710028_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

Type of Visit: U Compliance Inspection U Operation Review U Structure valuation U Technical Assistance V I
Reason for Visit: 0 Routine 0. Complaint 0 Follow-up 0 Referral Emergency 0 Other 0 Denied Access
Date of Visit: /4 ! Arrival Time: Departure Time: County: r�)1262- Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative., 9 7-u C tj 4j(, GV. js
Certified Operator:
Back-up Operator.,
Location of Farm:
Owner Email:
Phone:
Title:
Phone:
Integrator: f
Certification Number: _9�p'"1 A
Certification Number:
Latitude: Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Design Current
Wet Poultry Capacity Pop. Cattle
Layer Dairy Cow
Design
Capacity
Current
Pop.
Wean to Feeder "
INon-La er I
Dairy Calf
Feeder to Finish
Design Current
Dry $oultr C•.a acit P.o
Layers
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Other
Other
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWR)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
❑ Yes Ea <oo NA ❑ NE
[:]Yes [—]No
[:]Yes [:]No
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes WVNN
o ❑ NA ❑ NE
❑ Yes ❑ NA ❑ NE
Yes❑ NA ❑ NE
Page I of 3 21412014 Continued

Facili Number: - Date of inspection:
Waste Collection & Treatment
46Is 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? V Yes ❑ No ❑ NA ❑ NE
Structure 1 f Structure ,]2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier; LA �1J 1 LA GrZ}
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑'es No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes /XO ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmen 1 threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ 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 2 No ❑ NA ❑ NE
maintenance or improvement?
1 I. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Renuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes Q N
❑ Yes [
❑ Yes Zo
❑ NA ❑ NE
❑ NA ❑ NE
DNA ❑NE
❑ Yes
10
❑ NA ❑ NE
❑ Yes
6114
❑ NA ❑ NE
❑ Yes
❑ No
❑ NA N
❑ Yes
❑ No
❑ NA NE
❑Other:
❑ Yes ❑ No ❑ NA DINE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? [:]Yes [:]No ❑ NA
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes ❑ No ❑ NA NE
Page 2 of 3 21412014 Continued

Facili Number: 113ate of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑Yes
❑ No ❑ NAVNE
25� Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
❑ No ❑ NA
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge
levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
❑ Yes
❑ No ❑ NA
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[:]Yes
❑ No ❑ NA PE/
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
El No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
/No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
2 No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
ZNo ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑Yes ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments (refer to question #): Explain any=,YES answers and/or any.additional,recommendations or any Pother 'commedts. .
Use drawings of,facility to better:explain situations (use.additional page s as necessary)..:.
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3
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: ' b
Date:
2 4/2 W1S

O
Type of Visit U' Com liance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: a Arrival Time: I ,'� d 7 Departure Time: County: P6�jo�&� Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: fJ Title:
Onsite Representative: K�� r J
Certified Operator:
Sack -up Operator:
Location of Farm:
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = 0 = I = Longitude: = ° = 1
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish
12 Wean to Feeder . 2bb U6
❑ Feeder to Finish
❑ Farrow to Wean,
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other - - - - E
❑ Layer
❑ Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turke Poults
❑ Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at; ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dai Calf
❑
Dairy Heitet
❑
Da -cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures: =
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes L' [ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
[ N
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Facility Number: 7 — Z Date of Inspection $ D S
Waste Collection & Treatment
/
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
El Yes D o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structu�rie l Structur-e12 Structure 3 Structure 4
(.A 61 � LAGOON Z
Structure 5 Structure 6
Identifier: 00
Spillway?:
Designed Freeboard (in): 26 1 s
Observed Freeboard (in): qU 3 L
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes E/No ❑ NA ❑ NE
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes 14o ❑ 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 environmenta7No
eat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes Lz7 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 Lid No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes dNo ❑ NA ❑ NE
maintenance/improvement?
II. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes 6 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 ElEvidence of Wind Drift ElApplication Outside of Area
12. Crop type(s) r✓ Q S
13. Soil type(s) IJ6 L�
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ❑ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes C3 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination: ❑ Yes Ca o ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
L/Zo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
El Yes
❑ NA
❑ NE
YAAt-in I.oa 1L C0 °1ID
Phone:
Reviewer/Inspector Name ::v1f a U' : A f �' '�IU / 1 vt b5
Reviewer/Inspector Signature: Date: O SA
12128104 Continued

Facility Number., — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑ Other
❑ Yes dNo ❑ NA ❑ NE
❑ Yes C No ❑ NA ❑ NE
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1"
Rain Inspections ❑
Weather
Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
V. No
ElNA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
ElYes
I No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
Q�
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑
[NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
ElYes
L No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
[2 NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
LJ
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
;/N o
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
YJ 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
N
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
7Njo
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ NA
El NE
33.
Does facility require a follow-up visit by same agency'?
❑ Yes
❑ NA
❑ NE
'Qp•. �`'
Additional°Cain"meets and/orjDrawin�* n`' �OM
12128104
12128104

L
Visit rCompliance Inspection O Operation Review O lagoon Evaluation
for Visit %Routine O Complaint O 1=ollow up Q Emergency Notification O Other ❑ Denied Access
Facility Number Date of visit: /Z Time: L
0 Not Operational 0 Below Threshold
Permitted 13 Certified Conde ionaHy Certified Regist red Date -Last Opera or Above Threshold: ». .»».....
id
FarmNam. :lk .!�_ c ....�'e.... WF�1 � _ �`�i' itnty: ..»...........» ».»» .._._ .._...,
OwnerName -,—�2_4ry %V .... j. LO.q ..... ........... _....................... .... ........ ......... 'Phone No: ... ..................... »... »...... ............. »..»»»».... ......... ............
Mailing Address:.._
Facility Contact: ... »_.._» _...._..... _.» .».............-----.--Title:
Phone No: »-__.. .......» ..» ....
Onsite Representative:..
»....
»..... Integrator:.,,�,�,� ;,. �� � .... .............
Certified Operator:
Location of Farm:
Operator Certification Number:
[a'Swine ❑ Poultry ❑ Cattle ❑ Morse Latitude Longitude
Design • ��.Cariretit , �;.� ��"°�,� _. '�;
, .. Capacity,'
Population:
Wean to Feeder
Qv
OZ7
Feeder to Finish
is ❑ Farrow to Wean
Farrow to Feeder
Farrow to Finish
❑ Gilts
Boars
Discharges & Stream Impacts
o Ctirreat Y Design Ctrxt
tv Poaalatxon74
Cattle x.. ,. ` `..,Cat►aaty.-'Pauulation .
Other14
"
Y KTota►1 Design Capacity �a
a
` :Total SSLW ' T 1 �
1. Is any discharge observed from any part of the operation? ❑ Yes j( No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gaUmin?
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 0 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 ❑ Yes A No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): a5
12112103 Continued

I•acilily Number:
Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require 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? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAli ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops 'differ with those designated in the Certified Animal Waste Management Plan (CAWNT)?
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?
Odor Lssues
17. 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?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
23� ISO Awo Azime.,_ AV A/ka"dEo
2 Coo�
ReviewerAnspector Name
Reviewerllnspector Signature:
❑ Yes No
❑ Yes Po
❑ Yes ,ONO
❑ Yes No
❑ Yes No
❑ Yes A No
❑ Yes �No
❑ Yes 10 No
❑ Yes /No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes A No
❑ Yes FNo
❑ Yes ONO
❑ Yes P No
❑ Yes ONO
❑ Yes )SNo
Field Covv ❑ Final Notes
Date:
(Z/ll/UJ [:ontatued

Faci;ity Number: Date of Inspection 2 p
f
Required Records_& Documents T
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes PrNo
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 0 No
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes ;ZNo
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes No
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes m No
28. Does facility require a follow-up visit by same agency? ❑ Yes /Ef No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ZNo
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes ONo
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 V Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12/12/03

4� a `7 a g #� � 11 �.tf i F f - r -3 ,a� - - • l ..f
Water
a i a u E 1 vi 4 ,a
Diylsion OPSofI'and Water t~onservation Ei t s E icE ,'a # skat3 gs 9t•"
�� 1 h' 3 €ae foa Nei. if a ir,menc:.i ?
3 Jx „s
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit Routine 0 Complaint 0 Fallow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number I Z
bate of visit: OZ Time: 3 DfJ
IQ Not Operational Q Below Threshold
[j Permitted ❑ Certified Q Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: V i-�^OKh pe^�4 IV✓rSCr'- 14 K"17��, 7E AYPCounty: fe-7d"_
Owner Name: V fAVIN ° S a+ Phone No:
Mailing Address:
Facility Contact, Title: Phone No:
7 ; ,►� }� %! CA'0-
pti aria w h
OnsiteRepresentative: _ � Eh`t ��Avi � __ Integrator: —
Certified Operator: Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 0' K Longitude 0a I
:Design,,,_. Current Design Current' Design' Ce�rceiit
Swine Ca acity..:Po elation: , Poultry,. ''Ca achy "Po'ulation` Cattle Ca' ac�tv',Po`ulation'
❑ Wean to Feeder ❑ Layer
❑ Dairy
❑ Feeder to Finish ❑Non -La er ❑Non -Dairy `
❑ Farrow to Wean
El Farrow Other ,
Farrow to Feeder
❑ Farrow to Finish 'Toial Design "apacttf ':
Gilts, f '
❑ Boars T6111 ,SSliW` '''
�'
Di Subsurface Drains Present ❑ La oon Area
p umber of Lsgoolns ,F ❑ S ray Feld Area
f N
i��Holdtng?Foods'1'Sohd�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 ❑ 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 5
Identifier: K -J-) . J_z.
Freeboard (inches): 2-0 _Z y 36
05103101
❑ Yes 'PINo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ yes
❑ Yes ONo
❑ Yes No
Structure 6
Continued

Facility Number: '7 j — Z
Date of Inspection I 0 ?r
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 Anolieation
❑ Yes [21No
❑ Yes JZNo
❑ Yes 0 No
❑ Yes ZNo
❑ Yes XT No
10. Are there any buffers that need maintenance/improvement? ❑ Yes ,ETNo
11, Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes 'JZ No
I ] ,
12. Crop type 6,0,- , LJ 1�42 'ML 1 T7/ _ °-CA-Ij i s►"iLal l C2IC
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 ZNo
b) Does the facility need a wettable acre determination? ❑ Yes,M'Ro
c) This facility is pended for a wettable acre determination? ❑ Yes--
15. Does the receiving crop need improvement? ❑ Yes ONo
16, Is there a lack of adequate waste application equipment? ❑ Yes ;`No
R, e�uired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes JO'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 ONo
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ Yes ZlNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ONo
21. Did the facility fail to have a actively certified operator in charge? ❑ Yes Z No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes J'No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ff No
24. Does facility require a follow-up visit by same agency? ❑ Yes "�_elNo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ;Z'No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit. .
Cotiiiments (refer to'question #) Ezplain'any YES answers and/or:any recommendstlons piir aoy;oth'er,'comme€its
:...a.ads.,;i,:Y.Y,...ww-.4....J..•,�... x.r.i.1......w_....�r..w.�...
Use drawttigs offfaeiltty io better explatt>ttuations.'(usc adtlitionifl pages §❑ as necessary) !l Field CoPv ❑ Final Notes
rt /'L-t , `* q i P 71 e
T; f J V e r y well 1^' -t n'7 r rat � Kl-r�7
� ! e( C'
�l
r'6' CO r!Oe f [' i rt 100d O Hai e ►� . l 10 1 .f "'t -coy e,rt Pt� .
h'04A_:!f'&
11reg_r 411le Wet,
`�Gx e ear-�s -{o r�c��',�-� �; � -�l� e �a ►� �^-t in oo d1 oYol�;- q r�
U) Ofeh,,d o v+ cL-6 0.44
Reviewer/Inspector Name fp 4t t" ti Q' jr N
Reviewer/Inspector Signature: Date: 'L
05103101 Continued

Facility Dumber: r'f tt -2A Date of Inspectinn OZ
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes El No
liquid level of lagoon or storage pond with no agitation? ,max
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes [ , I No
28. Is there any evidence of wind drift during land application? (i,e. residue on neighboring vegetation, asphalt, ❑ Yes JZ 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 O 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 J'No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes .Z No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional .Comments and/or Drawings:.. - R
O5103101

O'Diirisionofof Water.Qualtty.
O Dtvlston of Soil and Water Conservation
IrO,Other,Agency.i: ! ✓ -� r,= r E y�.'r �.� 9
�.�.i _ .�hLc..:
Type of Visit compliance inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up Emergency Notification O Other ❑ Denied Access
Facility Number 29
Date of Visit: Ui Time: �Printed on: 7/21/2000
Q Not Operational Q Below Threshold
❑ Permitted Q Certified 0 Conditionally Certified © Registered Date Last Operated or Above Threshold: ..............
County: c.'��`
Farm Name: .............................................................................................................................. CY� .................................. ......................
F�
OwnerName: �{...!..`�...�... ...... .. ... ��............................................................. Phone No:.......................................................................................
FacilityContact: .............................................. ................................ Title:................................................................ Phone No:...................................................
MailingAddress: .......................................................................................................................................................................................................... ..........................
interator:... Mf �Onsite Representative:... ......I..... ..�.......................................................
Certified Operator:................................................................................................................ Operator Certification Number:..........................................
Location'of Farm:
❑ $wine ❑ Poultry ❑ Cattle ❑ Horse Latitude • A 46 Longitude • 4 «
Design' Current '
Design Current Design _ Current
„50>0e...:, . '.,." .... ...:. Ca' aci ty . Population .
Poultry Capacity Po elation Cattle Ca ci Po elation
Feeder
'rFd
Layer ❑Dairy
$? Finish
❑Non -Layer ❑Non -Dairy
i 3"o Wean
o Feeder
❑ Othero
Finish
Total Design Capacity
i rl!
Total SSLW
1�i'Na�IberoiLagoons kt
❑ Subsurface Drains Present
❑ Lag�x►n Area
❑Spray Field Area
r :ho F�ttig Ponds / Sottd Triips
❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Water of the State'? (if yes, notify DWQ)
c. II•discharge is observed, what is the estiFnatcd 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
Identifier: ........................................................................................................... ....................................
Freeboard (inches):
5/00
Structure 5
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Structure 6
Continued on back

Facility Number: 171 — 28 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
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?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
�VQ YiQlaiQns o� d0ciencies were 00f O. 00i . g t. s.visit, Yoi} wiii•i-epei. a qti fu t�tt'r • .
• correspondence. about this visit.
____-1.,,,:
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ YesXNo
❑ Yes ❑ No
❑ Yes ❑ No
r o
2) M, . )Amy rio 4, , ed 41,o� h ► s , c,1 � �Le,,'
A vi: t-%R I
Esc-kct d-�fo•�. hot.�se and ;non w�rCc-s of 4he -tom. olk+1
St�la .�>°ic t%ref t ry .Jq H �is�1'l°,'�� 46-bv�r5 SvsrreAce wc�%�f
7 y1 [ 40 be t"ore 41•«r, 15,000 � al�ont . N e�0� ka � s5ve press relerote
v,KAlot ke ec 4 a pub4ie ice- .
Reviewer/Inspector Name Reviewer/Inspector Signature: Date: Q I 5/00

{ s-Ail '-Dtvtston of Water Quality
i Q'Dtvtsioit of Soil and Water Conservation
r a x ji {j=0ther:Agency, -� s1 ,� ^� YI r
�.Y
r
Type of Visit )p Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit tP Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility� Number
[)ate of Visit: t0 1°1 b0 rime: •3d Printed on: 7/21/2000
'l
Q Not Operational Q Below Threshold
"IlPermitted 3 Certified © Conditionally Certified ❑ Registered Date East Operated or Above Threshold: .........................
Farm Name: sJi iha9fll `� Z 61f11hf�l.�.... Q County:.......prewtky ..............................................................
Owner Name: ......................... ....y......... It,
.............................
..........
Phone No:... :�.kQ�.zr '. s�C.............................................
Facility Contact: ..............................................................................'rit[e:....................................................... Phone No:
............................................................
MailingAddress: ....... �!...... Lr..+ti. .................................... ..........h,P!J! ....... A-,....................... .%�.............. ... .2-g 7
Onsite Representative: ..... .S+fI�Y^... .G6h� ...........................:.. Intcgrator:........,.!►�.................................
j I ..... �1�,umber:
...................}.... `,,
Certified Operator: ...............��,i1 s.................. ..........T....................................... Operator Certification . 1.4964 .......................
Location of Farm:
b yx Wwst sf c 'S�-140q l 0. rcX. o,.z VAt s nay o s� [cl3q
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ®• �< u« Longitude ©• S""7 i �«
Design Current
Swine Canacitv Population
Wean to Feeder
$rpd
-7 60
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Ca acity Po ulation Cattle Capacity Population
❑ Layer _d I❑ Dairy
❑ Non -Layer JE1 Non -Dairy
❑ Other
Total Design Capacity INC
Total SSLW 7-34 600
Number of Lagoons ❑ Subsurface Drains Present ❑ Lag"om Area JE1 Spray Field Area
Holding Ponds / Solid Traps 10 No Liquid Waste Management System .
Disu�harucs & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, %vas the conveyance man-made-? ❑ Yes 6P No
h. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) El Yes Cr No
c. If dischar«c is observed. what is the cstiin<ttcd liMw in gal/mitt? 1VJA
if. Does discharge hypass a lagoon system? (If yes, notify DWQ) ❑ Yes 1� No
2, Is there evidence of past discharge from any part of the operation? ❑ Yes {5� 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 §9 No
Structure I Structure 2 Structure ; Structurc 4 Structure 5 Structure 6
Identifier: ...........u.`................................... `,.�..Z..................��.........................................................................................................................
Freeboard (inches):
5100 Continued on back

Facility umber: 'j —2y I Date of luspection 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 CN 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 (A 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? )K Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ;9 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes (9 No
W,,Iste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN 0 Hydraulic Overload PYes ❑ No
12. Crop type `
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
. 15. Does the receiving crop need improvement?
❑ Yes RNo
❑ Yes ®No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes N No
16.
e ,-
Is there a lack of adequate waste application equipment?
❑ Yes 'R No
Required
Records & Document_5
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes [TNo
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 50No
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 �ZNo
21,
Did the facility fail to have a actively certified operator in charge?
❑ Yes W No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes 5 No
23.
Did Reviewed] nspector fail to discuss review/inspection with on -site representative'?
❑ Yes 59 No
24,
Does facility require a follow-up visit by same agency?
❑ Yes [PNo
25.
Were any additional problems noted which cause noncompliance of the -Certified AWMP?
❑ Yes ® No
?50.. h ioos:ar- deficiencies mere itbted d(Wiog t, s.visit: Y:ou wiil•reeeive;tio further.
•-�orres• oridence;abotit: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 necessary):
1hAJ*r J:VX wkkks o,, all +6trr [&tVnS sbtaulD be ► 904,
A,
.1
� A t- a- k a Q �,m; a" a � -h. I -11 4-
t • L wix s --I � ( as �. t mac,. r- Q.gy % * e
Iq_ St l y�s4 w�a�+ "4_a `rse& s au,O I&L C04blcw inui+e���t�Y. La�mr f bMr•ti f fLt., ds S6J
pf obm S rna,k ors sa a►s o, eh4,�►
Reviewer/inspector Name
Reviewer/Inspector Signature: %�//„_ram Imo— Date: 1011 q ado 5100

ability umber: _ -I(- Z$ Date of Inspection !0 9 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 Wor below Yes 0 No
liquid level of lagoon or storage pond with no agitation? f
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes rOgNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ISM
No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes P No
'Additiona-omments'an orDrawings:
J
5100

r ,C1 Division of Soil and Water Conservation OperationiReview
i •r' i° ; . 43?01tvher
ision.of.Soil and Water.'Conservahon t`'CompI ance Iiispectton;;1vision of WaterQuality-C pH"ce ectt Agency - Operathon,Review
p on
ARoutine Q Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number Sate of Inspection
Time of Inspection (] 24 hr. (hh:mm)
© Permitted Certified ❑ Conditionally Certified 0 Registered 0 Not O erational Date Last Operated:
Farm Name: `-'„� vy! /h.. �� I V rs �r a County' ..........L�l/1U, e..✓..................!�!�. �.......................
y............................................................................r ............
Owner Name: ................ ....m`v..... 21�4 ............................. Phone No:........,..,.
FacilityContact: .............................................................................. Title:......................... ..... Phone No:
,Mailing Address:..........................................................................................................................................
.......
.....................
*......................
....
...,.............
.....
Onsite Representative �� � } � Integrator: ••„
Certified Operator: ................................................... ............................................................. Operator Certification Number:....................
Location of Farm:
.......................................................................... ....................................................... ............... ............. ........................... ................
Latitude 6 Longitude ' �� �64
Design
Swine 1,r? �h... �,� . Capacity
Wean to Feeder _V-2_0C
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
4Number of Lagoons
Holding Ponds / Solid Traps
Current...Design Current Design Current
o ulation Poultry's ' t i Ca 'acit ,Po` ulatio.n Cattle Capacity Po tlation '°
❑ Layer JEI Dairy
". ❑ Non -Layer ❑ Non -Dairy
❑ Other ;
s '' Total Design Capacity,
Total SSLW'
Subsurface Drains Present 110 Lagoon Area I
No Liuuid Waste
Discharees & Stream impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: El Lagoon ❑ Spray Field El Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (Ifyes, notify DWQ)
c. I€ discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notily DWQ)
Spray Field Area
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 a
Identifier: 1 2—
Freeboard(inches): ...........7�.�.........................5L......................................................................................................................
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 1XNo
❑ Yes .,!!Zr
❑ Yes [❑ No
❑ Yes
❑ No
❑ Yes
o
ElYes
o
❑ Yes
�No
Structure 6
...............................
❑ Yes <No
Continued I back

Facility Number: — Z$ Date of Inspection
6. Arc 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 swetures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste A lication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence -of over application? ❑ Excessive Pending ❑ PAN
12. Crop type Ca3 1�1L„ La�'� S - " L d'—,,,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
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?
(ic/ 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 XNO
❑ Yes 1�rNo
❑ Yes TNo
❑ Yes X No
❑ Yes 'FINo
❑ Yes 'KNo
❑ Yes N�No
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes X'NO
Yes No
❑ Yes �(No
❑ Yes OkNo
❑ Yes No
❑ Yes o
❑ Yes 1KNo
❑ Yes 7No
❑ Yes Flo
ElYes PO
o
❑ Yes YINo
3/23/99

Facility Number: l — Z g fate of Inspection
'F 'ndor 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 RNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 'KNo
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 Po
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 KN0
32. Do the Flush tanks lack a submerged fill pipe ona permanenUtemporary cover? PYes ❑ No
Additional Comments .�;,
SJ175'�Qv f 4
aL P5 -�
F y<,
3/23/99

S
vision of Soil and Water Conservation [3 Other Agency
vision of Water Quality
19 Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Date of Inspection
Facility Nu
mber I Time of Inspection �! Zr� 24 hr. (hh:mrn)
0 Registered © Applied for Permit © Permitted 10 Not Operational Date Last Operated:
n,LV
FarmName: ............J..I.:N.`...'..�1.... ..1.C.Lfr5.4�..`,7..�. .............. County:.......................................................... .......................
Owner Name: ..............J...i.. „." ..... t .,?................................................. . Phone No: ........�... " Z S? - 3 D 3 .................
FacilityContact:............................................................................... Title:................................`................................ Phone No:...................................................
Mailing Address: ............r.z�C...... lLlri..�....................Cl4.rZy:..a.r'../../...G....Z.ys...................
Onsite Representative:.......... `..^'.' Y........ L...f�`.y�.................................................. Integrator .......... �:.:`.'..r .........................................
Certified Operator; ............. `L'%... .+�yl....... f ............................................. Operator Certification Number ;.........................................
Location of Farm: /
............
C
C
Latitude Longitude �• �' �"
Des, C
Cunt
a
Design Currngts
kCapacity
Capacity.Population
Poultry'h
Capacity Population CatfEe«...'
Population
can to Feeder
Szop
❑ Layer
❑ Dairy
f101!Feeder to Finish
❑Non -Layer
❑Non-Dairy
Farrow to Wean
.
6
t€AY
❑ Farrow to Feeder,
❑Other::�'
❑ Farrow to Finish
Total DeMgn Capacity
❑ Gilts
Total SSLW.
❑Boars::
Nttinber`of Lagoons / Holding`Ponds' Z ❑ Subsurface Drains Present
❑ Lagoon Area
JE1 Spray Field Area
}
No Liquid Waste Management System
�s :
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
PT —No
2. Is any discharge observed from any part of the operation?
❑ Yes
ro
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)
ElYes
19,
c. If discharge is observed, what is the estimated flow in gal/min?
J'
d. Does discharge bypass a lagoon system`? (If yes, notify DWQ)
❑ Yes
No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
#NNo
5. Does any part of the waste management system (other than Iagoonslholding ponds) require
ElYesl�YNo
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
L�Io
7125197

Fa:ility Number: —4 1
.J 8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (La;goons 11olding Ponds. -Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: I... z..................................
Freeboard(tt):..................................:5... v......... ................... ............. ............................
..
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?
Structure 5
Waste_ Application
14. Is there physical evidence of over application?
(If in excess of WMP, r runoff entering waters of the State, notify DWQ)
15. Crop type ................... .....y.er..............,................................................................. .............................................................
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?
❑ Yes "-�No
❑ Yes I o
Structure 6
❑ Yes '"No
❑ Yes F
"No
❑ Yes �No
❑ Yes �Ko
❑ Yes KNo
.................................t,................
❑ Yes
7
❑ Yes
4(No
Yes
❑ No
❑ Yes
WN-o
❑ Yes
�(No
❑ Yes
No
❑ Yes
PI(No
0 No.Violations'Ql" deficiencies.werenoted-during this:visit.-:You;will i&ei i'Ve•no-fur#h:er:
corresOWWence AhoW this:visit:: : ' ...... .
❑ Yes �fNo
❑ Yes No
El Ye
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: F64_4� Date:

Routine 0 Complaint 0 Follow-up of DW2 inspection 0 Follow-ue of DSWC review 0 Other
Facility Number Date of Inspection [�
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
2 Certified ❑ Permitted or Inspection includes travel andprocessing)
❑ii Not Operational Date Last Operated:.......................................................................................................................I................I...........
FarmName: ....l.. ....... ?�..,........................................................................ County: ...... pwtr............. .................... ...... ........... ............
LandOwner Name:....r;l .................�...................................................
Facility Conctact:..... +'.,1i!'li.Ili!n!u...... N.01.......I..........,.....-................... Title:....0lrs?uY
Mailing Address:...�1.L.1.x.....T !. ..!.+!3�....9J....................................................
Onsite Representative:..... . o1ml... I .............. ..... .......................................
CertifiedOperator ...................JI f!bf.....?iky.......... ................. .................. ..............
Location of Farm: I I
PhoneNo:... �g10�.1.-.........................................
........................... Phone No: ,.L!!01 :.4 ................
.......................45 2......................
Integrator:......✓. #.-f....................,:......................................
Operator Certification Number:....... 1��................ _...
.....i a.... ..1. .....�� rrr......r..t . ... r .... .n.^.... s....AA-............W.F."T.... i e............. 4
..........0.. ...................................................................................................................................................................... ly
Latitude • " Longitude ©0 K
Type of Operation and Design Capacity
General
I. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
2. Is any discharge observed from any part of the operation? ❑ Yes f &No
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes R1 No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes V No
c. If discharge is observed, what is the estimated flow in gaUmin?
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 RNo
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 �No
4/30/97 maintenance/improvement? Continued an back

Facility Number: .... 11 ....... —..., ....
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes [ 1 No
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?
Structures (i,agonnL-and/or holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure I Structure 2 Structure 3
....... 3%5.......... ............................ ............................
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?
❑ Yes ® No
❑ Yes K No
❑ Yes H No
Structure 5 Structure 6
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 type ............24 f*A.......... ............ _....... ........................ .................. idLgLf ............ ........... ..........................
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 Certified Eaciliij se 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?
U. erVim
oyy,#A &VT -Al M
,s6id . motued.
�24. Lai, l s,4 ktO
iwers'andlor any recommendatioris'or any'other comments '
❑ Yes [9 No
❑ Yes No
Yes ❑ No
❑ Yes ® No
❑ Yes 1A No
❑ Yes 0 No
❑ Yes JaNo
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes CRNo
❑ Yes 1A No
❑ Yes No
I$ Yes ❑ No
Ix R16d UtJ roeded. &re 'S A Sc6ld 6e rleseaV "acA "Os
nuory►ber owv} tjd Vium6e- ' r si ryi ''e[o�nk.
cc: umiston of water guaitry, water Livattry section, ractttty Assessment Unit 4130/97

Site Requires Immediate Attention:
Facility No. -7/- -�
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE. , 1995
Time:
Farm Name/Owner: 1_ LA- f QW.a`\ &LA.
Mailing A ess: ka31, �l
County:
Integrator:jnn J.0 aL
On Site Representative:
Physical Address/Location:
Phone:
Phone(,'/JJ 2.0 —1' 3 a
�2 r 0
Type of Operation: Swine _� Poultry Cattle �� �,
Design Capacity: , �o d Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: -b ttLongitude: �°-,�?_' 7_" -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 ` e or No Actual Freeboard: _'�>_Ft. Inches
Was any seepage observed from the lagoon(s)? Yes of Was any erosion observed? es or No
Is adequate land available for spray? Ge 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? 6e or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Lire Stream? Yes oQ9 .
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or o
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or Igo If Yes, Please Explain.
Does the.facility maintain adequate waste management rZe�orgo.
s (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)?Additional Comments: 0'A-0s r amL U1
Inspector Name
Signature
cc: Facility Assessment Unit
Use Attachments if Needed.

Site Requires Immediate Attention:
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
Time: aL)
Farm Name/Owner: 'YOA c QA0--\ T�J/Lr A
Mailing A ess:
County:
Integrator:--�-�-1
On Site Representative:
71
Phone:
Phone (f/Jd a0 :: Ye 3 cl
Physical Address/Location: :I, `Y� _Q4 'Z hn--t , �. �
2 LO s
Type of Operation: Swine Poultry Cattle \�` e"
Design Capacity: A & off_ Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Q _" Longitude: :2� ' 37 . 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 inchesxDor No Actual Freeboard: -.Ft. Inches
• Was any seepage observed from the lagoon(s)?- Yes olo Was any erosion observed? V r No
Is adequate land available for spray? eGor 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? Ce or No
Is the animal waste stockpiled within 100 Feet of USGS B1ue.Line Stream? Yes o l'
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes oro
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or@ If Yes, Please Explain.
Does the facility maintain adequate waste management rZ�or
s (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop,)? l o
Additional Comments:
Inspector Name
Signature
/L
cc: Facility Assessment Unit Use Attachments if Needed.

OPERATIONS BRANCH - WQ >=ax:919-715-6048
Ju1. 20 '95 8:59 P.ii9/18 .
•
Site Require$ lr=ediatc Attention.----=
Facili Number: -2� �_..
ry
SM VISITATION RMCORD
DATE. 1995
Owner: Jjam Eeaz Farm name: -
County: Pendex
Agent Visiting Site: Bryant M. SIAM _ _ _ Phone: �9i0) -- 259-1235 --
Operator, —jimmy Peay �_. _ _ Phone: [phone]
On Site Representative: Jig= p Phone:
Physical Address: Littie Kelly Road
SR '1411 wid SR 1409. Farm road is on the right,
Mailing Address: 423+4 Little Kell Road
Rocky Point, NC 28457
Type of Operation: 'Swine -M-- Poultry — Cattle
Design Capacity: 2600 wean: f eVumber of Animals on Site:
Latitude: ____„?Loogitude:
Type of Inspection: Ground ?�Aorial .
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard -of I Foot + 23 year 24 hour storm.event
(approximately I Foot + 7 inches) G or No Actual Freeboard: 2 Fcet � Incbes
For facilities with more than one lagoon, please address the other lagoons' freeboard under the
comments section.
Was any scepage observed from the lagoon(s)? Yes or e Was there erosion of the dam?: Ye or No
Is adequate land available for land application? l�e or No Is the cover crop adequate? (9 or No
Additional Comments: Erosion an interior and exterior of dam. ]ems not; appear
to be trams ate dancrer. This is a ngv_1W2n and ye
Mtation is stills rse.
Far to [phone] Signature of Agent