Final Notes
''mow �`�� .~—ems
1714we.. M60
&eo 41-4,5
x 7
Reviewer/Impector Name
Reviewer/ h%mtor Signature:
Date:
12112103 Continued

Facility Number: — Date of Inspection / 4
Required, Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ZNo
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 Y(No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes IzNo
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes ❑ No
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes PYNo
28. Does facility require a follow-up visit by same agency?
❑ Yes ONo
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes )ZINo
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
ff Yes ❑ No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
/❑ Yes 00
32. Did the facility fail to install and maintain a rain gauge?
❑ Yes ffNo
33. Did the facility fail to conduct an annual sludge survey?
❑ Yes YNo
34. Did the facility fail to calibrate waste application equipment?
/
❑ Yes � No
35. Does record keeping for NPDES required fortes need improvement? If yes, check the appropriate box below.
❑ Yes No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1 ". Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
�Uoc&� Pic
1421
�o�vAROs EfF- -i',o ©F
��p uin,o G�✓�� .ems ✓��17 ����.
12112103

Facility Number Date of Visit: Time:
Not O erational 0 Below Threshold
0 Permitted 0 Certi�fi(ed^ 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: .�E1-�-� Q County -
Owner Name: 2 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' 4 . Longitude 0 6 0.
Design Current Design Current Design Current
Swine Capaciq Population Poultry Capacitv Population Cattle Cavacitv Po ulation
❑ Wean to Feeder ❑ Layer ❑ Dai
❑ Feeder to Finish ❑ Non -Layer ❑ Non-Dai t
❑ Farrow to Wean
- - _ .....
❑ Farrow to Feeder ❑ Other
ElFarrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons 1>� ❑ Subsurface Drains Present ❑ La oon Area ❑ S ra Field Area
Holding Pond/SolidTaps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Sprav 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. 1 f 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: :14z- 1
Freeboard (inches): a (A7--,a
05103101
❑ Yes 01sff-
0 Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes P-N'a'-
❑ Yes C.N.
❑ Yes -El-No—
Structure G
Continued

rm
1
;1
Facility Number: I —
Date of Inspection 1--
5. Are there any immediate threats to the integrity of any of the structures observed? (icl 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?
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [--]No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes ❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required
Records & Documents
17,
Fail to have Certificate of Coverage & General Permit 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? (iel irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ 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 this visit.
C mments{refer to uestiun # Ezlain an YES ;answers and/or any recammendetions or�ariy"other, cflmments.
�..-. 4 ) p Yo
e .
m „
Use..dr`awings of faelllty�to better explain,situatlons. {use additiunaf��agcs.as necessary):
❑ Field Coov ❑ Final Notes
..s
_ n I
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: 4-
05103101
Continued

Type of Visit OO Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Foliow up O Emergency Notification O• Other ❑ Denied Access
s Date of Visit: 04-15-2003 Time: 1330
Facility Number 71 7
0: Not Operational Q Below Threshold
Permitted M Certified E3 Conditionally Certified J3 Registered Date Last Operated or Above Threshold_
Farm Name: UQUanJ.FAxma.............................................................. ........ County: I!mder................................... Wj.Q.__....
Owner Name:haCd--------------------------•-•---•-•-------- Phone No: 91Q:ZS:RZ4D------------------..._...-----
Mailing Address:.15Q{k.Cx.Qokteid.Rum.Road................................................................. Wa ard.NC............................................................. 2842B---......:....
Facility Contact:........................................................... Title:............................................... Phone No: .................
.....................
Onsite Representative: Integrator: Celr�l'�Fltods,�uc.---------------------•
Certified Operator: Rieltalyd.W,.................. p S........
........ m............................................. Operator Certification Number: 1.C4,S
....................
Location of Farm:
East of Penderlea. On East side of SR 1324 approx. 0.2 mile South of SR 1319. l
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 34 • 1 39 30 164 Longitude I 78 1-1 Ol 11 F­5'6
i ::i i Desi i s urrent ............. i ...... n. 'JGSuirreiit..... ..'...'. .:......: i De.
Poult .:::::::::::::::- ............ ...::: .......... :....:::::::Cattle::::::;::;::::::::............
ulation...................� J ::::-:::::::::: Capacity..: Pupglation:::::::..............:::::::::::::::::
❑ Wean to Feeder
® Feeder to Finish
5280
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
1
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Subsurface Drains Present
❑ No Liquid Waste
Discharge originated at: ❑ Lagoon © Spray Field [] Other
a. If discharge is observed, was the conveyance man-made?
77:
Lagoon Area 10 Spray Field Area
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/rnin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ 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? Q Spillway ❑ Yes 0 No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier: ........................... .......................... .......................... ...................................................... ...........................
Freeboard (inches): ............ 1.7 ............ ........................... ._.............._. ...................•.....
..........................
ncm-2m1 t ...;..,,,.A

Facility Number: 71-7 Date of Inspection 04-15-2003
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? El 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?
❑ 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
Required 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
❑ 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
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ElYes ❑ No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
❑ Field Copy ❑ Final Notes
IT TO FARM WAS TO LOOK FOR POTENTIAL PROBLEMS OBSERVED DURING AERIAL SURVEILLANCE BY
'Q-WIRO TODAY.
EXCESSIVE PONDING DETECTED. SOME MINOR PONDING ON PULL MADE ALONG FARM PATH HEADING
NARD ANIMAL HOUSES, BUT PULL WAS JUST COMPLETED @ 12:00. NO WASTE DETECTED LEAVING FIELD OR
rERING THE GRASSED WATERWAY THAT BEGINS ADJACENT TO THE PULL (FRESHWATER PONDED IN
TERWAY).
INO COPY OF THIS REPORT LEFT WITH GROWER. I�
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:

x
, Division of Water Quality
Division of,Soil'and Water Conservation'
O' Other
..
-.
& I
�"7..1��. 9. I� k°li.>>1, kl4 i;."°3•s
''p ; s
E € i
aP�Y_rs��=
3 �.,
Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number L qj
Date of Visit: fI Time:
Not O erational 0 Below Threshold
Permitted © Certified [3 Conditiona11 Certified © Registered Date Last Operated r Above Threshold:
Farm Name: 4944 A4D County:. rry�ER
Owner Name: 4 Phone No:
Mailing Address:
Facilitv Contact:
Onsite Representative:
Certified Operator:
Location of Farm:
Title:
Phone No:
r
Integrator:
Operator Certification Number:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude
Design.!, :Current "Design ,-',Current- _ �� ;.Design �' Currcni
Swme:, Ca aeth' . Po ulition` IPoultrr Ca acitr •P�o utniion ,Cattle Capaci0;.Popiilatioa:
. 3
�3
❑ Wean to Feeder
MrtoFinish
w to Wean
❑ Farrow to Feeder
❑aowinish
❑ Gilts
❑ Boars
t ❑ Layer ❑ Dairy
-] Non -Layer ❑Non -Dairy
_..
r : ,
"• 10 Other I I I
Toth Mulz
I
Number of Lagoons ❑ Subsurface Drains Present ❑ La oon Area
''HoldmgPonds /,,Solid .Traps ! �``'i ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste C011ecti2n & 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):
05103101
E
oEi
fi t
S rav Field Area
❑ Yes /2n No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ;x, No
❑ Yes No
❑ Yes No
Structure 6
Continued

7
Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
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 any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
/No
? ❑ Excessive Ponding ❑ AN ❑ H draulic Overload
11. Is there evidence of over applica7�n
Yes
N
12. Crop type
t%
13. Do the receiving crops differ with those designateJ in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
No
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
[ No
15. Does the receiving crop need improvement?
❑ Yes
No
16. Is there a lack of adequate waste application equipment?
❑ Yes
No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
t[Z(No
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
X,No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
El 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?
Cl Yes
No
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
ko
24. Does facility require a follow-up visit by same agency?
❑ Yes
VfNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
XNo
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments refer to esfi n'# Ea'`lain an YES answers; ndl�ar an ;reommendations or an othercommenUse
drawings of facility to better a plainNituations,'(use add tional pags necessary): Feld Copy ❑ Final Notes ; g x
re
A) 061
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 T Continued

Facility Number: — hate of Inspection I y
Odor Jum
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes [-]No
❑ Yes 9 o
❑ Yes y No
❑ Yes Y"o
❑ Yes Am
o
El Yeso
❑ Yes No
.� .
Additional Comments` and/nir Dfiwings. '` .. r
��0' lxwe /�f5 D 4F �i✓
AV,
J
05103101

`11W
Type of Visit C..Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 6Routine Q Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
'? .7
Date of Visit: Z 7 Time:
Facility Number
Q Not O erational Q Below Threshold
12Permitted DC��errtiried © Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
FarmName: ....... Q. {. !14 ..... 1..1f.!5........................................................................ County: ........ le.4., .....................................................
Owner Name; ........gch4� L ......................................................................... Phone No:
FacilityContact:............................................................................... Title:................................................................ Phone No:
MailingAddress:........................................................................................................................................................................... ............................... ..........................
Onsite Representative: ... a.3..!t eK............................. .............................................. Integrator:.... arw4.......................... ....................................
.....
Certified Operator: ................................................... ............................................................. Operator Certification Number:..........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Morse Latitude ' ' +' Longitude • a «
U
Design Current
wine. Cnnneity Ponu1ati6w
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design ; .Current' Design
Poultry....
Cii eci Po ulation'',' Cattle
❑ Layer
❑ Dairy
❑ Non -Layer
❑ Non -Dairy
❑ Other
Total D'essign' Capacity
Totai'SSLW ,L...�.�
Subsurface Drains Present ❑ La Spray oon Area ❑ S i
Number of i.agoons `. ❑ B P y Field Area;
Holding Ponds l Solid��Traps �. ❑ No Liquid Waste Management System .' iv ` ,
Discharp,es & Stream Im acts
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 iffl 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 29-No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes E]-No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 8 No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .......................................................................................................................................................................................................................
Freeboard (inches):
5/00 Continued on back

r' 4V
Facility Number: 7l — 7 Date of Inspection Z 6
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 lb 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 QjNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes allo
9, Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes 9No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes 25
11. Is there evidence of hnover application? ❑ Excessive Poonding ❑ PAN ❑,Hydraulic Overload ❑ Yes J}-No
12. Crop type A Ix5 104A�G Sot t ,-6 Gt:��P �,-4a 4 — 7-e-
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 9SNo
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 BNo
15.
Does the receiving crop need improvement?
❑ Yes
&No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
C5 No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
&No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
M No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
91 No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
0-No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
P No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
J5No
(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
E•No
Q Yi�1 ti$ s:oe 4hickac{el$ ire o0 ed. 40569 tbis;visit; • :Y:ojr wili•teet~ito 00 Wh .
correspondence A6o f this'visit:
Cotnmeints,(refer to;'question',tl
Uae;iir'awiries`:of facilit�.to heft
I� A.
yooh P tL�p 11t4rc -�Ia�f - - L• /fie
a ;d t4l 1 n-F4 Ka. zede jS %g 4)lf-K i9 C&O het'G��/C -ta e5 �lr�,/t d9j'r 2't
en �kr{ a re�5 ej4 dike 0' /15,
+{
Reviewer/Inspector Name
7
/�,yi� / j t ��
• .� .l-V.
Reviewer/Inspector Signature: ljf.,,,/ r�/ Date: /Z/7/O j Sloo

Facility Number:
Date of Inspection /2 D
Printed on: 1/4/2001
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
32. 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.)
33. Do the animals feed storage bins fail to have appropriate cover?
34. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes 13 No
❑ Yes KNo
❑ Yes '}•No
❑ Yes 0 No
❑ Yes 6No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.771
01/01/01

Facility Number 7 j
Date of Inspection a�
Time of inspection I $Q Q 24 hr. (hh:mm)
0 Permitted [3 Certified 0 Conditionally Certified © Registered 113 Not Operate Date Last Operated:
Farm Name: 0 j 1 A yt .... F.°t.'..' ``s..... ... County:. V....... '......fie n e(e .....
......................
....
........................................................................................... ...........
r �p 1
OwnerName:............... �. 1 !.q.... r�..............f!.... f r� K.........................................., Phone No:.......................................................................................
FacilityContact: .............. .. Title: ............................................:.................. .......
MailingAddress:...................................................... ........... ............................... ...
Onsite Representative: l, G Zlg ✓ G� +1.�.�.f.ar t'1
CertifiedOperator: ................................................. ; . ......................................
Location of Farm:
............................................ Phone No:...................................................
Integrator: ,� ru 'S
.. 1, ....t;.r..rfl............. �................................. ...... ....................
Operator Certification Number:,,,,,,,,,,,
.............. ......... ............... ............................................................. T
Latitude • 6 64 Longitude 0 6 «
Design 'Current, Design' - Current ;',�;Destgn : Cu `went
Swine„ Ca aci ,, I'o' 'ulation Poultry Ca aci ,,Population Cattle : _,..Ca 'act ty Po ulation'
❑ Wean to Feeder ❑ Layer ❑ Dairy
;, , ❑ Feeder to Finish JEI Non -Layer I 1 s ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
❑Farrow to Finish
TOWDesign.C' acityy
❑ Gilts
❑ Boars ,.Total SSLW !!
i Lagoons , Subsurface
Drains Present ❑Lagoon Area ❑ Spray Field Area
'Hold n Number
l:
Solid Tra s ❑ No Li uid Waste Management System
g P 9 g Y...t
u F�
Discharges & Stream lmtiacts
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 [3 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 l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: I
Freeboard (inches): ......................................................................
...........................................................................................................................................
5. Are there any immediate -threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, [:]Yes [:]No
seepage, etc.)
3/23/99 Continued on back

Facility Nugnber: r? f — 7 Date of Inspection
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 maintenancelimprovement?
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
�D
❑ Yes
❑ No
I& Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? 'S Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This "facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit 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? (iel irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. rail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
21 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?
.. .. yi.. tiOr s'O- de#icje deb mere )iO ed• dtrri6g �hjs'visjt; • Y'oO will •teeeNci 06 fuffte
corres�oridence: about: this .visit:
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 10 No
❑ Yes ❑ No
❑ Yes ❑ No
4. i E 'i 8 '1' "" 3 H �I Pt EI 4 F , i _1. i 0 Ui } Sf
Commentss(refer to, question #):`; Explain'any,,, answers and/or any recommendationslor,any other comments i,111?
Use; ti g f Facthty to°bett' r, ex s use adcLttonal pages�as+necessa
dra- e .� lam.situatton
p (
wl, l r h
— 1r1��cc��an GG✓r4�vur1c6� �tS fvllaW se-r6fidrl �
vp-Tc Pln,h4,-d As ons�rvG-1fP� ��-�oll�wV�.
St+outlX IJSe MI/ v1Vn 1'q E sp�-o, l�>✓�� del S �D tw A 4eL✓�i1{vl
GI-�a%�►„ -4ejef y^y pe'.14 -/e hgLe ad6/9ti/�i�� -s1.vr,01vie 40, �6Ss�d1� Liyr1'�'�w�1c�
?. L✓t�ds o� d;k-e c.vatls Y)eed 40 6e GdY1�ro11e�� �h�'rVis I1/oe-<e J)'nce
w a r• k 4a
qr
Reviewer/Inspector Name-r'o??�W�.�C'.� �t �� �` y, 1� �i�"�' 3CJ 5 ... Y' ,° t77
'�
Reviewer/Inspector Signature: Q/ �[�tr�%(,p Date: -7 hDd T

Facility, Number: ►f 1 — '•] Date of laspection 1 6/ JI O 14
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
[:]Yes
❑ No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
❑ No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
❑ No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, e(c.)
❑ 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
i�t11 1—,1 — 11-1 tsam or Drawings- 1 ,..:1 , 's . 1 , ,:;� .-L._, f,.,;..a � ;i,.E r�,.,f0,t,r .._ MA . 1 .111.
,�I. .4j a,4 T�e Te�r nye I�iS°OY1 Mqr k<, e— vg 1.o/e1e-Vn-�;p,1 t,, 1"44
-Ae 1awCs�l -fo;-7-4 oo Ae- d;,fie . Ovn44t�i Garrd(C'f (�%aw�"� Pabsnh).t',r
13 Doe -r; E rd or 1 e-(J 1-Ae5ClUe
GnYI��OI SrA ;n Wasa� P111n, l rr,,e,- irlOJri :g4c`L `T�i 4;5
is ffslv,-e. 07,,kP c,r4,dns so"" ;r�� prgG� �'ez
m���ckes L�las�e �1sr✓►.
l5, �SGUG Lt�ty �';�I�( tl�ottj�( �e C.u4 4bard �do,�l� �o I'.ti+Prp✓c
q " e'M 04 end off' c o rrl -Ic"e- l .
3/23/99

10 routine O Com laint Q Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Facility Number Date of Inspection 5-,3 2004
Time of Inspection /335 24 hr. (hh:mm)
J8 Permitted © Certified 0 Conditionally Certified 0 Registered JEJ Not O erational Date Last Operated:
Farm Name: 1"IO 1 �.`t .....FA wt f.......... County:......�Q.e.......................................................
Owner Name: ........ ..... .1L'� f................
... � ......................................................... Phone No:........................................................................................
Facility Contact: ................
........................
Title:
Phone No:
MailingAddress: ..................................................................................................................... ..................................................................................... ..........................
Onsite Representative: �Integrator
........................................C.f.......a....�...r....S..................
CertifiedOperator: ................................................. i . .................................... I ........................ Operator Certification Number:..........................................
Location of Farm:
t .. ...
Latitude D ales` 0,s Longitude = a =' =11
Des_ tgn Cur�erit
Design `Current `= ` ;: E , E, �Des�gn :Current. ,
,.:Swine Ga aci '. Po ulitition. ` Poultry
Ca `aci :Po"ulatton>' ;.Cattle ;ca ..,Ca'ac� 'fPo"ulation
❑ Wean to Feeder
Feeder to Finish 2n0
S Z,g
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑Gilts
❑ Boars
Discharges & Stream Impacts
1, Is any discharge observed from any part of the operation?
Discharge originated at: El Lagoon ❑ Spray Field El Other
a. If discharge is observed, was the conveyance man-made'?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gallmin'?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Colteetion & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? [I Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: 1
Freeboard(inches): 2.2,5.. .........................................................................................................................................................................
5. Are there any immediate'threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes X No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes ®No
Structure 6
❑ Yes JR No
Continued on back
3/23/99
Discharges & Stream Impacts
1, Is any discharge observed from any part of the operation?
Discharge originated at: El Lagoon ❑ Spray Field El Other
a. If discharge is observed, was the conveyance man-made'?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gallmin'?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Colteetion & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? [I Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: 1
Freeboard(inches): 2.2,5.. .........................................................................................................................................................................
5. Are there any immediate'threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
❑ Yes X No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes ®No
Structure 6
❑ Yes JR No
Continued on back
3/23/99

1s
Facility Number: t%J — % Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
R 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?
99 Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement?
❑ Yes
CKNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
® No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
& No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
No
12. Crop type Fe- $ G ve 01 C2,,4 Z e 1-tc v4 S6 Gt.r ✓11 re rc ue. 4q Ly
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA
P)? ❑ 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
0 No
15. Does the receiving crop need improvement?
JZ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
10 No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes .9 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 0 No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
ZYes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
[].Yes 0 No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes ® No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes ® No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes ® 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
yiglaiidris:or dtfci ....wire . . . 0 ci>jrririg t is:visit; Yoir will rec�iye rio furthg .. .
comes' oriderrce. ab6iuif this resit: . .
Comments (refer torques"tiori #) Explain any YES,answers'arid/or any recommendations or` any other comments
, �
e;drawrn s af,#acilr to better explain sttgations use:i ddrs asn tional a e.'
` p r r p g. Ar r3)
7. [Jock 46 G:r4A11;,si, Vcj-r- e44've co✓ewa+-+ Mara gear a. ao­,./Ylow •
tr.1 seals L'roe-i ; n ✓► aj.- d ; k e i,eJa 11 -1 spara i•^ d ;,ee'rs!'oh .
n¢eOf ow vP oAn A;t y,-awer
�allsa,r „p .�nslOcc��oY, .
15, �roWcr rnado �► �1;��;ot�5 -owed Go,rn �vt 3%2�I�2oD0. Gofrr ;J
no eA-beets ocdo4e oic ►'nr ee4;o►,.T4;s eXcCedjr 4 4 e 3D
o1a•y Prep/.Fn-r n�ef allocAA►)ot. &--,ot>cr-skvLtU pran-} Ge✓yt 4SAF. --
Reviewer/Ins ector Name
h tea,,1'!�ta�r9`ra� 39
p0 I
Reviewer/Inspector Signature: 917 Date: 51ZT-%

Facility Number: 171 — f7 late of inspection pQ
Odor Issues .
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes j$ No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes A 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, ctc.) ❑ Yes 2?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 Drawinp., , . " . ,� ; , j . ,,
i .,
18• 6e&wer -.r► vt4ld -rill ai4 inseC4 4 odor Goy140.01 rhtckl-.4 AL
Gr0LV,Qr sklould hAve Gt Cof 4t c Gee;,Cie L41-oh der^ �kle
IG,r w, wiA A i S eer-C dr. r
19. Grot„"e,• s1-LVgJ0( VSe F")Otr wgs4e gVk41YSi S /esvlfs p+-t
tda da ys "4 4lie 0(4+e eh 41)e 4mgl ys; F.
�iela( 3+�,'pv�l ��'1A r1 � �16,Gr'eS taklal �C o(i✓;e(,4j I
a reco0-d CA aki s010e ►"fi e zek7- (,)iA
7'
,qtD-ol e ia�c acreage 6e;...�/.�sl,aty►-7 orr eqG�. KKK - 2 as Q(,dK
ar1i' Df �1 e JPV /1 !' S oop?c t y .eGve 4&1, t 4ke rc �l iY�I�c,•-
! O h 1
24. I�)aw iAsre e4 ►',o-1,, t,., r ll be dene 4-s -moh �o
OA4+" Gt64;vc 1a9oeh 1✓l�0".►�i-}�`o+-�, at+1d Gi+'1SlJe✓ tVeS4i0h 1-7.
25 • ' Grot.vCr' Sk,,,k 1 A 4'6' VoW ai1v ,vif a W S in LVa13 PIq�
Grower Mef 1; ed or, w heal d , Oc,4d6er 7�cGeY►,t be r . �J� e
plate ecllows Whe4-y qff
-
G`►�®l,,jer slot,, 14 i)�tvcS41' 404e he( t4 fl wr,lyen'
`�'a ! n G 1 V � j e ✓►�,o� a ,�'! e ki �je �� �, c� ; o h t.� i �-io�e �.J .
4leinre 4tje )l��,rs old r�ccard:rrg -�a ►"'ewer.
be, G 1 e one 4 v� 4,; p r e v e`t-A ; n s eGf
3/23/99

Revised January 22, 199:
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number -71 - ]_ Operation is'flagged for a wettable
Farm Name:LW� _ acre determination due to failure of
On -Site Representative; _jzuLa A (-Jja..l� Part 11 eligibility items) F1 F2 F3 F4
Inspector/Reviewer's Name: Anij.,, l mpv,
Date of site visit:. _ %Iohe
Date of most recent WUP: 3
✓Operation not required to secure WA
determination at this time based on
exemption 0 E2 E3 E4
Annual farm PAN deficit: _— q j �.qk pounds
Irrigation System(s) - circle #: 1. hard -hose traveler, 2. center -pivot system; 3. linear -move system;
4. stationary sprinkler system wlpermanent pipe; 5. stationary sprinkler system wlportable pipe;
6, stationary gun system wlpermanent pipe; 7. stationary gun system wlportable pipe
PART I. WA Determination Exemptions (Eligibility failure, Part 11, overrides Part I exemption.)
E1 Adequate irrigation design, including map depicting wettable acres, is complete
and signed by an I or PE.
E2 Adequate D, and D21D3 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 111. (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 ill)_
PART 11. 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).
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 -
Part Ill. Field by Field Determination of 75% Exemption Rule for WA Determination
TRACT
NUMBER
FIELD
NUMBERtz
'TYPE OF
IRRIGATION
SYSTEM
TOTAL
ACRES
CAWMP
ACRES
FIELD
%
COMMENTS'
1
1
i
V
FIELD NUMBER' - hydrant. Dull. zone. or point numbers may be used in place of field numbers deoendina on CAWMF
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 "A
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 5911,0
of its annual PAN as documented in the farm's previous two years' (1997 & 1998) of irrigation records, cannot serve as the
sole basis for requiring a WA Determination. Back-up fields must be noted in the comment section and must be accessibi_
by irrigation system.

UDivision of:Soil Arid Water COnSCCVallon Operation R@View
,'Division of .Soil and'�WateC •eF"•
�° Conservation - Comp[iance inspection ,
ADivishm of Water Quality Compliance Inspection
11 Other'Agency'- Operation Review
Routine O Com laint 0 Follow-u of DW ins eclion Q Follow-up of DSWC review Q Other
Facility Number'
D itc of inspection
Time of inspection E�s24 hr. (hh:mm)
© Permitted © Certified © Conditionally Certified © Registered [3 Not Opera Date Last Operated:
Farm Name: Mallow!�......�Iid m�............... County:.... PMpP]r....................
........................................................................................
Owner Name: ...................... Phone No:...C..f�.L�-2L? b.......................................,...
Facility Contact: .............................................................................. Title: ... Phone No:.....,.
Flailing Address: ....... 1�Q..,..1. f U....,..R►H1......?,�.......................... � ±.��Qt� j 1�.�.. ..���' T...........
r
Onsite Representative: Integrator: .....
..........q..............................................L.....{,."..�.�...�...............,.,...............,.., ��; ............urn!....�.................................................
Certified Oper:itor:.,.......Gln(7yY......... W...............f�4..11i�YUU...,.....,........,......,.,......,. Operator Certification Number:.......................
Location of Farm:
T c
�k......Sti.a.....4F..... 5K.A-51 ltt....v,.&......w�h11 t .......sa........ ........5R.15Aj.................... A
... .. ..... . ...................I............ ............. ........................ .......
Latitude a 1 64 Longiludc �• �4 «
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder ❑ Layer ❑ Dairy
SM Feeder to Finish I; ❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
[J Farrow to Feeder ❑ Other
❑ Farrow to Finish Total Design Capacity syg p
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present 11CILagoonArea ❑ Spray Field Area
Holding Ponds / Solid Traps JE3 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 ratan -made?
h, ll' dischargc is observed. did it reach: ❑ Surface Waters []Waters of the State
c. If discharge is observed. what is the estimated flow in gallinin?
d. Does discharge hypass 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 & 'rreatnient
4. Is storage capacity (freeboard plus slorm storage) less than adequate?
Identifier:
Structure I Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes ® No
❑ Yes 52 No
❑ Yes (O No
N
❑ Yes F No
❑ Yes �M No
❑ Yes F No
❑ Yes P No
Structure 6
Freeboard (inches):
'......................................................................
1/6199 Continued on back

Facility Number: -11 Date of Inspection 3 1 a
5. Are there any immediate threats to the integrity of any of the structures observed'? (ie/ trees, severe erosion, ❑yes W 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 E� 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? j] Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes 19 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/imprrnverneitt`? ❑ Yes No
11, Is there evidence of over application'? ❑ Ponding ❑ Nitrogen ❑ Yes ( No
12, Crop type .... .......... �. GUI,................ ........ A ............ 4I...................................................................................................................................
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes EONo
14.
Does the facility lack wettable acreage for land application'? (footprint)
Yes
[] No
15.
Does the receiving crop need improvement'?
❑ Yes
No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
09 No
1$.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ic/ WUP, checklists, design, maps, etc.)
❑ Yes
No
19.
Does record keeping need improvement? (ic/ 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 certified operator in responsible charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application)
❑ Yes
D9 No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes [RNo
24. Does facility require a follow-up visit by same agency? ❑ Yes .� No
No.vioJatians.or. defAcieticies.were bated during.ttiis.visit:.I'.ot va ...ercei . e no ftirtiier .:.
'ecjrrespgrideitce''abou#;this;visit.:�-;•;•;•;•:•;•;•:�;•;•'•:-;-;';'•'• •. . . . .
Comments;(refer to question #): Explain any YES answers and/or any,recommendatioi s or any other comments -j
1
Use liawings of facility to better explain situations. (use additions! pages as necessary) it
- 6ut AKtu.S ON cxr N ht_ yYN P-!f{
Will \%e i(t ;,lb 4v, Wh— b6Vh4.ss , -� �p7�gtlsI cX
W vp l N\ �15 ` ��°7a -}o �l c-ci wSe I — ec-ck Reld 4,r
#� ea ..�; f 6 �J 44 ac+- aye. cNt4 61 &c.�uc�i cO oc . M
U11 I[,ttiQ0.dn 3e�Lia�iSt+� Qro�Ss;enal ��ylnt4lr {
`Ca �c l v alu,ti,rt ur��lt e}+w ax.rt aLie e : r� s houlff �� J a�a '�o �� 1r ��k� e w►oer.. ins �UA�es
o- I�{Z,--Z ja,4W 4,6 SaN (Uj( nVnnb� (, r e.,-� 111MY
,' ,4�rtcf PA a 0.c s oukt) lt-AJ ar 5Jy j "r41, OA 56or- CA. Wup. IR4L-z
'Ids r.r [.srr. on Lis}dcll soi �S s1�0�i�tf �..e Irs4��! ir.� Ll1UP. •
Reviewer/inspector Name
Reviewer/Inspector Signature:
1 /6/99

Division of Soil and Water Conservation ❑ Other Agency
Division of Water Quality
VMRoutine O Complaint O Follow-up of DWO insinxtion O Follow-up of DSWC review O Other
Facility Number
13 Registered Certified Q Applied for Permit �6ermitted
Farm Name: ......
Owner Name .............. ........b 0 �i.. . ^.ilt...............................
Date of Inspection 1 •-f 3 X S
Time of Inspection E= 24 hr. (hh:mm)
Not Operational I Date Last Operated: ..........................
....... County:...•....... �'!1 .... ......... ................
........ Phone No:.........U..r....z.g5........'sa..p.... ...........
Facility Contact:................................................................ . Title:................ ... Phone No:
Mailing. Address: ........ 1.��...00.......Cc-vQ� l,,....! ,..u.:.'.!........ ..............i'✓,`..�..�.4� .. .... ..g ....... ..........................
Onsite Representative:........•.!L �.a �-r, �I✓[ lnteKrator:...... ro ll 5 ......!....�� `.,.5................ x...I......................................................................... .................... .. �
Certified Operator; ................, :,....'_42 r!L.................................................. Operator Certification Ntunber;.. �. . y s
Location of Farm:
Latitude 0• 0' i{ Longitude • ° {f
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
F ❑ Boars
Current a Design Current y
Pppulation Poultry Capacity .;Population Cattle A
f 1; 11r�„P� I —In
c
"c
r - I .� _ _
v Drains Present Lagoon Area Spray Field Area
Number of LagootHoldtng Ponds ❑ Noo Isi u�d W te Mana ement S stem ; k
x
AM
{l g y
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
IHNo
2. Is any discharge observed from any part of the operation?
❑ Yes
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
((
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
N
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
�o
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?
❑ Yes
o
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
o
maintenance/improvement?
b. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
o
7/25/97

N
Viability Number: '7—
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes `�Yl�o
Structures (Lagoons.Holding Ponds Flush Pits, etc.) (_
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure)?(No
6
Identifier:
Freeboard(ft): ..........r�...............................................................................................................................................................................................
10. Is seepage observed from any of the structures? . ❑ Yes ' 'N0
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes II�N� o
12. Do any of the structures need maintenancelimprovement? Yes o
(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 No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop ryPe t Y..!'1 _4'. .. re'a 6 .................................................... .........
.....................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes �rNo
o
18. Does the receiving crop need improvement? ❑ Yes o
19. Is there a lack of available waste application equipment? ❑ Yes o
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 No
22. Does record keeping need improvement? ❑ Yes No
Far ertified or Permitted Facilities Only
23, Does the facility fail to have a copy of the Animal Waste Management Plan readily available? ❑ Yes o
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes o
25. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes No
[3- No.vlohitions' -6 deiiciencies:were`hkei d during this:visit.- You:Wrill receive�nafurther, :
correspObdeince
IZ. R4"'F_[L44!-L t]krr Q/BPS Lff�OuJF i /O a 1A'3OOK I%•, r(
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature-
'xsN:v Y
Date: �. I

® Routine p Complaint p Follow-up of DWQ inspection p Follow-up of DSWiC review p Other
Date of Inspection
Facility Number
Time of Inspection 24 hr. (hh:mm)
-- ota tme to traction ot hours
Farnt Status: Certified
.1:25 for:1)tr IS
{ez,miu)) Spent an Review
de'Ins ectiori'(includes'travel and p rocessin )
Farm (tame: Holland.Ear is.......................................................................................I........ County: Pender WiRO
OwnerName: MUM .................................. Hallaad ...................................................... Phone No: 285.-.6814 ....................................................................
Mailing Address: ISl).Q.Cronked.Ru&Road................................................................ !? jHiard.N.C........................................................... 284.7.8 .............
Onsite Representative: Richard.Holland...................... .................... I............................ Integrator: Ca rirnIr.s.Fnods.Inc.............................................
Certified Operator:Richard.R.......................... Haul.and............................................. Operator Certification Number: 1.6455.............................
Location of Farm:
Latitude ®° ®' ®°° Longitude ®• ®' ®"
p Not Operational Date Last Operated: ...............................................................................
Type of Operation and Design Capacity
IV;
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? (Ii'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?
p Yes ® No
[]Yes ® No
p Yes ® No
p Yes
® No
p Yes
® No
p Yes
® No
p Yes
® No
Continned on back

6. Is facility not in compliance with any applicable setback criteria?
p Yes
® No
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/1/97)?
p Yes
Ig No
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
®No
Structures_ La Mons and/or HoldingFonds .
9. Is structural freeboard less than adequate?
® Yes
❑ No
Freeboard (ft); Lagoon I Lagoon 2 Lagoon 3
Lagoon 4
1.5
10. Is seepage observed from any of the structures?
❑ Yes
® No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
®Yes
O No
12. Do any of the structures need maintenancefimprovement?
® Yes
p 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 Application
14. Is there physical evidence of over application?
p Yes
® No
(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?
❑ Yes
® No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
Ig No
18.
Does the cover crop need improvement?
❑ Yes
® No
19.
Is there a lack of available irrigation equipment?
p Yes
H 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?
p Yes
®No
23.
Does facility require a follow-up visit by same agency?
p Yes
® No
24.
Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
❑Yes
®No
Reviewer/Inspector Name
Reviewer/Inspector Signature: A }Date: 3 l i
.L. usvtaturs u! ►ruler vuuttrl', rimer vuutuv aecsturr, ructutp.naaeaamertt urr#t I I!!WWI

,Facility Number: --,-
Division of Environmental Management
Animal Feedlot Operations Site Visitation Record
Date:- 2 Zf Xlt G
Time: 3" 00 ;4—
eneral Information:
Farm Name: de, County:_
Owner Name: 12 Phone No:
On Site Representative: YIA�,Ja �____ �40 1 �,c,. vac Integrator: r_o..wv�
Mailing Address: {,S 00 Glr ©c k_-e_d (Ld -
2 fq -7. p
Physical Address/Location
Latitude: 1 1 Longitude: I I
Operation Description: (based on design characteristics)
Type of Swine No. of Animals Type of Poultry No. of Animals Type of Cattle No. of Animals
Cl Sow ❑ Layer ❑ Dairy aLe
❑ Nursery ❑ Non -Layer 0 Beef
2-feeder
OtherType of Livestock Number of Animals:
Number of Lagoons: (include in the Drawings and Observations the freeboard of each lagoon)
Facil tt Inspection:
Lagoon
Is lagoon(s) freeboard less than l-foot + 25 year 24 hour storm storage?:
Yes a —No ❑
Is seepage observed from the lagoon?:
Yes Cl
No 2r---
Is erosion observed?:
Yes ❑
No 3—
Is any discharge observed?
Yes ❑
No f3--
❑ Man-made ❑ Not Man-made
Cover Crop
Does the facility need more acreage for spraying?:
Yes ❑
No
Does the cover crop need improvement?:
Yes ❑
No Cr
( list the crops which need improvement)
Crop type: Acreage:
Setback Criteria
Is a dwelling located within 200 feet of waste application?
Is a well located within 100 feet of waste application?
Is animal waste stockpiled within 100 feet of USGS Blue Line Stream?'K
Yes ❑ No
Yes ❑ No 3-'
Yes a No a-'
Is animal waste land applied or spray irrigated within 25 feet of Blue Line Stream? Yes ❑ No Cr--
AOl -- January 17,1996 � CW/tl � l,"►i {-i�r YX 100 -� - p t��' �� cy� �e v yv� i�w..�

Maintenance
Does the facility maintenance need improvement? Yes ❑ No U—
Is there evidence of past discharge from any part of the operation? Yes ❑ No 2-
Does record keeping need improvement? Yes ❑ No Q--
Did the facility fail to have a copy of the Animal Waste Management Plan on site? Yes ❑ No 3—
Explain any Yes answers:
Signature: Date: ' 9 // z-/ P6
cc. Facility Assessment Unit Use Attachments if Needed
Drawings orObservations:,
AOI -- January 17,1996

Site Requires Immediate Attention:
Facility No. -%
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
Time: /S
Farm Name/Owns
Mailing Address: / 10Z) Kr-k LR t I i &A V 1\1
County: , - - •
Integrator: 0 a Phone:
On Site Representative: 6A ua (aA,& Phone:
z Physical Address/Locatioh: `L
Type of Operation: Swine Poultry Cattle F t h 1-511 i ►,
Design Capacity: i Number of Animals on Site: 18r-6
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: ` 3 ' U _" Longitude:i Sr ° 0/ Elevation Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches)(!!
5es
r No Actual Freeboard: _6 _Ft. Inches
• Was any seepage observed from the lagoon(s)? Yes o� Was any erosion. observed? 69s or No
Is adequate land available for spray? r No Is the cover crop adequate? es r No
I ­_ 0Crop(s) being utilized: 4�OC c&e -- . �_;, oe)Q4A:r,, �s_3. t -C4_-c-v ,P
Does the facility meet SCS minimum setback criteria?" 200 Feet from Dwellings? 4L6�)or No
100 Feet from Wells? 96 No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes o<
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes oK
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other,
similar man-made devices? Yes o ONo 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: _6 _
aaQ
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

1995 17:01 9102591291 PErIDER COOP EXT SER PAGE 04
Site Requires Immediate Attentioa
Facility Number.
SrM VISITATION RECORD
DATE: July lap 1995
Owner:' Richard Holland Farm Narna: Holland Farm
County:
Agent Visiting Site, -nn2th Cook Pender SWCD . ,-.._,,,,,_ Phone: (210) 259 - 305
Operator: Richard Holland Phone: [phone]
On Site Representative: Righard Holland Phone:
Physical Address: of the intersection of SR 1324 and SR 1332. Farm road
is on the ri ht.
Mailing Address: 1500 Crooked Run Rd.
Willard, NC 28478
Type of Operation: '.Swine x Poultry Cattle
Design Capacity: 5280 FinishingNumber of Animals on Site: 5280 Finishing
Latitude: ° Longitude: 0 _"
Type of Inspection: Ground X Aerial
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of I Foot + 25 year 24 hour stoma event
(approximately 1 Foot + 7 inches) (e or No Actual Freeboard: 5 Feet 9 Inches
For facilities with more than one lagoon, please address the other lagoons' freeboard under the
comments section,
Was any seepage observed from the lagoon(s)? Yes od Was there erosion of the dam?: Yes o N
Is adequate land available for laud application? (9 or No Is the cover crap adequate? Yes oN
Additional Comments: area stabilization needed -around building and dike
hslilaina area.
Fax to [phone] Signature of Agent