710019_INSPECTIONS_20171231

NORTH CAHOLINA
Department of Environmental Qual

'Y Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 16 Emergency 0 Other ❑ Denied Access
Date of Visit: l� Arrival Time: Departure Time: County: PRegion:
`
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative: Fex
Certified Operator:
Back-up Operator:
Location of Farm:
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: =' ='
= Longitude: = c =' =
Design " Current Design. .Current Dc
Swine. Capacity" Population Wet Poultry`,, Capacity Population : _Cattle , . Ca'
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ harrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
ralnlr.w
❑ Other
❑ Layer
❑ Non -Layer
Dry Poultry .
❑ Layers
❑ Non -Layers
El Pullets
❑ Turke s
❑ Turke Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: . El Structure ❑ Application Field El Other
a. Was the conveyance man-made?
gn�'. Current "'
clty� Population
El
Dairy Cow
El
Dairy Calf
El
Dairy Heifer
El
Dry Cow
❑
Non -Dairy
El
Beef Stocker
El
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?
Page I of 3
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
[]No
❑ NA
❑ NE
❑Yes
❑No
❑NA
ONE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
12128104 Continued

rfacility Number: '�� — 5 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
2Ycs
❑ 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: o
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 1,
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
❑ No
❑ NA
❑ NE,
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat, notify
DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ❑ No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA ❑ NE
maintenance/improvement?
1 I . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Y
El No
El NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): .
4V LA LL, X J it LA 6 Q L.EU+✓t, )4-r 1
4PAA, L PR-E X o +)S
NZCqT. St,L
Po A u xTo S 0 A no SU ]o 7a
P W A . Do A/ PT Pu me
10 oA `i,
b►`ti'��(`T
Reviewer/Inspector Name — -_a-- -.6'}
— — ' Phone:
I `& —IS yr
Reviewer/Inspector Signature:
Date:
Idle Q la
Page 2 of 3 1 12128104 Continued

1
Facility Number: 'j — Date of Inspection �I b
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
2L Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
❑ NA
❑ NE
Other Issues
2$.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Page 3 of 3 12128104

Type of Visit PfCompHance Inspection 0 Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Oj" Arrival Time: 6 (/ Departure Time: County: ?6Wj2j —, — Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Wits
Boars
Other
❑ Other
Owner Email:
Phone:
Title:
Phone No:
integrator:
Operator Certification Number:
Back-up Certification Number:
❑ c
Latitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & 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'?
Longitude: =O=t
Design Current
Cattle Capacity Population
❑
Dai Cow
E]Dairy
Calf
❑
Dairy Heifer
crPry
Cow
DNon-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
o
❑ NA
ElNE
El yes
No
❑ NA
❑ NE
12128104 Continued

Fac�hty Number: 1 - f 9 Date of Inspection e
A
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: C,A6oc)O i
Spillway?:
Designed Freeboard (in): a_0
Observed Freeboard (in): a-t
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes [ /No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes ❑ N ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? El Yes L��/o
I No El NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes El 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 El yes Ej� o ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Ld No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application'? if yes, check the appropriate box below. ❑ Yes /No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window El Evidence of Wind Drifl ❑ Application Outside of Area
1 L),
12. Crop type(s) a6a-, C P \1 S Go
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination: ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
tort-bS :rfj G�oa,r> SNaPE 6
Q No ❑ NA
U� ❑ NA
lL(N El NA
WVo ❑ NA
o ❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
Reviewer/Inspector Name [.'1 'p�� i s � � � ,�. Phone d 111 02
Reviewer/Inspector Signature: Date: 6�
12128104 Continued

Facility Amber: '71 — 19 Date of Inspection
1
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes E No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [ Ko [I NA ❑ NE
[I❑ Design El El the appropirate box. [] WUP Checklists !!
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ 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
ENo
ElNA
ElNE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
EITN'o
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
EJ A
❑ NE
Other issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑,<o
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
JCa No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
P<
❑ 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
[3No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
�No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ NA
❑ NE
A"ddrtional Cornmenis.and/or'Draw1 gs
' } f ... F `r„ a• gg,, �� ,� •"
121228104

of Visit 0 Compliance Inspection 0 Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up 0 Emergency Notffication O Other ❑ Denied Access
Facility Number Date of Visit:
Permitted 0 er fled ©Condidonally Certified 0 Registered
Farm Name: .... ....._ ...... 7 .»
Owner Name: ..».»._.»�
Time:
Date Last Operated oor� Above Threshold:..
County: _.1..L! �.�� _ ..»_ .» »........__.........
PhoneNo: _._» ._....._.__.._ .. ____ . ».. »»....... _._...
:Mailing Address:
Facility Contact: . ».. ». » » ----- Phone No: .... »»_»._.. __ »» »........
Onsite Representative:.. Integrator: _ _ % �....»..»»............. _ .._ ..»_....
Certified Operator:...._._..._W_....__.........._....... Operator Certification Number:
Location of Farm:
ASwine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 " Longitude • 4 41
Design Cure
'SiVy11e .. i'r iwyw.h. CD��nla
ElWean to Feeder
�
❑Layer
Feeder to Finish
❑ Non -Layer
77-1
Farrow to Wean
Farrow to Feeder
y ,e
Other
Farrow to Finish
TotaliDts�j
tp..
r' .
lFg -.Jk 4 I i.1 i.
❑ Gilts
Boars
Discharges & Stream Impacts
i. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches): G 7_
.12/!2103
� ''Cnrient
Po elation
❑ Yes P1110
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes ;'No
Structure 6
Continued

ji,ccility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes 9No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes VNo
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 ONo
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
❑ Yes No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes VNo
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes J9 No
❑ Excessive Ponding ❑ PAN ydr alit Overload ❑ Fro n Ground Copper and/or inc
71,H
12. Crop type " ✓f j✓-�f f
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Pl CAWMP)?
❑ Yes ;2rNo
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 ;2'No
16. Is there a lack of adequate waste application equipment?
❑ Yes )ZNo
Odor Lcsues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes INo
liquid level of lagoon or storage pond with no agitation? /
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes )9No
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 ❑ Yes XNo
Air Quality representative immediately. L
1V4'f'0Ear.
A�<' 00
4 Copy
Field Com ❑ Final Notes
Arco �OID S �rr2�rty7 C. T•f� /S�CO.P,D. 144m_
d,�"o F4'e0'gk0 k11'C0a.0 s
A4cr el� 71zolo3.
Reviewer/Inspector Name
Reviewer/Inspector Signature:
l vG7�4 AI C04ro, No, 4664,o4lics
Date:
12/Lz/U3 t onanuea

acMty-Number:
Date of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Waste Application J&Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
27. Did Reviewer/lnspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP2
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
3 L If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
.ZYes ❑ No
❑ Yes gNo
XYes ❑ No
❑ Yes )Z(No
❑ Yes RrNo
❑ Yes Po
❑ Yes P1110
❑ Yes 7. 0
❑ Yes No
Yes ❑ No
❑ Yes PrNo
❑ Yes P�No
Z(Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? OYes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ff No
❑ Stocking Form PIrcrop
Yield Form ❑ Rainfall ginspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
3 No violations or deficiencies were noted durine this visit. You will receive no further corresvondence about this visit.
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12112103

Type of Visit Vompliance Inspection 0 Operation Revie�,w,�0 Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up Emergency Notification 0 Other ❑ Denied Access
-- � Date of Visit: � Time:
Facility Number
— � #� Not O erational Below Threshold
Permitted OCertified © Conditionally Certified 0 Registered Date Last O iwrated or Above Threshold:
Farm Name:' 1� �� 2 - - County:
Owner Name: Phone No:
Mailing Address:
Facility Contact: I Title: I Phone No:
Onsite Representative:
Certified Operator: _
Location of Farm:
Integrator:
Operator Certification Number:
�R.Zt`jq
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude De 4 064 Longitude • 4
Design ., Current Design Current Design Current
Swine Ca aci Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder JE1 Layer I ❑ Dai
❑ Feeder to Finish ❑ Non -Lay er 10 Non -Dairy
❑ Farrow to Wean -
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish ! Total Design Capacity.
❑ Gilts
❑ Boars Total SSLW
Numbe' ❑Subsurface Drains Present ❑ La oon Area ❑ Spray Field Areal`
r of Lagoons
Holding:Ponas 1 Solid Traps ..� ❑ No Liquid Waste Management System
Discharges & Streamlimpacts
1. Is any discharge observed from any part of;7a2oon
ration? Ycs El No
Discharge originated at: ❑ 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) 2res ❑ No
c. 1f 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
Ward Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway t3Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): 1,14
05103101 Continued

1.
1.
FacilityNumber: — Date of Inspection
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?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do anv stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Aw2lication
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? (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 DVVQ of emergency situations as required by General Permit?
❑ Yes
1114
(ie.1 discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
Z N`o
24.
Does facility require a follow-up visit by same agency?
EKes
❑ 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.
r...:a,u � w-7riI°a, � tF �_'� Sa.W �:i�. ... � m �1,,, Ott �rf d7�« �-�� r ,+� es,,.�'k�KM�r 4a x�4'd�ri'^^ i�"T.��: - " - � tip, s�l�,� - w
Comments (refer to gnestson #j..E p>Esin and YE5 answers andlor any MommeadatIong ar any.otlte�r commedta '' d��
r
us drawings of facility Eo better e�latn situations ,(use additi6ni&pages as necessary} ;'
r - ❑ Field Copy ❑ Final Notes
r=
ow rle ht�fi 1�1 ea � o1^G UV a �J E Sl.v Y\ 1 GR s t. 1 Y1� \ CL
C.'1SC,V1cuqX. +eoc_-K A+rvuS muA- e .P
` Iv� �1 S Li '� 2 C Woo�� �?
1. .�— C ec
Z cvv►kp I YL
,►r}„�•°E r�,,�,�yy
ReviewerllnspectorName k �rr �M.r�ae
�t.,t
Reviewer/Inspector Signature: Date: 2
O5103101 T r Confinued

Edward Earl Padgett
Pete Padgett #2
PO Box 478
Wallace, NC 28466
910-285-6266
August 3, 2003
Division of Water Quality
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
SubjectTac 71-19,Dischargc
Dear Sirs:
This letter is in reference to the call I made as required by my permit.
On July 30t', 2003 at approximately 11:30AM I called in informing the DWQ office of a an incident
which had occurred at my farm. Below is an account of the events as they happened, to the best of my
knowledge, as required by NPDES 111,8 a,b,c&d.
A,C) The riser ruptured at approximately 10:30AM. Due to a faulty KILL. SWITCH the pumping unit ran
for approximately 25 minutes before being stopped by BJ. Waste flowed around the lagoon dike and into
the road ditch on the East side of my farm. I estimate approximately 10,000 gallons may have left the
pump. I don't feel that all of this left the farm due to the actions taken by my employees.
B) We will replace the pressure switch and repair the riser and air relief valve. These things will be
completed by 8/9/03.
C) NCDA&CS waste sample attached.
B) My farm manager, Jody Sumner retrieved the backhoe from my house and began to dam the road ditch
to stop the waste from reaching the creek. By L30 PM we had acquired a pump capable of pumping
approximately 128GPM and began pumping the waste back into the lagoon. Approximately S:OOPM
personal from the DWQ Regional office were on site monitoring and assisting our efforts to contain/clean
the spill area.
B)There were five dikes positioned along the road ditch to block movement of any waste which may have
inadvertently left the farm. These were pumped repeatedly from approximately 1:30PM until 9:OOPM at
which time we were advised by DWQ that it would be OK to leave the site. Friday Mr. Sumner
monitored the site and continued pumping as water appeared in the dammed areas. Mr. Chester Cobb
spoke with Jody and advised him to continue pumping through the day Friday.
As required by my permit samples have been taken by Hygro Inc. and submitted to Vann Labs Wallace
NC. for analysis(per section I1I,9,a). Samples were taken from the lagoon and from a point downstream
from the discharge area.(sce attached map). These will be forwarded as they become available.
If you need additional information regarding this matter please contact me at the above address.
Sincerely,
��f0a
Edward Earl Padgett
Attch:

NCDA Agronomic Division 4300 Reedy Creek Road Ralejqh, NC 27607-6465 [phone]
(I"rovier: Padgett, Pete
f"O COX 4/8
WasteAnalysisReffort
Pender County
Reloort No; 1400350 VV
C(,P;0,5 To: 1 iygro
Sam ple Info.
Laborator-y Results (parts per million unless otherwise noted
Sample 10:
N
j; K ca Al "..71 S
c
00 V'O
'I P I fiv,
lr�01 (,0
7'�'. - -)
87' i 711
4
0.29
MI, A,
Waste Code.,
NH f
;"_s
NO3)
iklo Ni c"I I
F
SS N OARCCE ns 111�Kc fl)
9ascription:
ON-N
Recommendations:
Nutrients Avai able for First Crop
1���Iqns
Mar
Other 'Ions
1ppfic'viol Mc,"hod
N P --0:
C, 3 A��) S P 0 In 4 7
cu R Mo C/
Na Ni ("d '01) /1/ SO L
1.2 t).7(} TO
ID C, 1'1 0--A I
i 0.0 1
IJ
2.0 0.80 7,
1.2 0.4!0.21 1 f). 02, 1 (M) 1
i 0,01
1.7
I ,
ru, pH i;i wle �,�Tcx iquo. r', rip.iowv iro irj�zi rc-T.T 101 OiXlon��; "MW LI'd WEYO IFNNHIN'�. (JU.O.-�Tv aljl-�I !)H Oy il!(IOQ I I0. GI 'I;0r.1.1h. 1-�'I jllll�� �1.3' cil., ��. CI V100 it lr(� 1-c-pr'r, 2�1100 111(.1
Ir I-, I-I'j I" I'd (Ir I I,Fil i.xh I it j5 !,,JNr To, dc')il',A fi'xq,i d 7,i)-8.0.
ample Info.
Laboratn
Results ( arts per million unless otherwise noted)
'ample ID:
14
P K (:'i - -!Vq S
it "I? ZrI
CLS
C-1 c
P2 19
1)(11
50.0 87?1 171'i 71.0 'i a' 1
12 1 0.1119 1.111
0'11�1 1.-,7
/N -N
Vaste Code:
-NH4
-S
-nQ3
IV...I Ivi Cu' Pb Al
Sc L) [)N
§5 CW
OM%
"I
YO
lescription:
ok-tv
eco rn mendat ions:
Nutrients Available for First Crop
/hs/7000 yallons
Other Elements
Ibs1Iq00_ga11qns
-IlyliclI Mr/hr-ld
tv
K-0 cd 1149 S �c IVIII Z11
(Al 1,A)
R 0
N�) h1i
cd R7 Al k ii
irri:lzlir-lr
li.,� 'u.67
1.0 IP R 19 Rot I I
i (.)r)1
1.7
(Ob
7.9 —1.2 GA1 0:22 0. 0 *2 i 0.01
1 (M) j
U
t! f)" II! WC 11T. C 1:� 11T IM21 Ic'r k1FAlf t"N"', Z(M-St Ohl 0"! 1 H). f'I F'-I M-ft 1)(IF lull) U , 11. ("1 I!ql..Il 1,011VI1,01 F 11,0 �.F'illpk Wc !I-IT-Q-
I-V rd cr! - I i c It: e J, il -: 1 fjh a Ii1 i+ i ll'il- 1 IT 00q'i-Id (Frile d 7.0-8. 0.

Padgett #z
Fac 71-19
Approximate Path
Of Discharge
Approximate Location
Of Earthen Dams

s A
All
ANALYTICAL & CONSULTING
CHEMISTS
Customer:
NCDENR-DWQ
127 N. Cardinal Drive Ext.
Wilmington, NC 28405
Attn: Ed Beck
Date Sampled:
Sampled By:
WATER:
07/30/03
Ed Beck
Environmental Chemists, Inc.
6602 Windmill Way • Wilmington, North Carolina 28405
[phone] (Lab) • [phone] (Fax)
[e-mail]
NCDENR: DWQ CERTIFICATE #94, DLS CERTIFICATE #37729
� ►r�r�riu.rr
lei
REPORT OF ANALYSIS
Date of Report: August 5, 2003
Purchase Order #:
Report Number: 34348
Report To: Ed Beck
Sample ID
DS1
DS2
US1
Parameter
Lab ID
# 10081
# 10082
# 10083
Fecal Colifonn, colonies/100 mL
2,200,000
1,100
200
Reviewed by

ENVIRONMENTAL CHEMISTS, INC
NCDENR, DWQ Cerdlkate #94, DLS Certtticate #37729
Sample Collection and Chain of Custody_
L
Camnlp Tvnp- T = Tnfinpnt_ V = F.Mimp rt_ W =WAL CT=Rtrnarrv_ W1 =Cnll_ QY= Clrrrlop fUhar-
6602 Windmili Way
Wilmington, NC 29405
Phone: [phone]
Fax: [phone]
Email: EchemWCa?aolxom
Rennrt No: 3-4.; 5
Sample Identification
Collection
o o
U
o a
v-
PRESERVATION
ANALYSIS REQUESTED
C
z
a6
z
x
b
z
F
p
DATE
TIME
TEMP
�J^-
<,
`� _ •
r
G
I�
C
do
100YL
_
a
G
C
/ocP3
4M
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
i
G
IG
C
P
G
I G
NOTICE — DECHLORINATION : Samples for Ammonia, TKN, Cyanide, Phenol, and Bacteria must be dechlorinated
0.2 ppm or less in the field at the time of collection. See.reverse side for instructions. E
Transfer
Relinquished By:
Date/Time
Received By:
i
Date/Time
2.
j
Temperature whey ec ived: 0.9 G Accepted: Rejected: Resample Request d:
Delivered By: Received By: l%a-, /' _ Date: 7� 3 Time:_ lc?= /�
rt Comments: ti ;� r

�7 f
ORT AN' NOTICE
QTICE
North Carolina Division of Water Quality (NCDWQ) is strictly enforce EPA regulations for sample collection and
preservation.
Client Must Provide the Fofiowza2- information
1. SAMPLE IDENTIFICATION (Contain= Associated with requested testing :
2. SAMPLE TYPE (Composite, Grab, Wat, r, Sail, etc.)
3. DATE COLLECTED
4. TIME COLLECTED
5. SAMPLE COLLECTOR
6. PRESERVATI N (Including Temperature and pH)
Temperature: e: Samples MUST be refrigerated or received on ice between 2 and 6 ° C. Samples received
within two (2) hours of collection must show a downward trend. Therefore, please record tmperature at
collection in space provided on collection sheet.
pff: A twd (2) hour limit to chemically preserve samples by pH adiustrnent is allowed, except for metals
samples reported to, the Groundwater Section which must be acidified at the time of collection.
Caution
These sample bottles may contai a small amounts of acid or other corrosive and potentially harmful
chemicals. Laboratories are required to add these chemicals for certain analyses in order to comply
with EPA preservation requirements. Use extreme care when opening and handling the bottles. If
any chemical should get on your skin or clothes flush liberally viith water and seek~ medical attention.
DECHLORINATION WSTRTICTIONS
CAUTION: DO NOT Mix thiosalfate with acid in bottle before colleting samples as a
violent reaction will occur.
Dechlor natinQ Samples that Require Acid Preservation
1. Add 4-5 granules of thiosulfate to -a bottle with no acid preservative (unpreserved BODITSS bottle).
2. After mixing to dissolve the thiosulfate, pour half of the sample into a bottle containing acid as a
preservative (AmmoniwTKN).
3. Then completely fill both bottles with fresh sample.
The Laboratory will verify and document the above requested information.'
ref_ NCAC 2H.0805 a
"At any time a laboratory receives samples which do not me-- sample collection, holding time, or preservation
requirements, the laboratory must notify the sample Collector or client and secure another sample if possible. If another
sample cannot be secured, the original sample may be analyzed, but the results reported must be qualified with the nature
of the infraction(s). And the Iaboratory must notify the State Laboratory about the infraction(s). The notification must
include a statement indicating correcive actions taken to prevent the problem for future samples.
Of NKAC M-0805 (a) 0 (N'l."
i

Sunday, August 03, 2003 7:29 PM
BILLY HOUSTON 910-298-4629
Attention:
Mr. Chester Cobb
Company:
DWQ Wilmington
Fax Number:
19103502004
Voice Number:
9103953900
From: BILLY HOUSTON
Company:
HYGROINC.
Fax Number:
910-298-4629
Voice Number:
Subject: Padgett Farm #2 Discharge
Comments:
Date: 8/3/2003
Number of Pages: 4
Chester Cobb
Here is a letter outlining the events on the Padgett Farm 71-19 as
we discussed. Samples were sent to Vann Labs of Wallace. These
results will be forwarded when available.
If you need anything else give me a call.
My Mobile is 910-289-6093.
Thanks Billy

Sunday, October 19, 2003 8:15 PM
! 5
BILLY HOUSTON 910-298-4629
P,01
Attention:
Der. Chester Cobb
Company:
DWQ Wiluungton
Fax Number:
19103502004
Voice Number:
9103953900
From: HILLY HOUSTON
Company:
HYGROINC.
Fax Number:
910-298-4629
Voice Number:
Subject; Padgett Farrel 02 (71-19)
Comments:
Date: 10/ 19/2003
Number of Pages: 2
Chester here is the information from the samples that were taken
from the Padgett Farm. Sorry it took so long in getting them. Vann
Labs was a little slow In getting the results back to me.
Thanks
Billy

Sunday. October 19, 2003 8:15 PM BILLY HOUSTON 910-298-4629 pM
For: Pete Padgett ?arm #2
Vann Laboratories Phone: [phone]
P. O. Box 668
Wallace, NC 28466 Wastewater ID #; 22
WASTEWATER ANALYSIS REPORT
Date Samples Collected:
August 1,2003
PARAMETER
UNITS
DATE
ANALYZED
Laaoon
Downstream
PH.
BOD5
mgX
8-1-03
92
2.3
COD
+ng/L
Fecal Coliform
c01.1100m1
8-1-03
2,400,000
ab
Toral Kjeldahl Nitrogen
rnalL
8-2-03
476
1.1
Total Residue
M91L
Total Suspended Residua
mg1L
8-1-03
920
22
Detergents MBAS
rng/L
Oil & Grease
mg/L
Total Phosphorous
mg&
8--6-03
52.6
0.26
Sulfides
m91L
Phenols
U91L
Total Chromium
U91L
Toral Copper
U91L
Total Magnesium
mg1L
Total Zinc
ug/L
Ammonia Nitrogen
M91L
8-1-03
308
<0.20
Nitrate
mg/L
8-1-03
<0.10
<0.10

Type of Visit 0 Compliance Inspection O Operation Review 0 Lagoon Evaluation
Reason for Visit O Routine O Complaint 0 Follow up OEmergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: ► Time:
Not O erational 0 Below Threshold
Permitted 0 Ce ified /�O Conditionall Certified 0 Registered Date Last Operate Above Threshold:
Farm Name: 0 & FTC ?_ County:-n1�Dep
Owner Name: F�")*1?,0 /J =— Phone No. -
Mailing Address:
Facility Contact: Title: Phone No:
Onsite.Representative: I Qr� Integrator: 5
Certified Operator: Operator Certification Number:
Location of Farm:
i6 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0 4 " Longitude ` 6 64
Design
Current
Design C*arrant
Design Current
wine
Ca aci
Population P,nultry,
Ca aci , 'P,a ulatloa Cattle Ca aci Population
Wean to Feeder
❑ Layer
❑Dai
Feeder to Finish
❑ Non -Layer
❑Non -Dairy
Irrc---
Farrow to Wean
❑ OtherFarrow
Farrow to Feeder
to Finish
Total Design Capacit
Gilts
Boars
Total SSLW
er of Lagoons
uP
❑ Subsurface
Drains Present ❑ La oon Area
❑ Spray Field Area
Haldin nds 1 S
g nlid Traps ❑ No Liquid Waste Management S stem
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon Rf 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 Collectilln & 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
?Yes ❑ No
❑ Yes [ZNo
zYcs ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Yes ❑ No
Structure 6
Continued

Facility Number: I I — 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?
zYes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Aonliggtign
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over applicatio ? 2TExcessive Ponding ❑ PAN Hydraulic verload
Yes
❑ No
�n❑
12. Crop type (� L.t. R� OOF-95 ( F
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?
❑ 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
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer, to question #) ExplsinaRy YE5 answcrskandlor any recommendations or any other comments
Use"'Arawings'of facility to better, explain situations (use additional pages as necessary} ❑ Field Copy ❑ Fi�al Notes r
a. h
f nn-
V�S�T G0�1l�yCr,E,C� D�CE�Pn1�ivG X �PcG,z v�/J fL
N =4a," z 0; v v,:: A
-
Reviewer/Inspector Name 7�t
Reviewer/Inspector Signature: Date:
09103101 Continued

in
Facility Number: — Date of Inspection
��2' 3
Q.&-r I&MU
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Additional Comments and/or .1)rawings:;,.
w �fFaRF pGf�L�n�G- �D21� /�G.s �r
6 FZ 6&o � 4n1.0
�� 1R, vu►Y��J�'2 K E�o��E � �,q � FF,o�D o �� Rr�
PF'-PvA-z�-O �A-r f ,� �u� PF %r5r-Fq,0A y
An�D �►-�H' % -� 7 ��o LSD �� �FO I ��n� /a /���GZ��-�2p/�J•
\+k P y` Rau!tJ To V\KoE '�VMEoGI E: Gome. [)u'T,
�5, N{�v�7� 1ilJ--LL2�mSD�.I l:P�O\V� OUT' Stae- 't5EPp2?iew
T©o K
-po
� a-5 E �� �� A c F-_.) �� ht2nr` UN
�o M--1
C� A� 00'7� RfEAI z�►��� us �P��
Cz r' F �o �o
��Jc � , �5 � y
OS/03/Ol (49
a

Facility Number: — Date of Inspection r�
Odor !am
26, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Additional Comments and/or Drawings:
(t4 7;W t �" O►�
o�_
T -P�P, riPrN !V OF 7�'fF
-�,E?-- of C-/Qf:ff J
K
:So i -2� E�l� c CF,-5
1
'-'-C �
n L �
-,- ��arr✓ '��C��,F'S�f" K ��O(�5 J�C� �SDfJ
O-C
0
05103101

!,
1
Type of Visit lzcompliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit O Routine O Complaint f�rFollow up 0 Emergency Notification Wother ❑ Denied Access
Facility Number I
Datc of visit:
Permitted © Certified [3
oi[/Conditionally Certified [3 Registered
P Fnrm Nnmr- ,,t,c# Az
Owner Name: GGi1-✓Ot t� �� �� d `� E
e
Mailing Address:
Facility Contact: Title:
OnsiteRepresentative: Pady`>
Certified Operator:
Location of Farm:
Time: I 14 ' 3D
Date Last Operated or Above Threshold: _
County: J L-441f
Phone No:
y�,� Phone No:
Integrator: "! u
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 6 0" Longitude 0 4 0"
MMODesign'
Current.
Deslgn Current :..., Design Current
Swine
Ca xci
1Po ulationP,oultr..
❑ Layer
�, ❑ Non -Layer
❑ Other
Ca fact P.a ulation Cattle Ca aci P,o uiation
❑Dairy
Irl Non -Dairy
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
'
Total Design Capacity
❑ Gilts
❑ Boars
SLW
Total SPim
Number of Lagoons
❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds 1 Solid Traps=�Ei
❑ 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. 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 A Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillwav
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches): al Jr
05103101
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
Continued

!A
* Facility Number: r] — ( Date of inspection 2 1 b
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? ❑ 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?
Reauired Records & Documents
17, Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to 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?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ZNo
❑ Yes ❑ No
❑ Yes ❑ No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
t.pR�•j',. ",s6 '� �. c*-' . `* :• > 3 k M1, �;
Comments,(refer to questiodl#): ExplaintanyicyES answixae`+'r.a.s�a'idloizany,recommendations;oedr t•�any-other com.,i;ments: z •F
3
Use drawiflgs;of facility to better explain situations {i<se additional pages,as necessary) ❑ Field Copy ❑ Final Notes
TA;s inSloe C4;A�-, is a �a/lo�-up... Padua �l"P.�s
OJ'S L,�e� f �.P- armor geld �'�nd� ;��-,s c,11ctj t,Jk;Irle �c�ak�"•-1`J
q� Ae 6e a re-b-"Iev.-N /"'40c¢
S ; fl a ," Padjr# k•r161-i
wkk-i ke,df cee used 4j z 40 lee P'01atg ell T Foci Id b e bO t-C
tivr,�'l, �/3>�G�'"',A��a•-, t9n pl►'1 �rpGeSi�r AC.};'O,.1J.
Reviewer/Inspector Name _• ,
Reviewer/Inspector Signature: Date: / D3
05103101 Condnued

I
it
W
i+ ,Dfvisfon of Water /jnall a,; I ; r r ?
i 3 aE iy t
f 7 iV l
1 i S ii
' 'Dl01i Of SOT8ndEW$ter bomerVa%l
VDnt
°
is 7 i� I F°a{a�iS ap r
n
e
x, .. H.
. F.f ',t�. zf 4.4E � i ":,a> i S -•i d re . ,. _. _ '.
Type of Visit 'Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit oRoutine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit: O 02 Time: I 14 4 S
Not O erational Q Below Threshold
[] Permitted Cj Certified [3,(Conditionally Certified © Registered Date Last Operated or Above Threshold:
Farm Name: f d C1¢ r7 4Z County:
Q
Owner Name: 1"��'�ol 1 oaf Phone No:
Mailing Address:
Facility Contact: Title: Phone No:
Onsite Representative: O4� Sv �", r�t� Integrator: M V
Certified Operator: Operator Certification Number:
Location of Farm:
[:]Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude' u Longitude ' 0"
'De sign,
Swine capacity
e ❑Wean to Feeder
,, 0 Feeder to Finish
u Farrow w wean
❑ Farrow to Feeder
Farrow to Finish
Gilts
i ❑ Boars
Number of Lagoons
f "biding Ponds`.'/'Solid Traps
Design
I,Pouttry.. i'Ca'Dacity
LI Non -Layer
❑ Other
TOti:
110 No Liquid
rent !i �i r ;, #"esign;:
Present IIL Lagoon Area
E1
Dis-chaLges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes XNo
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 ZNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ZNo
Waste ollecti n & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ YesZNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): Z
05103101 Continued

Facility Number: 1% t — Q Date of Inspection D
5. Are there any immediate threats to the integrity of any of the structures observed?•(ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/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 ✓ r-% V dr, Shyfl' G YYct.. i ✓7 Qvc -S ecA
13. Do the receiving crops differ with thosi designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fall to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (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 Reviewcr/lnspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes XNO
❑ Yes ONo
❑ Yes ❑ No
❑ Yes ZNo
❑ Yes tNo
❑ Yes ffNo
❑ Yes No
❑ Yes 1Z No
❑ Yes J[2rNo
❑ Yes ONo
❑ Yes JO No
❑ Yes ❑ No
❑ Yes �YNo
❑ Yes J'No
❑ Yes 9No
❑ Yes )—Z No
Yes No
❑ Yes �dNo
❑ Yes 0No
❑ Yes �ZrNo
❑ Yes WNO
❑ Yes PrNo
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
t,—''.a ti,'II:, .">a t� ¢p
Comments'(refer ta,question #) Explain'any YES onswers�,nnd/or�any recotntnendations'ar anyaother comments: a� jt''
aLlse drawiogs;of facility t`o better xpiatn sifivationsa (nse9additit►nsl'pages as necessary) ti + r Notes
❑Feld Copy ❑Final
< , t
7A; s 7L, e ),_ecorAS aee well
7ke mnd 1ng0ev, i- i-s avc�ctl� wF1�
-� �► e f�-ta
1'1/1 A j ', e, v re d ,' s of M e ed o 1; + r -� a I1
S%1✓'"6�`7 ��1��'D+� t�s^er� —�ine 66 -n,, op 4k 1 a9 oe+-� �/�e
/1/P�e
e►r'^'1 V F T iQ l `� 9✓ "0411 a V SOY veof • _T11 P be rY`��/(,�(/� S�oi--, /'X
i►^'��rav;,,c� n!Cell, -Thzre' r.s '-';I vleeof �o ,^es�o,��r� -�, e.s-iab1,'s�►�ceti��
/lI
Reviewer/Inspector Name a.
Reviewer/Inspector Signature: Date:�—
05103101 Continued

If
Facility Number: Date of Inspcefinn O S 02r
du Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atior 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 fanblade(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 J2°No
❑ Yes j2No
❑ Yes 'Femo
❑ Yes 2rNo
❑ Yes ,O'No
❑ Yes ❑ No
Additional'Corriments and/dr,Drawings:
be" wt t1d o, OP, 2 0-Ie' 3, a >td r l a As are eq 1 w d n jol a C e �o
do ) us 4 4)ig4 ik7 Zop3 . The 1.,eeb-,ver^( eeoo,-d s q-,-e
r) a 1 A Va ; f 6( b 19 /A,- t ,rlSlOe C4 " a -% . /V /'. -rVJ41 n e 1�- Sa � � 41'Q4 Lie
beet, keer)-'5 akd he -Ara w; dl seed
IMP 2402-rveebom,^d ✓ eon4I 1�e r-Pi e b /�%o Vern. 6ei
P eT�lDr4-1 7D n.a�'�, �Gl1'h j't, J tGt ✓► t� h dOU '0--Ae w Ore
h ,5
ex/;den4 alo1A- Aflp, eCIg4ed - You 90 �Wo 44V'n bf
y d" ,- L''t"'T'o✓ 4f 00 ;wl pry ✓ ; Inq 44, berrvl ✓ dG C r`Ojo
05103101

Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint. O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: �G l Time:
Q Not Operational Q Below Threshold
Permitted 0 Certified Conditionally Certified © Registered Date Last Operatfedd or Above Threshold:
Farm Name: ..... ... e � ... ` `.............. County:...... l�.C�....-Z4Q+�................................................
OwnerName: ................................................... ........................................................................ Phone No:.......................................................................................
Facility Contact.,
Title:
Phone No:
MailingAddress:......................................................................................I........................I........................................................I.................... .... I.....................
�6 . 5 .....
Onsite Representative:....?.....K`1�`Qsr................................................ integrator:....0� z!1^'....................................................
Certified Operator:
Location of Farm:
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 6 66 Longitude ' 6 66
Design Current Design Currerti
, •�� ;'
Ca cit ,To ulatton.
❑ Wean to Feeder
Feeder to Finish
'3 �0-
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
djn Capacity ; L
Total SSL W E
1Vu`mber of Lagoons El Subsurface Drains Present ❑Lagoon Area ❑ Spray Field Area e
Holding ooiiditSolid!.Trupsl No Liquid Waste Management System x93 a �, f, EE
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d..Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure S
❑ Yes 9No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes '4 No
❑ Yes *No
❑ Yes C�No
Structure 6
Identifier: ......................................................................................................................................................
Freeboard (inches): 30
S/00
Continued on back

acility Number: 01 — ` Date of Inspection
5, Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes WNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes NO
(If any of questions 4-6 was answered yes,,and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? t<Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes tTNo
Waste A lication
10. Are there any buffers that need maintenance/improvement? ❑ Yes AIN
( No
11, Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes IgNo
12. Crop type 50�1•v-.t.�, � �, � 1 5'q C3 V e--3=Q, gj,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes 9NO
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
ONo
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?
kYes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
PTNo
Renuired
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
kNo
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
XNo
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
MfNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
gNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
Yes
M
(ie/ discharge, freeboard problems, over application)
❑
No
23,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
tM No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
IgNo
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
NO-Y1P10tiQijs'o- dgfcijenjies ware npteO O(Wift thps'visit; • Y:o0 wili•tee$iye do ]Fofft1r
correspondence. about this visit. •
`�� S(c,.�5e. b�c►►-,�Q�t h�s � � �an.�� �� ��ss��l� ►�,�.-�t c-.
l t kQ(
1 Y� hem, Wt'R"CS � 1-0 Ier . 1�1�\\
� P
IVY
ILO "o ve �yg--c des Ce �i�. [ �-� ��,�e°cy�,. —
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: S/pp

Facility Number: 1 — Date of Inspection
y
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? C
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes 'L�No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes e0o
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 t�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 qNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes e<No
AddlifionaMomments and/or
Drawings:
; ,,: #' E.
p
et
CJ � t C � \ f c'�' h/''�� � ►^�� 1-�:�� +-��iT,
"\t5
a. d
rJ v J
t.,G_ er-��;� ►its i i
5/00
J

,WDiyision of Water Quality
er>€E
�OttAgency
Type of Visit �)B'Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit -DCoRoutine 0 Complaint Q Follow up Q Emergency Notification Q Other ❑ Denied Access
Facility Number
Date of Visit: 11 Z 40 Time: l2= Z3 Printed on: 10/26/2000
1
Not O eration:d Q Below Threshold
Permitted [3 Certified [] Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
!► 47- Count . Yer�C'�
FarmName: , �.......................................... Y'.....................................................................................
Owner Name:.. ,� t�a/J j�n&(� �.. Phone No:.......................................................................................
WC ..................... ... ................... .................I................
FacilityContact: ........................................................ ............... -,"'Title: ................................................................ Phone No:...................................................
MailingAddress; .............T............................................................................................................................................................................................ ..........................
Onsite Representative: V.at ..Sv. � VL4 r............................ Integrator:. A..'r5.4 -f..` .. ...................................lJ
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location of Farm:
Ak
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' �� ��� Longitude •
Design Current
awtne C:a i
❑ Wean to Feeder
Feeder to Finish j
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design. Current
Poultry Capacity Population Cattle Capacitv Population
❑ Layer I Dairy
❑ Non -Layer I Non -Dairy
❑ Other f I J
Total Design Capacity
Total SSL W
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System —71
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-tuade?
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 galhnin?
d. Does discharge bypass a lagoon system? (lf 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?
Structure I Su.uelure 2 Structure 3
Idcnti fier:.................................... ....
Freeboard (inches): .Z 17
5100
❑ Yes �!( No
❑ Yes J 'No
❑ Yes �No
❑ Yes ONo
❑ Yes ONo
❑ Yes -iRNo
❑ Spillway ❑ Yes WNo
Structure 4 Structure 5 Structure 6
Continued on back

Facility Number: 1 .— l Date of .Inspection J Z d Printed on: 10/26/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
S 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
1KNo
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
XYes
❑ No
' f
12, Crop type [aef rJ 1 r Yi' .i/' Ah ri v,6i 1
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?
XYes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
t6No
16. Is there a lack of adequate waste application equipment'?
❑ Yes
ZNo
Required Records & Documents
17, Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
f'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? [:]Yes '�j No
• ; �'Vo•yiQla�ipn;s or defit:iencies •r;v�re n�tte¢d�ririg �his;vispt�- Y:o� wi#�-ree�iye �o fu}�t�gr, •. ,
corresp6irideince. ab"t this .visit_ . . 6.
lCo'mfitettts`(refer to'quesdon #). Explain any YES answers and/or any recommendatioets ar any other comments . €
Use dirawin s of facility to ;better explain situations. (use additional pages as necessary): ,
g
S IUeeA 4o .�, Jl �►-� c,f0Q ojA eeee4ly le fet;red e;ser.r.
fl. fiver^�P 1,"G°rf ioti, c� Plmgj No, f'/,m J/e Aj,-teoggv) hftJ oeawrreA op) Zo00
�T. r.. neaXf A IveIe GdLr4L' �E�Ir'j/i'lrvt a1�1 ohI ik-M— e 1016" qo
feaardf keP4 betsed otn 4z. C
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Y3 a L,141 /7' q4 1�1
Date: 1I 1900, 5/00

Facility Number: — f Date of Inspection Printed on: 7/21/2000
Odor Issueti
26„ Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or helow 25 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
XNo
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
ONo
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
[:]Yes
XNo
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
CRrNo
3 L
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
66No
32.
Do the flush tanks lack a submerged Fill pipe or a permanent/temporary cover?
'Yes
❑ No
,..—,.......M.. -.. ".. ..a,.........
M -AJee4 4e kee b.lBE�)y AreebNurd ✓r-00 s , �v-} cnjo e00 fete
o a 1 s s t Yt l�cGArd s, jf re L✓-t rf M rta is
Zv D r.,1 � � i'r
do+4ed uVq'4t1;11 Ce dctf -of a l,-cA�P,Pn -r,&/ cet(iUPt4^s cH
N�c : Grvt,✓cK JP7eeXX AO ehsvre �L%O es�a b lisl�.�-teh 61"Atl
Pig e,,t4e t,w; 4oP- G4Ver e,rop fide- mpfag4)aj*1.
.1
S/00
J

P
a t'', 3,• D�v�s�on of Water JQnallty
Division of Soil and Water Conservation
t i �� r'��Eti e
OtherAgency: ���,� r' ;''�� ��� s 0�
Type of Visit Rcompliance Inspection Q Operation Review 0 Lagoon Evaluation
Reason for Visit 4Routine Q Complaint XFollow up Q Emergency Notification Q Other ❑ Denied Access
Facility Number Date of Visit: C�-otime: LUU Printed on: 712112000
NNot Operational Q Below Threshold
Permitted 0 Certified 0 Conditionally Certified 13 Registered pate Last Operas dor Above Threshold:
Farm Name: `a County:.....`e�dQ�................................................................
.....�...................................... `�.......:.................................................
OwnerName: ................................................... ........................................................................ Phone No:.......................................................................................
Facility Contact: .........—Title :...:................ Phone No: .........
MailingAddress: ..................................................................................................................... .............................................��......................... ..........................
Onsite Representative'. � ��' ^l'�Qr(. ?,., "��°� Q Integrator:.... �,,,..!^'"
CertifiedOperator...................... .......................... .... ........... .................................................. Operator Certification Number:..........................................
Location of Farm:
❑ Swine []Poultry [-]Cattle []Horse Latitude �� �° �' Longitude
Design Current
Swine Canacitv PODulatiOn
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer Dairy
❑ Non -Layer [,IEI
Non-Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System .
Discharges & Stream Im act5
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
1). If discharge is observed. did it reach Water cif the State? (if Yes, notify DWQ) El Yes ❑ No
u. if disc:haro'e is observed. what is the estimated Ilow in gal/min?
cf. 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 C�No
Su'uLture l Structure 2 Structure I Structure 4 Structure 5 Structure 6
Identific:r:..................................................................................
Freeboard (inches): 3-0)-
5100 Continued on back

}
Facility Number: Date of Inspection Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure'plan? ❑ Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ 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 U2�. F _T
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? KYes []No
.
16. Is there a lack of adequate waste application equipment? ❑ Yes ❑ No
Reuuired Records & Dneuments
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, tiiaps, 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?•
❑ Yes
❑ No
o yiolatidos oe dceciencies -Were pgtecl ilt,ring this;vispt' •Your :wiii receive �iti. #'urthet
cotres'oridence: abouti this :visit...
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use
additional pages as necessar[y)�:� r l
<51S J 1 .�� �cc�-.ems-.�i `'� 4..1 L� ae ` t Lz •
� 5� �i���,, ._�� t���-.� �ue�.L � he��. ��'�L-.L-u.C.� �,t51-. +�.�.c ��-►�e� -� �-
e-5�:�s�.—
��
I^E'�� ��� h•C'�d 'tom -2.J 1� h .� t'�21L� S,A � �� .
Reviewer/Inspector Name
`3�s 396a
Reviewer/Inspector Signature: �� 1��� �� Date: 5100

i
Facility Number: — ick Date of I.uspection Y3 GO Printed on: 7/21/2000
Odor INsues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge Wor blow ❑ 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 peimanentltemporary cover?
❑ Yes
❑ No
,.Additionall'Cornments and/orDrawings:
J

S
D1vlsion of Soil and VYater Conservation 'Operation Review ; :x t ' , „ { $ rr, ,
�. i .. , - ,�-- # I t .:i f, ">. • } 1 ,,g
I' io nD1V191DII ofESOiI and+WBt r ons ry bon m 1 ncefi e°cti Ilta3
i ! l �: e , e a Co is ns on
.aviii0[ oWater Qu.. aiy'- Comp_ li_ an- ce II,.ni. s- pection
.a €SF je tqy r � t` u
'OtCr AD:ICp @t�i0n3Revew Irr4 t t g, . s E,1 �10 r 1'
'
10 Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 20ther
Facility Number Date of Inspection
Time of Inspection /3: `/S� 124 hr. (hh:mm)
13 Permitted 0 Certified [3 Conditionally Certified 0 Registered F13 Not O erationai Date Last Operated:
Farm Name: y: ............. ..............................I....fl.&.....................-�7 fit. .......... .................... Count lt°r�It ... .�1.:.......
OwnerName:...." �r......................``.............!tK............,............... Phone No:.......�a...'.LET'.................................
Facility Contact: ...:.ti..�.f� . ..?k!1/Yl .r ........Title: rn [.. JPl�............... Phone No:...91
Mailing Address: !....
.................................................................................................................. ...................................................... ..........................
.............
Onsite Representative: �.Id „ �h ,K,yf��....... ............. Integrator: ,,, � ................ �'1 , k��
..... ....
Certified Operator: ......s._p14...................... :........ 51w►r&� — ........................ Operator Certification Number ........
�...1„�� ............
Location of Farm:
A
....................................................................................... .................. ........................................... .
Latitude Longitude •
'''' `Design Current'' ` De`sign ' 'Current"''' 1;' 3 "ttDes1gII ;Current
;CaactPo lationPoultry 'Cattle aa CPtrlation
[]Wean to -Feeder ❑Layer ❑Dairy
Feeder to Finish ❑ Non -Layer ❑ Non -Dairy
4i
❑ Farrow to Wean
❑ Other
❑ Farrow to Feeder
❑ Farrow to Finish TotaUDe8i n. Ca aClf
❑ Gilts
g P Y :€
J.❑ Boars Totai'$SLW ;;
{. Number of Lagoon§ ;` ❑Subsurface Drains Present 0 Lagoon Area ❑Spray Field Area
I So11d' s ❑
T.,... _:
H6Id1II Ponds , No Liquid Waste Management System f �
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? (Il' yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (II'yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches):
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
5. Are there any immediate t rears to the integrity of any of the structures observed? (ie/ trees, severe erosion, []'Yes ❑ No
seepage, etc.)
3/23/99 Continued on back

Facility Number: — Date of Inspection
6. Are i'hefe structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ❑ No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes' ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ❑ No
Waste ADulication
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
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ 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?
❑ Yes
❑ No
�'Vq Yigl'alrigns'or dgficier{cies r► re pQte during xhis•vasit! • Y:oit •will-reea.Kce ij lF�> tbgr. :
ctirres oric�ence. a�aut this visit«
_._
Comments` (refer to question #)c `Explain' any .YEB answers aidior any eecommendations or'`ariy oilier coin°menu
,Use �drawin s'offacilit-to`:b°etter'ex lainsituations us addihonal1 a esas�necesha ; I';!' i'
f g. y P { ,P, g r; r,, rJ'J� ,�, t� , �'le,E
19, eM Ales t rtdoine� drry d�`�rd� �j 2 SPr / �-r'C�nL A,we- br.n rrj4ircoC, Ckrren4 - hrork Is
/ J /
i6v
—,3 4mi &O�' /%me.. Ann.s 4'410's in I!17 /9fg, Soil sa,,fAejr 4101 �e Sty OtQ w1•pn ewrics ow&
Po/4 s#;Il acAvf..
ReViewer/Inspector Name
Reviewer/Inspector Signatur Date: ,3 J
3/23/99

�w.
�Dtvision`ofSuilandWaterConservabon,'Operation Review(i`r� �t; to 15"'
�.
M.
Dtbts�o�n of Soil1andi,Water Canservahon ,Compliance inspection , C rxf
E i'L;',�:'r .`,i t„E,i ",L` `.d..E•.a€„€ sB ;` " rEE.'::f:a, Y:,:=-E . .rfri ab ?'i; r ,ia 3;rssi §( @ w I E R ; art
'v� n'of�Wate Q tyi ompliance L�specti n , `� _ _; ,a s It i I�1G J at,1 ' f �i
I sio r uMi C O � gp 1 j `� � r € h� f
• Other Agency - �perahon Review
ft2utint 0 Complaint 0 Follow-uE of DWQ inspection 0 Follow-up of DSWC review Other
Facility Number Date of Inspection n--co
Time of Inspection 'IcJ0 24 hr. (hh:mm)
[] Per [3C rti fed [3 Conditionally Certified [3Registered JE3 Not Operational I Date Last Operated:
FarmName: . ...................................... .... ...... ..... County:...........".......................... Owner Name:........................................................................................................................... Phone No:.......................................................................................
6. 4.- K)
Facility Contact: ............ .. Title: Phone No:
MailingAddress:..................................................................................................................................................................................................... ......... I................
Onsite Representative: .ram �"t.... ..6d hW.hQ✓ InteJ,rator:........................................................... �t ..... ....................................... ......
Certified Operator: .....y..........a..... ,r^......Vl Operator Certification Number:....., 1,03
,..............
Location of Farm: I
..................... ....................... ..... .... ......... ... r
Latitude 0 & " Longitude ' 6 46
„Cae acgit Po' ulatt Cattle estgn Current
rDesign
ne , �, ' ,� Cu , Poultry Capacity -Population �:..:.� �; F , �r
S apacity 4!6pulation'
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number'of Lagoons❑Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area E,
Holding :Ponds/ SoLd ❑ Tcaps No Liquid Waste Management System
r; r
Discharge s & Stream Impacts
I. 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? (Il' 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 ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
Identifier: 2
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 Number: — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
❑ 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 Aeplication
10. Are there any buffers that need main ten ancelimprove men t?
❑ Yes
❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ 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
h) 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?
9Yes
❑ 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
❑ 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.)
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?
o yiol'aiigns'or d ficie'nc;ii • 66= noted- Oirrixig this;visit: Y;oii will •tooiye 06 rurtlxt e ;
�cores�ondeixt:e: abaix>k. this visit ;
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
,Use Arawings of facility to.better explain situations (use additional pages as necessary)s
6� G Q
Pr
ReviewerlInspector Name
Reviewer/Inspector Signature: p_ Q Date: — to
3/23/99

Facility Number: — Date o1' Inspection (JQ
• a
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? Cl Yes ❑ No
f
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 bells, 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 permanenthemporary cover? ❑ Yes ❑ No
ihona omme n 'an or, rawin s �. �, �',n� ` i �_� i +;�
pl , i_. �
11,E �Cw�t�-
Az
CVk\GL
3/23/99

Lagoon Dike Inspection Report
Name of Farm/Facility-�--
Location ofFarm/Facility
Owner's Name, Address .! 1✓ram n --- J41ac - and Telephone Number
�16J A
Date of Inspection
Names of InspectorsYA
r3DS
ei t, feet
Structural Hgh F e
Freeboard Feei
1 �`
Lagoon Surface Area, Acres
- 4 _Top _
Top Width, Feet
Upstream Slope,xH: I V
Downstream Slope, xH. IV L/
r INo
Embankment Sliding?
Yes
(Check One, Describe if Yes)
Seepage?
Yes No
(Check One, Describe if Yes)
Erosion?
Yes No
(Check One, Describe if Yes)
Condition of
ve Cover ' s.
{Grass Tees) ,
Did Dike Overtop? Yes No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? Yes No �
Engineering Study Needed? Yes No '
Is Dam Jurisdictional to the Dam Safety Law of 1967? Yes No
Other Comments -0-,i C-1, Q=gnL.,G joi C,, c;

Y 3),3
Division' of Sgal and rWater .Consetwation ''Operation Review fiO3
5 �� . � �
r , �`ti� Division Of SOiland>WateCCOILSerVatlOn gCOmpllanee Inspeet10n1114"
t. D1V15lOnl0IV
( Wate QliRhtj'' r COlilphAnCe iIIISpeCtlOii 'I t , i(;f'i 7� J i j i P 5t r {obi t �r'e t �w'i 3�f it";a
y, j bi! tF G t F ��t }
r ' ° Other Ageno O erAtion�{RevieVV ti} , t `i p � �a 1 ir' Jj
p
{ i� 7
LE Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-ug of DSWC review 0 Other
Facility Number Date of lnspection S
Time of Inspection $: S 24 hr. (hh:mm)
© Permitted P Certified [j Conditionally Certified © Registered 113 Not OperationalOpera= Date List Operated:
FarmName: ........:............?,.t) .......,...,...,...,............I............................................. County:....TP44!1jcy..............................................................
Owner Name: t-Ztl,j.... ..................LA J.Y.. Phone No- .0!! z8341........,..........................I............
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
MailingAddress:...........Q......Zz 47............................................................. 1 rI ,N l ...........................I.... ..�4�
Onsite Representative:......... L .......T1n,JI'd............................................................ Integrator:..... U;VLSD.............................................................
Certified Operator:..................................................I............................................................I Operator Certification Number: .........................................I
Location of Farm:
A
................................................................. ... ... ..................... ....... .. ................. IV
Latitude Longitude
r Design
Current D
'n.,!Capacity
Population
Poultry Ca
,rF
❑ Wean to Feeder
Feeder to Finish 3 � ,� �
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
A.,
❑ Other
gn° ' Current Design, i' Design, . Cn'rrent, ; i,
c tE Population Cattle Capacity Popelation�'
�f L❑ Non -Dairy
Total Design Capacity F331 Z
Total SSLW'
rI Number of:Lagoons ❑ Subsurface Drains Present
�Holdhi Ponds / Solid Traps ❑ No Liquid Waste Manager
o :,..,
Lagoon Area g ❑Spray Field Area
System
,r'�
Dischames & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ,t 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 ycs, notify DWQ) ❑ Yes ® No
c. If discharge is observed, what is the estimated flow in gal/min'? t.1
d. Discs discharge bypass a lagoon system? (If ycs, notify DWQ) ❑ Yes [nNo
2. Is there evidence of past discharge from any part of the operation? - 91 Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ONO
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway CRYes ❑ No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): ............ ..................................................................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes IffNo
seepage, etc.)
3/23/99 Continued on back
f
A.,
❑ Other
gn° ' Current Design, i' Design, . Cn'rrent, ; i,
c tE Population Cattle Capacity Popelation�'
�f L❑ Non -Dairy
Total Design Capacity F331 Z
Total SSLW'
rI Number of:Lagoons ❑ Subsurface Drains Present
�Holdhi Ponds / Solid Traps ❑ No Liquid Waste Manager
o :,..,
Lagoon Area g ❑Spray Field Area
System
,r'�
Dischames & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ,t 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 ycs, notify DWQ) ❑ Yes ® No
c. If discharge is observed, what is the estimated flow in gal/min'? t.1
d. Discs discharge bypass a lagoon system? (If ycs, notify DWQ) ❑ Yes [nNo
2. Is there evidence of past discharge from any part of the operation? - 91 Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ONO
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway CRYes ❑ No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): ............ ..................................................................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes IffNo
seepage, etc.)
3/23/99 Continued on back
f

Facililty Number: 1 — 19 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 maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimpro vement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type �0
13. Do the receiving crops differ with those ksignated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
t5. 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 reviewlinspection 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?
Vo yi. . ti6iis:or• ftf1:ciencies iv�re pQte d�rrin th js'v�sit; Yotr wTeceiye Rio fn>Tth tr
corres�oridence'.ahaut. this .visit ' . ' . ' .. ' . ' . ' . •
❑ Yes P No
R Yes ❑ No
®„Yes F] No
[]Yes IN No
❑ Yes [R No
❑ Yes M No
❑ Yes UNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
R; Yes ❑ No
❑ Yes I a No
❑ Yes (S No
Yes ❑ No
Yes ❑ No
❑ Yes No
❑ Yes [0 No
❑ Yes �3 No
❑ Yes 9 No
Yes ❑ No
❑ Yes No
Comments,(refer to:question� #):,"Explain any' YES answers and/or any; recomiitendat ons `orl any, other comments.;
Use:dmw7ing1s (u'se'a'adihonal as
offaciility.to°,betteraexplarn;situations pages necessary)
1
v
2_ 4Y , Ca rlq t~ �'KCC �i ,i,�J��k L- kSt-
ti AVM 0 (;xll s
Or, $ f Z7 due it yCCPSS; v, Yzj
�,�
4. I_o�m, 60 -,WO he l o xvC3 1, o-
res��Si�O(� c�c� �-+t,,� w Y wv r.
Wc,(k -'kO 1 I0,- "Wed.
r, �4 d(, I %kx l�� 1
G��ir E� t t�C3 iJI�
�� V�a+ YLi r '1 •
I S. ht?XY►xUQC� 7 r. �';e ��� ( �"
tl-Z 5 6uj1 (,?e-
t rA py-aA 7 ,\. -Spf ?r of ?_Wo,
18. A r\,a 5ywW i N,. 5p+r&,,l Zohc S �� A%tj� 5
f ( d * Z 51ovjfl Le r+__
—
,
Reviewer/Inspector Name , r " { ' ; E t' .� w,�t
�P.¢
Reviewer/Inspector Signature: r Date:
3/23/99

'Facility Number: — iq Date of Inspection E
Odor Issuer
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes Wo
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 properly)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes EVNo
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 PNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes IRNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes R No
Additional omments an ors rawrngs• r ! ° ' �. ...' < . � 3 ,�:a �€, K�, G� „' �� J l:. , ..i: €E�l 11 I" r,'Fj r7� '.€t -k,
k om4t �+ul Ses. <.kovO 6e.. i af�U a� + T r etvr� re cads.
50`1 4,S� oxf- >r v Owm'l+,, 154J ek(4)rZ% 51s !�VIWO 4a,
-WA-. V'C O-- eU" 3 yv\o As
3/23/99

Lagoon Dike Inspection Report
Name of Farm/Facility
. ` 1 frcJ t) PA_
D 4e-IL
Location of Fann/Facility
P_ 60U
Owner's Name, Address
---li Lv/rl�c_4sZ'T:_._____-_-'--
and Telephone Number
Date of Inspection
Names of Inspectors
A - �aG• Suva
Structural Height, Feet
5' Freeboard, Feet
1 `
Lagoon Surface Area, Acres
4spL l
O —Top _ _ Top Width, Feet
Upstream Slope,xH:lV
Downstream Slope,
xH:1V _ ! . 1 L/
�'-No
Embankment Sliding?
Yes
(Check One, Describe if Yes)
Seepage?
Yes No
(Check One, Describe if Yes)
Erosion?
Yes No
(Check One, Describe if Yes)
Condition of
yleg"Ve Cover
I
(Grass reel)
Did Dike Overtop?
Yes No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection. Needed? Yes No
r
Engineering Study Needed?
Yes No
Is Darn Jurisdictional to the Dam Safety Law of 1967? Yes
No
Other Comments
: r L e' Z ' e e•.
cj�

Revised January 22, 1999
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number Operation is flagged for a wettable
Farm Name: acre determination due to failure of
On -Site Representative: ei6 k 6-my Part 11 eligibility item(s) F1 F2 F3 F4
Inspector/Reviewer's Name: — 4 Operation not required to secure WA
determination at this time based on
Date of site visit: 1�.�' - exemption E1 E2 E3 E4
Date of most recent WUP: �'" �� Annual farm PAN deficit: pounds
Irri ation S stem s -circle #: 1. hard hose traveler; 2. center -pivot system; 3. linear -move system;
stations s ri er a ipe . stationary sprinkler system wlportable pipe;
fi. stationary gun system wlpermanent pipe; stationary gun system wlportable pipe
PART I. WA Determination Exemptions (Eligibility failure, Part II, 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 Ill. (NOTE: 75 % exemption cannot be
applied to farms that fail the eligibility checklist in Part II. Complete eligibility
checklist, Part II - F1 F2 F3, before completing computational table in Part III).
PART II. 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 III.
Facility Number �� -�

Revised January 22, 1999
Part Ill. 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
C,
is 4
0- q
FIELD NUMBER' - hydrant, pull, zone, or point numbers may be used in place of field numbers depending on CAWMP
and type of irrigation system. If pulls, etc. cross more than one field, inspector/reviewer will have to combine fields to
calculate 75% field by field determination for exemption if possible; otherwise operation will be subject to WA
determination.
FIELD NUMBER2 - must be clearly delineated on map.
COMMENTS' - back-up fields with CAWMP acreage exceeding 75% of its total acres and having received less than 50%
of its annual PAN as documented in the farm's previous two years' (1997. & 1998) of irrigation records, cannot serve as the
sole basis for requiring a WA Determination. Back-up fields must be noted in the comment section and must be accessible
by irrigation system.

F:►cility Number 1).ae of Inspection
Time of Inspection L-I-C--�� 24 hr. (hh:mm)
13 Permitted (o Certified [] Conditionally Certified © Registered JE3 Not O erationai Date Last Operated:
Farm Name: . - y' .... .' ` ............................. � ....1.Ql�t. .... [kx.ri�.... Z............................................... Count ..............T�+F�.4r.....
l 1
Owner Name: "W.4IJ.......�r..4.'tiY...................... W .trJ?................................................. ['hone No:...��ltZ�...��'..�`�f.�...........,...............................
FacilityContact'.................................................................Title:................................................................ Phone No:...................................................
Mailing address: i' P kx....q2- .. ............................I.......... .....,... �i�QL�,.....ls%................................... ...... .,ZB' .k4........
Onsite Representative:.......... ....................................................................... Integrator:....... -�-+K.................................................................
CertifiedOperator:..................... .......... .................... ............................................................. Operator Certification Number:..........................................
Location of Farm:
r�.........rue!l-i. _.....s;..k .... Qk....... S,R....... 1. oo..r,A-..3... x A5........wfs.t...of......... R,..t..iR....................................................
...................................................................................................................... ............................................... ........................................ .............................................................
_'
Latitude Longitude
swine
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer T= 1[:] Dairy
❑ Non -Layer I I JE] Non -Dairy
❑ Other I I I
Total Design Capacity
Total SSL W
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation (If ycs, notify DWQ)?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. It discharge is observed, was the conveyance man-made`'
I). If discha►gc is observed, did it reach: ❑ Surface Waters ❑ Waters of the State
c. if discharge is observed. what is the estimated flow in gal/min?
d. Docs discharge hyp'ass 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?
Spray Field Area
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
j� Yes ❑ No
Structure l Structure 2 Structur- 3 Structure 4 Structure 5. Structure G
Identifier:
Freeboard(inches)..............................................................................................................................................
1 /6/99 Continued on back

i .
�acilitjr.t umber: -"j — I� Date of Inspection 13 Rq
5. Arc here any immediate threats to the integrity of any of' the structures observed'? (ie/ trees, severe erosion, ❑ Yes ❑ No
seepage, etc.)
6. Arc there structures on -site which are not properly addressed and/or managed through a waste management or
clasure plan? ❑ Yes ❑ No
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any pact of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required. top of dike, maximum and minimum
liquid level elevation markings? 10 Yes ❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence ol'over application'? ❑ Ponding ❑ Nitrogen ❑ Yes ❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. Does the facility lack wettable acreage for land application'? (footprint)
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, frceboard, 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 certified operator in responsible charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
[:]Yes ❑ No
❑ Yes ❑ No
❑ 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
:: h'o:vio atiions.or. deficiencies :were ntaYed: during :this -visit:: You vvi7l:re�ceive tta further : :
eorres'bbiidei ee: about: this visit... ........................::::..... • . • .
Comments (refer to question #):. Explain any YES answers and/or any.recomrrrendatiork or any other comments ;.,, � .:
7
Use drawings of facility to' better explain situations. (use additional pages as necessary):' t # '
.1 aJ,.:.<
`I� `�- I a�oo�. hac i'rtc.a ���- ��owr� • `[j.,_ � �ao�. itw�[ '�.vsf lx- � aw� i �. c. ��.s�1�(x
t d 1,J1 tna,>~vu
IL L-0yo, M r4v- % �O \of— vQvi W 4 — a.CLLnW_y. . ]k
S I1J: C) ct cal 4A3 blmc s 6n of W04iU qvo,[ '�'IJ a�Ok,� to a
�1 Ct � �Y Cc►r�`;ar.c,� W t k , t-�a�u�o �cl.1rt:.rwt,►�'�S . [
z
Reviewerl]nspector Name Qr iA� L• 4"
Reviewer/Inspector Signature: Date:
1 /6/99

M
._,w,�::..i3ie3nw.,..,.....:u.Ew:'..::.k:u',�r.P
Division of Soil and Water Conservation ❑ Other Agency
Civision of Water Quality
MRoutine O Complaint O .Follow-up of DWQ inspection O Follow-up of DSWC review O Other
T. .,
Facility Number Date of Inspection
Time of Inspection jC9 ` V 24 hr. (hh:mm)
0 Registered Certified Applied for Permit 0 Permitted 10 Not Operational Date Last Operated:
... .....................
Farm Name:......---- fit . �2 Count ����.. te/i.F..�``..........
Owner Name:............E- ! . col.. `t�.......!!,................................................. Phone No:..� .." ...9.5....�...5 . �. ......
Facility Contact . ..................................... , Title:................ .... Phone No:
Mailing Address: ............
....... ,.......... ... .�...Q............................................................ .14..!.r4 4'� .. f: lK...L... Z.. .... .........................
f _c
Onsite Represcntative:.......L.�`'Gr-1......i�. `............................. grator:............`..1....... v
,I a
Certified Operator: ..... ..........�"...�..........'!..........`� ... ............................. Operator Certification Number :.........................................
Location of Farm:
a
"o
Latitude ' 4 "
❑ Wean to Feeder
Feeder to Finish
Z
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
[] Gilts
❑ Boars
Longitude
Design Curtertt y Design C
Poultry; 3 < Capacity Populatign Cattle, Capacity i'o
❑ Layer I JE1 Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
T,.<
Total Design Capacity
Total SSLw ° C
General
1. Are there any buffers that need maintenance/improvement'? ❑ Yes KNO
2. Is any discharge observed from any part of the operation? ❑ Yes Aslo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes No
h, If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes No
c. If discharge is observed, what is the estimated flow in gaVinin?
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
!�1` o
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
o.
. maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
ko
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
eVNo
7/25/97

;Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Laioons.Holdine Ponds, Flush Pits. etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes XNo
❑ Yes ❑ No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
...................................................................................................................................................................................................................
Freeboard(ft):...............0............................................................................................................................................................................................
10. Is seepage observed from any of the structures? ❑ Yes o
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? XYes ❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waiters of the State, notify DWQ)
15. Crop type 'k" QI f.. 5e41...C'`!-4.1. ........................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0 • No.vialationsor' ddiciencies' were. noted'during this:visit.- You All ir&dVe' ,iwfurih'er
correspundeke about this: visa: :
1 Q . V v i F-- O Yy b,r AG,V.+ 5 rr"'.1) ,
zZ- keep tveeltiy cK 54�4
❑ Yes JQ No
❑ Yes P(NO
❑ Yes XNo
❑ Yes P<No
YYes ❑ No
❑ Yes No
❑ Yes X
No
❑ Yes o
Yes ❑ No
❑ Yes 32�o
❑ Yes XNo
❑ Yet X' 0
7125/97

,Q Routine OLCom faint Q Follow-up of DWQ ins ection O Foliow-up of DSWC review Q Other
. Date of Inspection Z� F
Facility Number
Time of Inspection Use 24 hr. time
Farm Status:"'" """'""" "" G l '� 1'�_.. """ Total Time (in hours) Spent ouReview
""" "' "'" or Inspection (includes travel and processing)
FarmName:.. .. s ...:...<..'f................ .... _"................... ...... _..... County:...2 ................................................
Owner Name:...'�1 .if ?...._ "....."...._ .... L- .1g 1.sL —: ".. __...._... PhoneNo: �5.. "...... ...g......5..
NlailingAddress:..14_z.'.. "( ,,J` ._-I .t .........."..... ........... _..... _"..._ ...Zi 7."...,
Onsite Representative ly,,d .) ti.4 .�!"`' +°� �.,�.__....__......_..... ........ ...... - Integrator:
CertifiedOperator:_.w._"............... ....... ""..... "....... .... "_ .._ ."._ ..... .......................... Operator Certification Number:.".......................................
Location of Farm:
Latitude • �f0 ° ©« Longitude 0` �«
113 Not U erational Date Last Operated:.. __.....
=` Type of Operation and Design Capacity
'' ag, ',^a,3'''i}�`
Noamtiero �s,:.
❑ Wean to Feeder ❑ Laver ❑ Da'
Feeder to Finish i Z� � t ❑ Non -Layer Al 10Beef
Farrow to Wean «�
Farrow to Feeder mMm
°M xnr€,wr,x .s {gym@
Farrow to Finish ❑ Other Type of Livestock
ti YP
s ...V ` � . '° ,vim ,,., ^ .$ram �"' ,, - �, :. $ ns w &ci;�; . , � k 'e, ` r .,k. ; ;1, .�2Zs .....
�k��I.agaans /Holding Ponds # ❑ Subsurface Drains Present #
Number of
-.{ '
❑ Lagoon Area ❑ Spray Field Areaft
General !
1. Are there any buffers that need maintenance/improvement? Yes ❑ No
2. Is any discharge observed from any part of the operation? Yes ❑ No
a. If discharge is observed, was the conveyance -man-made? ❑ Yes No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min? r
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) Yes ❑ No
Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
4. Was there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes ZI No
5, Does any part of the waste management system (other than lagoons/holding ponds) require 5d Yes' ❑ No
maintenance/improvement'?
Continued on back

6.~Is facility not in co—mpliance•with any applicable setback criteria?
7. Did the facility fail to have a certified operator in responsible charge (if inspection after 1/1/97)?
❑ Yes ® No
❑ Yes ❑ No ' '
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Laeoons and/or I{oldim! Ponds
14 Yes ❑ No
9. Is structural freeboard less than adequate? Yes Z No
Freeboard (ft): Lagoon 1 Lagoon 2 La_oon 3 Lagoon 4
10. Is seepage observed from any of the structures? ❑ Yes E2 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 VrNo
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do arty of the structures lack adquate markers to identify'+ start and stop pumping levels? ❑ Yes 10 No
Waste Application -
14. Is there physical evidence of over application? - ❑ Yes 91 No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type _ _. _ ..:.. _ ».:...-W,...W » ..... .......
_ _ ......... ...
16. Do the active crops differ with those designated in the Animal Waste Management PIan? ❑ Yes ® No
17. Does the facility have a lack of adequate acrcage for land'application?_ _ ❑ Yes EO No
18. Does the cover crop need improvement? ❑ Yes 12 No
19. Is there a lack of available irrigation equipment? ❑ Yes 14 No
For Certified Facilities Oul
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? 4 Yes ❑ No
24. Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge? ❑ Yes ❑ No
�vlr��i✓G� ^4� �r5eiPL--q.r9 ,C.. ]�lsY� iU 1p:F- (.ocibEx
/lt'G /j �G f�✓l7 !-�GvoN , G�' �s f v�lrl> 71-V9
�� � � l� ��r G w/ /?z �'/ZPf� �Ae�is � � �� c� -ro � � f.�h-, i'h v� jTv,•r.�
!lam
Reviewer/Inspector Name -AN." 4 '
Reviwer/Inspector Signature: f �-- Date: 2-7— Y ?
cc. Division of Water Quality, Water Quality Section, Facility Assessment Unit 11/14/96

Site Requires Immediate Attention:
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
. ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
•
Time: Dg30
Farm Name/Owner: 545E-er WZl 15 FV,,A / :Y, r -t-vlort_
utn-e.4. )hdrJ �65(1e_
Mailing Address: �ID- ! If_1 _f ,.-1-0eNe_ ?
County: Fe_e)�eR
Integrator: A k p _� Phone: 17 )fig
rn; 01 o)
On Site Representative: r-AicK zwklor- Phone: _2e-5- Fn?
Physical Address/Location: A,,e, ('3ov Ro 7, e,
bN 1,e �
Type of Operation: Swine. ✓ Poultry Cattle
Design Capacity: 3100 ��5� �-� Number of Animals on Site: 31 o 0 . r
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 3�' go ' 3_"
Longitude: 7 �- ° 014 ' __LY_
Circle Yes or No
Elevation:- Feet
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot f 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) es r No Actual Freeboard: .3 Ft. 0 Inches
Was any seepage observed from the lagoon(s)? Yes or No Was any erosion observed? Yes or
Is adequate land available for spray? (13Dor No Is the cover crop adequate?fe r No
Crop(s) being utilized: C'sN�Tr 1xrry,„�c.
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellingsz�9or No
100 Feet from Wells? GNo
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or(9 If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or
Additional Comments: j,&ick
/NU .x��`,� fn c e 4 r rr� /r n,`( uffe Egzt2� A44eP i 7b .5C 4-el(
Inspector Name Signature
cc: Facility Assessment Unit
Use Attachments if Needed.

OPERATIONS BRANCH - WQ F'ax:919-715-6048 Jul 18 °95 12112 P.19/23
Site Requires Txt=diate Attention -
Facility lumber: D�-- .___w
. SITS VISITATION RECORD]
DATE:.. July 17,
Owner: _ Jamie T` LXior _ •• Farm Name: Papa's Pride #1
County; Ppndgg
Agent Vi.sidcl Site: K=eth Q22k Pender SWCD phone: _(910) 2i59
Operator: Jamie& Lisa Ta for _�. Phone: [phone]
On Site Represeatative: Jamie Taylor Phone:
Physical Address: .3 miles SW of the intersection of vs 421 and SR 1212. Farm Road
As on the right:. `
Mailing Address: 744 Newkirk Road
W2 tha r NC 28471
Type of Operation: Swine X Poultry Cattle
Design Capacity' 2500 Wean—feederNumbe'r of Animals on Sloe; 2500 man to feeder
Latitude: � ' �" Longitude:
Type of Inspection: Ground ? -- AcrW
0 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) les or No Actual Freeboard: 1 Feet 7 Inches
For facilities with more than one lagoon, please address the other lagoons' freeboard tinder the
comments secdon.
Was arty seepage observed from the lagoon(s)? Yes ora Was there erosion of the dam?: Yes or&o
Is adequate land available for land application? es r No Is the cover =p adequate? Yes o6�1
Additional Co=ents:
Fax to [phone] Signature of Agent