710024_INSPECTIONS_20171231

NORTH CAHOLINA
Department of Environmental Qual

i/
Type of Visit 0 Qprr�pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine O Complaint O Follow up 0 Referral O Emergency O Other ❑ Denied Access
Date of Visit: I 71 2b os Arrival Time: / Q3iU Departure Time: County:.9CAJ6E4Z Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Owner Email:
Phone:
Title: Phone No:
Onsite Representative: CAM Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Gilts
Other
❑ Other
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = 6 Longitude: = ° =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
_I ❑ Layer
aZoo I <? S 11 JEI Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dai ry Cow
❑ Dai Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
, other than from a discharge?
❑ Yes C3 No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
[:]Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
0, No
El9 Yes
o
❑ NA
❑ NE
❑ Yes lJ No ❑ NA ❑ NE
12128104 Continued

I
' Facility Number: Date of Inspection
':Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ['No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:�t AGHC—`
Spillway?:
Designed Freeboard (in): Iq
Observed Freeboard (in): as
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
ENo
❑ 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?
ElYes
E] No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
21No
❑ 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 AUglication
10. Are there any required buffers, setbacks, or compliance alternatives that need
El Yes
^^//
[9' o
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
,�,
l�'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 Drifl ❑ Application Outside of Area
12. Crop type(s) 7P rL+MuDA C G) FE$GyE L G) S G U
13. Soil type(s) F
„
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ETl o
ElNA ElNE
15. Does the receiving crop and/or land application site need improvement?
ElYes
D No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination'
❑ Yes
ErNo
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
NN/o
Z,,
El NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
El Yes
,
El o
❑ NA ❑ NE
UPDATE. L J OP WMI-A JrZCLD +AGM<,UAL. AtJD Soc.zD SET ACkAACsE GV 7.00E.
aW pEa_ ?L�gtas To ComjRat* -7(—:) ' ANt> 11--)l 1..1UPr PEtZrr✓� ITS
alb jPmATE crzoP L?M&L.DS Arjr> f3EGMtj Usr*.I&_ t?2od'LDCC> 5T►aTE �'6fLrns
4- TI" NO t 3000Z_ GRA7_14dG. GLaA0G.0 �'AfJ 2A'iEs of CaOPS S"j tj 10 Woe
Reviewer/Ins ector Name ' y a Phone:
4ty
Reviewer/inspector Signature: Date:
12128104 Continued

Facility Number: '7 t Date of Inspection 7 L
ikenuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ZNo ❑ NA ❑ NE
20. Does the facility fail to ha;�W
l components of the CAWMP readily available? If yes, check P Yes El No El NA ❑ NE
the appropirate box. UP ❑ Checklists ❑ Design ❑Maps ❑Other ,,��,,/�
21. Does record keeping need improvement'? If yes, check the appropriate box below. l� Yes ❑ No ❑.NA ❑ NE
❑ Waste Application ❑ Zeey Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
ElRainfall ElStockingop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
/ZNo
❑ 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
aNA
❑ 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
ElL
�❑
3 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
["NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�/
Ef No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ZNo
❑ 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
f!1 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
ETNo
❑ 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
E No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or: Drawings:...
12128104
12128104

Type of Visit i6 Compliance inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine p Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: Time: /
Not O erational O Below Threshold
Wernitted M Certified 0 Conditionally Certifii d 13 Registered Date Last Operated
Above Threshold: ....: »..».»....
Faroe Name:County: ....... L..f�..r�l�................ ... .......
OwnerName: _ » J...... �� rL�.. .... ..................... _........ _....... .... . Phone No: .... .................... .......................... ....._.......
.»_ .....
MailingAddress:.._...._._.._........_ ......... ......... »...................................................
FacilityContact: »....».».......».»........_.. __._......._._ Ti .._......... �, ...... ._..... Phone No:
Onsite Representatives Int. tor- � �� �, , wet)
Certified Operator: , .....».»...............»_.__._ .. _...._. »_» _.»._ » .._.._ ... Operator Certification Number:..
Location of Farm:
r�
Swine ❑ Poultry ❑ Cattle ❑ Norse Latitude • ` " Longitude �• �� C��j
1 -I11�. ,n .C1ilL G/t j"} 1 f4 Ei CfY ILYt. i 1�:e{n 4CMi t
Swne a.Ca Po thin �ftt'Y `°ci Popiilateon Cattle Capacdy,.^Population ..
LZWean to Feeder
Feeder to Finish
El Farrow to Wean
El Farrow to Feeder
Farrow to Finish
❑ Gilts
Boars
'RAU
Other
,a
..Total D .Ca �° acr
r
Total �SSLW ..
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 "a Structure 4 Structure 5
❑ Yes M No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
P'No
❑ Yes
ZNo
❑ Yes ONo
Structure 6
Identifier: ....._................
Frecboard (inches):
12112103
Continued

Facility Number: — Date of inspection p
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ yes Ja'No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ yes f ) No
closure plan?
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes PrNo
S. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes RrNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes A No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes 0No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes Z No
❑ Excessive Ponding ❑ PAN P Hydraulk Overload ❑ Frpzen Ground [Copper and/or Zinc
13. Do the receiving crops differ with�those designated in the Certified Animal Waste Management Plan (CAVVW).) JgYes ❑ 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 '0 No
16. Is there a lack of adequate waste application equipment? ❑ Yes ONo
Odor Lssues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ yes No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes JNo
Air Quality representative immediately.
A111e
L `" r
Reviewer/Inspector Name
Reviewer/Inspector Signature:
❑ Field Copy ❑ Final Notes
Date:
12112103 Condnued

Facility Number: A7 I - ZifjDate of Inspection
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ;a No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes A No
23. Does record keeping need improvement? If yes, check the appropriate box below. 3Yes ❑ No
❑ Waste Application reboard Waste Analysis ❑ Soil Sampling
ECG
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ONo
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes V1 No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ONo
27, Did Reviewer/Inspector fail to discuss review/mspection with on -site representative? ❑ Yes No
28. Does facility require a follow-up visit by same agency? ❑ Yes No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes VNo
NPDES Pe 'tted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes 9 No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes [:]No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

t-
c'-
g �Division ofWster Quality
EE.i
a;',;0.'DiYi�iQn90f�S0iI,SOdWstir Cq€ISerVatlOtt. tt rs a
���aan ¢ �' iiii. • {. 3 a e' .,.r<.E 31, , 7.g1,� 3 s¢ Fib I i v - }3. f3 a 3 pr .f '.e, @,
©�i Agetacia Ed Ed' pI lei i€d
Type of Visit j2rCompliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit Routine Q Complaint O Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number 2 Date of Visit: 1 / 2 Z 11me: 1�.J
10 Not O erational Q Below Threshold
0 Permitted ❑ Certified 0 Conditionally Certified © Registered Date Last Operated or Above Threshold:
Farm Name: Tea �Va `z �y rJc,-N, — - County: Pc--d,_
Owner Name: �°� m e J4 c 7 Phone No:
Mailing Address:
Facility Contact:
Onsite Representative
Certified Operator:
Location of Farm:
tJ rr� �G'Ct C• oil
Title:
Phone No:
Integrator: r "' u �a Z✓'�
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Worse Latitude 0 u Longitude o
Design -Current Design'` Current Destgir"'" Current.
Swine Ca achy. Population.' 'Poultr' Ca'act'Population Cattle r'Po`ulition:
❑ Wean to Feeder ; ❑ La er u ❑ Da'
❑ Feeder to Finish i ❑ Non La er [] Non Dai
❑ Farrow to Wean
i
❑ Farrow to Feeder ` ❑ Other
❑ Farrow to Finish Total Design Capartty,'
_ ❑ �ltIt5€E C�a t ��y�!y'j�y
. 4� i F - �E F .TOta��: sk,! i•'( Eax
Boars
Number of Lagoons 0 d • ❑ Subsurface Drains Present 110LngoonArea 10 S rav Field Area
Holding p"';Ponds ',Solid Traps
,,: ❑ No Liquid Waste Management System l,
.
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Water of the State? (If yes. notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: l
Freeboard (inches): Z
05103101
❑ Yes ErNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ErNo
❑ Yes _ZNo
❑ Yes ZNo
Structure b
Continued

Facility Number: 171 — 2. Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require 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? ❑MOP'
ve Ponding ❑ PAN ElHydraulic Overload
12, Crop type (� a fw... 4[a Ad-� .��C� � Ca ✓�a f ►�
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
I5. 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 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 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 JeNo
❑ Yes JZ(No
❑ Yes XNo
❑ Yes PNo
❑ Yes ,!fNo
❑ Yes 9-No
❑ Yes �No
❑ Yes J'No
❑ Yes ,E!I'No
❑ Yes ,� No
❑ Yes No
❑ Yes J�_erNo
❑ Yes �2rNo
❑ Yes SRINo
❑ Yes 2 No
❑ Yes JZNo
❑ Yes ZNo
❑ Yes �ZNo
❑ Yes EfNo
❑ Yes JzNo
❑ Yes ONO
❑ Yes )allo
C] No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
9E-1.4
ny6.tBmEl ut.
om.ments(refer;to Yany,er, coimentsl �I,e E f ;11i';1l i ' T ' 3`! E
.. r,exeur o�us » (use;
scaildhotac pages a- EaE ece�s:n ac,,✓r ry'betyp:..F3_e�wld.,..C.wo..�n�...v.:,...,«»..ui..cFolilLn.—a..l�:.Nwx:o�.o.t..e�cUe llawngs of faclitytoti......1.s...._ ,b
It ,
r,—�.�, iS Well e . The reco�dr are
-wt ��G' �r
6--01 P y- . I AC C r�,CfA S A G r4 J Li/e i'�La+'✓1-�ot, n t D!< _
I
7~l, � SI,eJ ,' �► e !-to � .l q � d jay co n ; s w e�I r-`a n ,' c v r��4� .
�
AIea\
Y�srt� e-f��r�J th✓� a�o�ofea�'G���
i . i''ilp^E 1
Reviewer/Inspector Name-�o +� i.✓ �, %i°l i SE iE
-, ,.
Reviewer/Inspector Signature: Date: 1 D
05103101 Continued

1
' Facility Dumber: 21 — z, 4 Date of Inspvctinn d Z
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below [] Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes XN0
29. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 1zNo
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 ONo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes �VNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
05103101

ty,
IS Division of Water Quali
0 -Division of Soffandj Water COlfSerVatiOn
Other Agency
Type of Visit ®Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit & Routine O Complaint O Foltow up O Emergency Notification O Other ❑ Denied Access
Facility Number %
2� Date of Visit: Time: E== Printed on: 7/21/2000
0 Not Operational 0 Below Threshold
19 Permitted 0 Certified ❑ Conditionally Certified l] Registered Date Last Operated or Above Threshold: ..................
NI�Y Pii ,J
FarmName: .......,�i .f I.G.....................5........-.........�. ........................................ County:....... t?(!F........................................................
OwnerName: .... T!no..................................(.eA L ey.............................................. Phone No:........�j.u.. j—...7�1.y.............................
if
FacilityContact: ............................... ............................................... Title:................................................................ Phone No:...................................................
Mailing Address: ..........................................
Onsite Representative: ;,� ........
Certified Operator:
Location'of Farm:
................ ........................
..}J........................................... ..........................
Integrator, ....... ,e',<.�.(d-r#-,y.............................................
Operator Certification Number:,,.,•,,,,•,,,.,_..,
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' S 66 Longitude �' �6 69
Deslgti Current
r` Canaelty . Population
Wean to Feeder
Feeder to Finish
t�
,r Farrow to Wean
Farrow to Feeder
<< Farrow to Finish
Gilts
uulBoars
Design Current Design C went
Poultry Capacity Population Cattle CajNjei Po elation
❑ Layer I I ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity.
Total SSL'W
❑ Subsurface Drains Present ❑ Lag�nn Area ❑ Spray Field Area
i f x -,• ONO Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in galhnin?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ..............
W.............
..........
..........................
...
................................ ........................................................
Freehoard (inches):
5/00
❑ Yes R No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 9 No
❑ Yes C&No
[]Yes JRNo
Structure 6
Continued on back

Nacility dumber: 71 — 7q, Date of Inspection Z Z 6 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 [9 No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes CANo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? ❑ Yes 5,No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes E&No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes XNo
Waste Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes i,No
11. Is there evidence of over application? ❑)Excessive Ponding ❑ PAN ❑ Hydraulic Overload ElD� Yes v0
J�/
12. Crop type %ihl.�iCt. C(rr4Z�Z/ &&Sed 56:
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes El No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes JZ1 No
c) This facility is pended for a wettable acre determination? ❑ Yes &No
15, Does the receiving crop need improvement? ❑ Yes k No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
9 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)
91 Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
0 No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
'® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
yIQlA1194S.0ir- dgfldencies -wgrifltgte#• d(rritig •thjs'vjsit; - Yoo 'Will-f&oh ie iio futtho
irorres orideRce: abo' UA this visit: .
Comments r�eferi,to' uestton # Ex lain an YES answers and/or any; recomnien ations'or any other eomments r x K,,
t �� ) � p� y -...: , ., . .. • ,. � .fit
/Pecdivert V10/01 = .$�•�
41,j1p f, kn rc ea 141 b Aht j lqw L,I n - fs were ,4111 of of
3/i5/al = 1, 9 rV
6f a km re core k)ere 1n gov/�
Reviewer/Inspector Name (e / r� a? i�i'
Reviewer/Inspector Signature: Date: 2 2 5100

Facility Number: 7 Date of Inspection Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes �'No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes O 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 CR 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
31 Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes P:No
5100

FFacility Number Date of Inspection IV
Time of Inspection 24 hr. (hh:mm)
0 Permitted © CCertifiedf © Conditionally Certified ❑ Registered rNot Operational �7Date Last Operated •
Farm Name: ..........L.G./r�.].Pix.............I...a.rn`1...................................................... County:..........pd-- ........................... ............
OwnerName :........ Tames ................................-7,eet(44,..................................... Phone Na:.......................................................................................
Facility Contact:...:'!c-5.................{.r.AG�t.... I itletneil�..-.............................. Phone No: ...................................................
.........
MailingAddress:........................................................................................................................................................................................................ ..........................
Onsite Representative:... !r`�.......�.i �.......... a!'?� ....li.. .sf.Integrator :................r,r,.F.....................................................
Certified Operator: / ...................... Operator Certification Number:
Location of Farm:
I&
.......... ......... ...............................................................
Latitude �� �� �`� Longitude
g JP., ....` I E. 'i� , Current
Dent n Current Desi Current. Des
�tSWWean to Feed Ca ��t Po ulation : Poultry Ca act Po' iilatioti Cattlet .t act ," Po 'ulation
Feeder ayer ❑ Dairy
❑ Feeder to Finish ❑Non -Layer I ; ❑ Non -Dairy
❑ Farrow t0 Wean
` ❑ Farrow to Feeder ❑Other a
❑ Farrow to Finish Total Design Capactty
❑ Gilts .a
❑Boars Total'.SSLW
i
' Nuinber,of'L'a'oans f Subsurface Drains Present ❑ Lagoon Area Spray Field Area ;
I� g „
Holding Pon"ds / Solid Traps ' ❑ No Liquid Waste Management System �' , j
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes (KNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance Evan -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) ❑ Ye O�No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes XNo
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? ❑ Spiliway ❑ Yes C(No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Identifier: 10
Freeboard(inches): .........................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, [j Yes IN No
seepage, etc.)
3/23/99 Continued on back

Facility Number: ! - Date of Inspection
)
6.
Arcrthere structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
❑ Yes
1ANo
(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
ANo
S.
Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
'W No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
.�gNo
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
N'No
11.
Is there evidence of overaapplicat<'on? ❑ Excessive Ponding ❑ PAN
❑ Yes
JRNo
12.
Crop type �� SG . AAl
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
la'No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15.
Does the receiving crop need improvement?
Cl Yes
D(No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
9No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
Q(No
19.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Yes
KNo
(ie/ WUP, checklists, design, maps, etc.)
❑
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
F--%
El No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design.?
❑ Yes
EkNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
RNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
[XNo
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
5Wo
24.
Does facility require a follow-up visit by same agency?
❑ Yes
I (No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
No
No viola icjris:or dgneieiicies vvgre nptea .(Wing •this'v1sit' • Y:ojl :w.ilk•r. eoeiye)o tiier ' '
coeresponc�eRce: a�(Jtit: this vesit_ ...... ... .. .
Comments uefer to=question #) 'Explain „s f 3 i 9: ; ii P '9 C 1 i !i3 1 4 F
any YES answers and/or any.,recommendattons nr any other comet_
_ • o better .. �
Use drawin s of facility to better explain situations use additional a es as necessa t ti
_ pp�/1
[ - - f1i 1 d..
13 r rave �'tSCK�. iit � sR or r6YiSG rJ1AA rrklee+ [arias,... 8,4r*,4.ds_ w6itik Gwvecv► i
Show. i.1 �'it�• 1
rJ
rq) U...w►r.t0>, WUP too re-wri 11k 4v ineorjaorat- 4*t rv►r.ci,,o�e d� aG�ci
Fj e lot 5'i
A , 41SO, �`°� w�& 4af-clk' � G i' 8Crm► A*,_ a p1- ca,i:n,% worms
Ft' b - nwa,%. +'+ N1 ^ - Sc P Cv+���l 011,+- Pi?d w Sa i I* W�►-{•ate
� �, y p�t,r W� �r+ryv► l
.r, [Sow 'rarrw-�. I��tP StPara�1-�_ r�2-2 �ntvr. tr.�G . crop tse'u"q "t .
Reviewer/Inspector Name t� �i, _�� i F ��1 t� E� } Y. �t 3 V. ' � 3�� "€ €,a
ReviewerlInspector Signature: Date: Z —A!9
3/23/99

Facility Number: Date of Inspection BIZ
Odor Asties
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? ❑ Yes [Vio
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
No
31,
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
'Additional omments an ar Rrawin
,� ��',�'�` ;
l*n�' C"y'-' A4-t- W41d!- 41D yiS pgnG� s Vwi `�1a.►+ 1. `
.�' -Air4,,rae
J
3/23/99

{
[3 Division of Soil and Water Conservation Operation Review
0 ivision of Soiland Wati onservation Compliance Inspection
i
Di'visiiin of Water k E, = Goixi' hence Ins ection' , l i
E
i
r
• 1 1
-Other Agency - Operation Review it
J
pp
1`
l
a
,
Routine Q Com taint O Follow-up of DW ins ection O Follow-u of DSWC review Q Other
Facility Number 1 Date of lnspection -t U `►'9
j� Time of Inspection ; a 24 hr. (hh:mm)
13 PermittedxCertified © Conditionally Certified [3 Registered 10 Not U erational Date Last Operated:
Farm Name: .. c4rr+- (Sr.
�` ( �� y• ....et...
...........j..0 . n��.......................�....L.........`. 44 County: Ql.................................. ...� ......
Owner Name: Gi ►~ [� Lj- tCc .��.y... Phone No: d Z Y f
.., e �..1.....................................i�...............................
.r
Facility Contact: ...... ° w` .......... e I l� : ..... `, ............. Title:.. ... ...................................... Phone.No:..............,....................................
Mailing Address: ? 0 L✓ci„ ice
b.................N`�.................................................................... ....i.................... .................... ......................
Onsite Representative: ....... >T'! mf ....... LS°r�C��^P`� ........................................... .. . Integrator: ...... ,4... � r..........................................................
..
Certified Operator: ..............J.4.,'"�g,.. 1 etc. .,.C``,•,,,. Operator Certification Number
Location of Farm: I
r
............................. ......................................................................... ........
Latitude 0 & 11 Longitude • 6 4&
Design Current Design Current Design Current
Capacity Fo elation "Poultry,Ca 'a'cif Poulatyon;� Cattle ,Ca acit Po'ulation� a
Wean to'Feeder Z CC96 f
Layer ❑ Dairy
.;i ❑ Feeder to Finish „ Non -Layer [[]Non -Dairy
❑Farrow to Wean
Ohl,
❑ Farrow to Feeder ❑ Other
Farrow to Flnlsh �� �l���� `� !¢��i t- ��ErE s, � E'� '� � �� � � E �" �
Total Design. Capacity !
❑ Gilts,
"
❑Boars 1SSLW
jl . ,;„ '1111iember of;X.agoons ,! ❑ Subsurface Drains Present 11CLagoonArea I0 Spray Field Area
,HoldirigiPonds /Solid Traps ❑ No Liquid Waste Management System .
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
h. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/ruin'?
d. Does discharge bypass a lagoon system? (If yes, noti Fy 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 Su ucturc 5
Identifier:
Freeboard(inches): .........3.©...................................................................................................................... ............................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
❑ Yes �10
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
[]Yes W10
❑ Yes )�rNo
❑ Yes e�No
Structure 6
...............................
❑ Yes ((((((>>>»>o
Continued on back

Facility Number: —Zq I Date of Inspectionj(_1,Q-9yJ
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan`?
El Yes �60
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Da any of the structures need maintenance/improvement? Ye
Yes
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes WNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes XNO
Waste APplication
10. Are there any buffers that need main tenancelimprove ment?
❑ Yes XNo
11. Is there evidence of over application'? ❑ Excessive Ponding❑ PAN
❑ Yes XN 0
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 "u-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 00
Reuuircd Records & Documents
17,
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
)no
IS.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
XNo
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
XYes
❑ 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
WNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes �eNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes j"No
24. Does facility require a follow-up visit by same agency? ❑ Yes �To
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes gNo
IO V01atQI.Or d��CeICi4S rETQt'(�[>Ctl . W g •tfils,vEslt! • ,Y,oli WIlI•te06*e 06 fu�'t�l�i'
corres' oric#eitce: about: th1S .V1 It.
E� • . , . E:: .. ., ions or arty other comments ';
Comments (refer.to�gaestion #) iExplam any YES answers and/a_r any�recommendat y
Use di 'Wings of facdit to'�tietter ex lain srtryattons t bs64dlditiotral' a es�as�neeessa .
V'
RCV1eWCC/InSpeCtOr Name
, ,
Reviewer/Inspector Signature: ,M Date:
3/23/99

facility Number: -4-(— Date of Inspection �J
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below �es
❑ 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 //lo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, El Yes KO
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 *�6o
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.) El Yes yR -o
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes �(No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? xyes ❑ No
Additional omments'an or rawing8: . I ; q E :
_i," ai 1:r
3 Z . PI U s h 4ce, -ti -' k C r e k G1
1 C
3/23/99

Lagoon Dike Inspection Report
Name of Farm/Facility
-'
I
Location of farm/Facility
_ - - 67FF- - _ - 1 I"7 - ---- - - -- - - -
Owner's Name, Address
and Telephone Number
Date of Inspection
Names of Inspectors.
,
Structural Height, Feet
r Freeboard, Feet c
Lagoon Surface Area, Acres
i
0-7-5-Ac— Top Width, Feet _ 1�
Upstream Slope,xH:1V
. f V — --_ Downstream Slope, xH:1V 3
Embankment Sliding?
Yes-')( No
(Check One, Describe if Yes)
Seepage?
Yes No
(Check One, Describe if Yes)
Erosion?
Yes_ No
(Check One, Describe if Yes)
Condition of
^� L7 -----------------
Cover
es)
Mt
Did Dike Overtop?
—Yes No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? Yes No
t
Engineering Study Needed?
Yes Y_ No
Is Darn Jurisdictional to the Dam Safety Law of 1967? Yes No
Other Comments

Lagoon Dike Inspection Report
Name of FarmfFacility
11J c.-�-_------
-- - ------ -- - _
^_
Location of Farm/Facility
e'er
I
Owner's Name, Address
_ll,tl;c:S�
r
and Telephone Number
4
Date of Inspection
`c� 4
Names of Inspectors _
�3� y1r�Seeu
Structural Height, Feci
[a
c�
Freeboard, Feet
Lagoon Surface Area, Acres
m� s
Top Width, Feet
Upstream S1ope,xH:1V
P ._1 ✓ ---- --
Downstream Slope, xH:IV
Embankment Sliding?
Yes No
^
(Check One, Describe if Yes)
Seepage? Yes No
(Check One, Describe if Yes)
Erosion? Yes Y!::_ No
(Check One, Describe if Yes)
Condition of
M
t
Cover
es)
i
Did Dike Overtop? Yes No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? Yes No
r
Engineering Study Needed?
Yes _�_ No
Is Dam Jurisdictional to the Dam Safety Law of 1967? Yes No
Other Comments

J
�.: s �,�ii. '�' •.0 � ,•, �•.v�x � - - _.max. - ;�•,�rcwv .. .,. ��, . .. ;c� v. - ,;:q -�'.`�''u,:a,a �y>s. �vs' ' y a < �
Division of Soil and Water Conservation ❑ Qther Agency �..<.a '
Division of Water Quality
RN
Routine O Complaint O Follow-up of DNVQ inspection O Follow-up of DSWC review O Other
Facility Number Date of Inspection
Time of Inspection $ D O 24 hr. (hh:mm)
13 Registered)9 Certified © Applied for Permit U Permitted JE3 Not Operational Date Last Operated:
Marna Narne:...........K�!o r' TG'�•�./c�{Ser?y/ i County:.........'f'....................................................
................ {``f ` �
Owner Name• . } or H GS -Fe c !+ L Phone No:....f.!. q......7r. $.5....'..-7.:5. �..I...........................
...... .........................
Facility Contact: ..................................................................... .. Title:................. ........................ Phone No:
MaitingAddress:.......... ..................................................... ..........................
Onsite Representative:.......3+ �* t 4 e tJ/
........4............................................................
Integrator:.......... ,.......... .
Certified Operator: ............. J.....;.'. ......
............
........
............ Operator Certification Number,....j.. .... .. L.7...
Location of Farm: /
Latitude Longitude �• o� �"
FIDesign Current Design Current Desi �Si�' Current
.1 , .a
S.wltte« Capacity Population ao :Poultry • Capacity �1?opulation Cattle Capactty,PopulaEiian
Wean to Feeder
Z 1, of-)
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
p
❑ Boars
❑ Layer
❑ Dairy
❑ Non -Layer
❑ Non -Dairy
❑ Other
0.
"Totl Des>ign'Capacaty
Total ssiw
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes �fNo
2. Is any discharge observed from any part of the operation?
❑ Yes PNO
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yeso
c. If discharge is observed, what is the estimated flow in gal/min?
/Y ��
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
Cl Yes �rNo
3. Is there evidence of past discharge from any part of the operation?
ElYes No
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 1XNo
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design'?
❑ Yes �No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes`6No
7/25/97

F�ty Number: — Z
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Laeoons jjoldina Ponds, Flush fits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Freeboard(ft): ............. .. ..........................................................................................................................
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop h'Pe,....��............................ ..................
❑ Yes YNo
❑ Yes �No
Structure 5 Structure 6
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 Qnlv
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?
[]• No.viO'Ntionssoir deficiencies:were"noted-during thkvisit., Yodwill ' kei ive•mistirther.
correspQddehO about -this. Visit'.,' : .
7 7 • /1", �- w&-& ly
❑ Yes �No
❑ Yes �3_No
❑ Yes 'KNo
❑ Yes dio
❑ Yes �Cp No
❑ Yes KNO
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes K
o
9-Yes To
E] Yes �No
❑ Yes ENo
❑Nro
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: _ Date: l) - 1 Z -• 7

iI
❑ Division of Soil and Water Conservation [3Other Agency
® Division of Water Quality
`® itoutine O Complaint O Ftillovv-up or 1)N%-'(2 ittsp_getion O Follow-up of US WC review, 0 Other r
Date of Inspection 2, L
Facility Number
Time of Inspection 24 hr. (hh-mm)
d Registered jj_CertiBed [3 Applied for Permit © Permitted 0 Not Operational I Date Last Operated:
./� G I 11`7 i� aQ L County: -. P—` ..........................
FarmName: �� �......�'1. %.1.......................F....: ..............................,.....................................
J J�f,—,,4 -f—
Owner Name:...... Y1rsr.4..'.r..........................................................y..................... Phone No:....................
Facility Contact: �t`�
Title: ..,�.. . Phone No: .......�.'`i.
Mailing Address: ........
ppQ. G...c�................................................. ..........................
Onsite Representative:...Integrator: ...... OL...................................
Certified Operator........................................................................................................ .. Operator Certification Number;............. I...............
Location of Farm:
c
Latitude • 6 46 Longitude ` 4 "
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
® No
2. Is any discharge observed from any part of the operation?
J4 Yes
❑ No
Discharge originated at: ❑ Lagoon Wpray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
,) No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
J4 Yes
❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
7" / &1104
cl. Does discharge b}lpass a lagoon system? (Ifyes, notify DWQ)
❑ Yes
IQ No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
Q No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
[WNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
J0 No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
M�No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
0 No
7/25/97
Continued on bank

Ail Facility Number: — 2'
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons,11olding Ponds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure's
Identifier:
............................................................................
Freeboard(ft): ...................................................................
10. Is seepage observed from any of the structures?
Structure 3 Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14.. Is there physical evidence of over application?
(If in excess of WNW, or runoff entering waters of the State, notify DWQ)
❑ Yes E5 No
❑ Yes O-No
Structure 5 Structure 6
...............................................................
15. Crop type C...'3....L...................................�..'L........................ .............................................
........... .A... .... ........... 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?
. ............ I .......................
❑ Yes pVNo
❑ Yes 4 No
❑ Yes W No
0 No.vi0itionsor de kiencies.werenotedduring this:visit; Yod'Ai11 recei've•no•hirtlie r,:
:. Ofn p6ndepce AlSouE this;visif.-"
❑ Yes ,ONo
,'Yes ❑ No
❑ Yes Q No
❑ Yes [9No
❑ Yes (H No
❑ Yes Q No
UYes ❑ No
❑ Yes KI No
❑ Yes 0 No
❑ Yes R] No
❑ Yes © No
❑ Yes 0 No
CfKeJr�tVo qu,e�stiion*), xpari.an.yS ansrers anfd,/n.�r a_ny,� rskc3n'�>r'eYnLdatyionas oArany o#' Y 'er comr rnen�t
`�
n�Z- t
is+r{amre�
i�7`ns/tgo dtty o n rtiaatiw
drnslr
� vA.4r- 2
bmmi
%y
-r
sOkj I%4 (J,� C_(2 f4
T,nP13,5 c��=o D;t��a ►s P�w���,,c�
-w-cL jr. -e ij , ti,itc3 '-rt, ; t:. P I ,g sJ
e &
VIC7 V&O, 71LAc-Hf 5" �,. �i-� �£iJc c J YY � Lt cJw. p✓x� c. .� S i�.n� �r.�
1erf(
••__t .��
tlW I 1 r /if'i%� QGL✓�'Q.w
7/25/97
Reviewer/Inspector Name ^i
Reviewer/Inspector Signature: Date: A4.��

ENVIRONMENTAL CHEMISTS, INC 6602 Windmill Way
� Wilmington, NC 28405
® Sample Collection and Chain of Custody Phone: [phone]
FAX: [phone]
Client. -7-->� Collected By AOi :•�' G JZ T Report No: T _
SamDle e• Infl -gin Eflluen Well eam Soil. Oth r:
SAMPLE
IDENTIFICATION
COLLECTION
BOTTLE
ID
LAB
ID
PRESERVATION
ANALYSIS REQUESTED
TIME
NONE
O
HNO,
NaOH
TWO
OTHER
7 1` Z'tf
,[-'DATE/
�z/st
I j OCR
YCI
Maximum Holding Time Between Collection and Analysis: BOD 48 Hours. Coliform in Wastewater 6 Hours,
Coliform in Drinking Water jkBou
iLs,
Transfer
Relinquished By:
Date/Time
Received By:
Date/Time
i
2
Received with Ice Rater C 'lied to 4° • r No Acce ted: � Rejected:
Delivered By:\ Received By: L,� C _ Date: a 1 t z-h e Time: q : 3 5- P
Comments: - - - - - -
L-A-J

Environmental Chemists, Inc.
® MAILING ADDRESS: TELEPHONE: SHIPPING ADDRESS:
P.O. Box 1037 [phone] (Office) 6602 Windmill Way
Wrightsville Beach, [phone] (Lab) Wilmington,
CONSULTING North Carolina 28480 [phone] (Fax) North Carolina 28405
CHEMISTS NCDEHNR: DWQ CERTIFICATE #94, DLS CERTIFICATE #37729
Customer:
NCDEHNR-DWQ
127 N. Cardinal Drive Ext.
Wilmington, NC 28405
Attn: Rick Shiver
David Holsinger
Date Sampled:
Sampled By:
STREAM:
02/12/98
David Holsinger
REPORT OF ANALYSIS
Date of Report February 20, 1998
Purchase Order #:
Report Number: 8-0477
Report To: Rick Shiver
Copy To: David Holsinger
PARAMETER
Sample ID
71-24
71-24
Lab ID
#1017A
F1
#1017B
N1
Fecal Coliform, colonies/100ml
280,000
-
Nitrate + Nitrite Nitrogen, NO3 + NO2 - N mg/L
-
0.19
Ammonia Nitrogen, NH3-N, mg/L
-
224
Total Kejeldahl Nitrogen, TKN mg/L
-
267
Total Phosphorus, P mg/L
-
23.6
Reviewed bAJ
CXn��-and approved for release to the client.

renvirochlem
ENVIRONMENTAL CHEMISTS, INC
m le Collection and Chain of Custody
6602 Windmill Way
Wilmington, NC 28405
Phone: [phone]
FAX: [phone]
Collected /,0 G R ortNo:
CamnlP 'Bursa- I<nflnant Ti'#ntitant Wd-11 r� n1r um� Cnil [lth&n -
SAMPLE
IDENTIFICATION
COLLECTION
BOTTLE
ID
LAB
ID
PRESERVATION
ANALYSIS REQUESTED
DATE
TIME
NONE
HSO,
O
NaOH
TRIO
OTHER
'? 1- Zq
Z11a/S'
/5 ao
"Cl
I
X"
Inc C'A
r
Maximum Holding Time Between Collection and Analysis: BOD 48 Uop Coli orm in Wastewater 6 Hours,
Coliform in Drinking Water 3 H urs,
Transfer
Relinquished By:
Date/Time
Received By:
Date/Time
i
2
Received with Ice Water C ifled to 4° - No Acce ted: Rejected:
Delivered $y:\ Received By:_-{1a Date: v I t -1g9' Time: q., 3si°
Comments:
e-A—)

r�
CONSULTING
CHEMISTS
Customer:
NCDEHNR-DWQ
127 N. Cardinal Drive Ext.
Wilmington, NC 28405
Attn: Rick Shiver
David Holsinger
Date Sampled:
Sampled By:
STREAM:
02/12/98
David Holsinger
Environmental Chemists, Inc.
MAILING ADDRESS:
TELEPHONE:
SHIPPING ADDRESS:
P.O. Box 1037
[phone] (Office)
6602 Windmill Way
Wrightsville Beach,
[phone] (Lab)
Wilmington,
North Carolina 28480
[phone] (Fax)
North Carolina 28405
NCDEHNR: DWQ
CERTIFICATE #94, DLS CERTIFICATE #37729
REPORT OF ANALYSIS
Date of Report February 20, 1998
Purchase Order #:
Report Number: 8-0477
Report To: Rick Shiver
Copy To: David Holsinger
PARAMETER
Sample ID
71-24' .z
71-24
Lab ID
#1017A
F1
#1017B
N1
Fecal Coliform, colonies/100ml
280,000
-
Nitrate + Nitrite Nitrogen, NO, + NOZ - N mg/L
-
0.19
Ammonia Nitrogen, NH3-N, mg/L
-
224
Total Kejeldahl Nitrogen, TKN mg/L
-
267
Total Phosphorus, P mg/L
-
23.6
Reviewed ;'. � + OvvtC -and approved for rek!&i., to the client.

ENVIRONMENTAL CHEMISTS, INC
® Sample „Collection and Chain of Custody
Client:
Ramnle Tvna• Influanf_ 1pfilnant_ Wall_ Qua m� Qnll_ llthal- _
6602 Windmill Way
Wilmington, NC 28405
Phone: (9 ? 0) 392-0223
FAX: [phone]
SAMPLE
IDENTIFICATION
COLLECTION
BOTTLE
ID
LAB
ID
PRESERVATION
ANALYSIS REQUESTED
DATE
TIME
NONE
O
HNO
NSOH
TWO
OTHER
-Z, y
,z �'
/s O/
J�
to(
Maximum Holding Time Between Collection and Analysis: BOD 48 ours, Coliform in Wastewater 6-Hours,
Coliform in Drinking Water 3J11Q1Lrs,
Transfer
Relinquished By:
DatefFime
Received By:
Date/Time
1
2
Received wi h Ice Water C illed to 4° • No Acce. ted: Rejected:
Delivered By:\, _ Received By: (L C - Date: z 1, L- g d Time: q : 3 P
Comments:
5

Routine O Complaint O Follow-up of DW2 inspection O Follow-uR of DSWC review O Other
Date of Inspection
Facility Number"�
Time of Inspection 24 hr. (hh:mm)
Total Time (in fraction of hours
Farm Status: ❑ Registered ❑ Applied for Permit (ex:1.25 for I hr 15 min)) Spent on Review Z.'1
$jCertified ❑ Permitted or Inspection includes travel andprocessing)
❑ Not {Operational Date Last Operated: ................. ................ . ...... . ................... ........ ........................................................... . ...............
FarmName: .............. ............ _....... ...... ........... _....... County: ......... &.J-a....... .................... ...... ......... ..............
LandOwner Name: ». x S..... ................................................. Phone No: »..JL.gI�.... d'S . . � i.....................................
Facility Conctact:.........da ,&.......lea &el .................... Title:...... DAJ,n.0t....................... Phone No:::3S14 ............
Mailing Address: ... �..h4......10................................................................................W,1la
.G..... ..hj.G................................... (ab.....................
Onsite Representative:.... '....... ............... _........................................... Integrator: ............ AkUj9......................................................
Certified Operator: ..�.n. kc5.......F.. ............... .................................. Operator Certification Number:».(�q-z.6.................... ...
Location of Farm:
....1i.�.� .. �[. . .&W..50.w...... 5&-c .....al......Qt�my......J..Mi. .......max. of ...... SEL..1 ..... 4
Qx......`��r4s.,.......tvt►a...... —gje...... LEA,.......................................................................................................................................................... 43,
Latitude ®• —97 Longitude 55 ` 3p66
Type of Operation and Design Capacity
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
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes EbNo
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes P 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
3. Is there evidence of past discharge from any part of the operation? ❑ Yes IXNo
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes 19 No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes Pa No
maintenance/improvement?
4/30/97 � Continued on back

Facility Number:..... j...... �.........
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
8. Are there lagoons or storage ponds on site which need to be properly closed?
Stt_ ci t�s (Lagoons and/or Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure I Structure 2 Structure 3
......... &.4........... ............................ ............................
10. Is seepage observed from any of the structures?
Structure 4
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes M No
❑ Yes 19 No
❑ Yes ja No
❑ Yes Jallo
Structure 5 Structure 6
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff
l_entering waters of the State, notify DWQ)
15. Crop type ..................................... .......... ..... 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?
For_Certif-ed_Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes ff NO
❑ Yes No
Yes ❑ No
❑ Yes 0 No
❑ Yes 19 No
❑ Yes 19 No
❑ Yes ® No
❑ Yes
ER -No
❑ Yes
19 No
❑ Yes
No
[:]Yes
No
❑ Yes PQ No
❑ Yes IN No
EA Yes. ❑ No
Comments {refer to quest�an #) Explain in YES' answers'and/ordny recommendations or any other comments.
Use drawings of facility to better explain sttuations. (use addrtional.pages as necessary)
.._ 's" �-... ..a .� _; . ,. .. �.�., :�,�.,.� •fie. Q __,� . e. .? .,<,:r_t„ .f- -"
�x. jr m r WA`l 4` (ayo,,\ _t6oj} 4e OVWej. CmS Om t Vt 131 CurT sko�d be. 4
t Intl W i � c_6,,� &,,,j a seel'ed, `�11� 1
�mwds skauid 6t 141 t by 4 r7scr Iiiu. • �+�la�-, of s�ro ? j at�, sExeol � be-
,�►�, CtA i P e j Teo N -56 J d t f\.CU+d e_ ( kr r.. OA e S 1 .
Reviewer/Inspector Name a•, ��� •a„�,� _ ..4 �� s�;., , "." � s;<,`r us
Reviewer/Inspector Signature: Date:
cc. Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97

' Site Requires Immediate Astenn'or :`
Facility No. 7
DIVISION OF ENVIRONMENTAL MANAGEMENT 4
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: i , 1995
Time:
Farm Na
Mailing
County:
Integrator: Mwt&4 Phone:
On Site Representative: :T�t „ _ _ Phone:
Physical Address/Location: o"
Type of Operation: Swine ✓ Poultry Cattle
Design Capacity: 2 00 lit, o c e&c Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: '3q ° -Lfv ' 01 Longitude: -Z° 2 " Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1" Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes r No Actual Freeboard: �Ft. _o— Inches
Was any seepage observed from the Ia oon(s)? Yes or (�as any erosion observed? Yes or No
Is adequate land available for spray? e or No Is the cover, crop adequate? Yes or No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings e or No
100 Feet from Wells? es r No
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(DIf Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? e' or No Additional Comments: 1 3 , kQAi2�_ Zelel
inspector Name
r
cc: Facility Assessment Unit
41
Use Attachments if Needed.

07l19l1995 16:25 9192591291 PENDER COOP EXT SEP PAGE 22
Site Requires Irnmediate Attention
• Facility Number. 1 �
&f
SITE VISITATION RECORD
DATE: July 17 . 1995
Owner: Jg=s F. TeaclMy Fans Name: _, Teachey Farms #1
County: _ Zender.
Agent Visiting Site: Kenneth k Pender SWCD Phone: [phone]
Operator: -Tames F = Tenehey , _ Phone:
On Site Representative: James Teachey Photo;
Physical Address:
Frm Road is on the ri ht.
MaiEng Address: 7848 US Hwy 117
Watha, N.C. 28471
Type of Operation: Swine x Poultry Cattle
Design Capacity: gnn wA;;n_fepie1Vumber of Animals on Site: r„?&ao wean to feeAr
Latitude: o .' Longitude: �e "
Type of Inspection: Ground x Aerial
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) � or No Actual Freeboard: 4 - _ Feet a_ Inches
For facilities with more than one lagoon, please address the other lagoons' freeboard under the
comments section.
Was any seepage observed from, the la;oon(s)? Yes orno Was there erosion of the dam?: Yes or(go)
Is adequate land available for Iand application? to or No is the cover crop adequate? nor No
Additional Comments:
Fax to (919) 715-35S9 Signature of Agent

07;' 1911'395 16: 25 91 e'2591291 PEHDER COOP,, E J DER PAIGE 23
Site Requires Trnmediate Attention
Facility Number. l /
SITE VISITATION RECORD
DATE: July 17, 1995 1995
Owner: James F. Teachey Farm Name: Teachey Farms #2
County:
Agent Visiting Site: Kenneth Cook Pender SWCD Phone: [phone]=4305
Qperator: James D. Teachey Phone: [phone]
On Site Representative: JAMES . F . TEAM Phone:
Physical Address: 2.0 miles north of the intersection of US 117 and SR 1502. Farm
road is on the right.
Mailine, Address: _7848 US Hwy 117 _. ..-
watha, N.C. 28471
Type of Operation: Swine x Poultry Catde
Design Capacity: ?rann wAan-FPPderNumber of Animals on Site: 2600 wean -Feeder
Latitude: 0 Longitude: e "
Type of Inspection: Ground X Aerial
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) es or No Actual Freeboard: rg_. , -Feet �_ Inches
For facilities with more than one Iagoon, please address the other lagoons' freeboard under the
comments section.
Was any seepage observed from the Iaaoon(s)? Yes or Was there erosion of the darn?: Yes or
in
Is adequate land available for land application? Cesor No Is the cover crop adequate? e�or No
Additional Corarnents:
Fax to [phone] Signatu� of Agent