240005_INSPECTIONS_20171231

NORTH CAROLINA ..�
Department of Environmental Quai

Type of Visit p Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint XFollow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: 2 G Q Arrival Time: DeDarture Time: %G i �County:
Farm Name: l i� Owner Email:
Owner Name: jl,�ia i. �Phone: _
Mailing Address:
Physical Address:
Region: G • e c
Facility Contact: I Title: Phone No:
Onsite Representative:�`� ���17J'� Integrator: �cl.Q�if�i�/�a 4✓�
Certified Operator:
Back-up Operator:
Operator Certification Number:
Back-up Certification Number:
Location of Farm: Latitude: = c [= 4 = Longitude: = ° [= i =
Design Current
D11113111111
Current
Design Curren#
Swine Capacity Population
Wet Poultry
Capacity
Population
C+attle C+apacity Population
❑ Wean to Finish
10 Layer I
1
❑ Dairy Cow
❑ Wean to Feeder
10 Non -Layer I
1
❑ Dairy Calf
Feeder to Finish 2.11
❑ Daia Heifer
El Farrow to Wean
Dry Poultry
❑ Dry Cow
❑ Farrow to Feeder
❑ Non-Dai
❑ Farrow to Finish
❑ Layers
❑ Beef Stocker
❑ Gilts
❑ Non-Layers
❑ Beef Feeder
El Boars
❑ Pullets
❑Beef Broad Cowl
❑ Turkeys
Other
❑ Other
❑ Turkey Pouets
❑ Other
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
10 No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yesy
No
El
El NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: — Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �N- ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2t
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes ❑ No ❑ NA �NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ❑ No ❑ NA VNE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ No ❑ NA P'NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ No ❑ NA NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes ❑ No ❑ NA PNE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ No ❑ NA [�NE
maintenance/improvement? l
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA XNE
❑ 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 Accep
table Crop Window El Evidence of Wind Drift ❑ Application Outside of Area
12. Crop types)
13. Soil type(s)
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
❑ No
❑ NA XNE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑ No
❑ NA �yNE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA XNE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA �NE
Comments (refer to question ft 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):
49
Reviewer/inspectorName I ` ' Phone: /D �—
Reviewer/Inspector Signature: Date:
Pane 2 of 3 12,18104 Continued

Facility Number: — Date of Inspection /�-
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA NE
the appropriate box. ElWUp El Checklists El Design El Maps El Other
,�f
21. Does record keeping need improvement? If yes, check the appropriate box below. El Yes El No El NA JCJ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
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?
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
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes ❑ No ❑ NA ONE
❑ Yes
❑ No
❑ NA F"NE
❑ Yes
❑ No
❑ NA Y NE ,
❑ Yes
❑ No
[INA
El Yes
No
[I NA
rjKE
❑ Yes
❑ No
❑ NA ��T'
❑ Yes
❑ No
❑ NA X NE
❑ Yes
❑ No
❑ NA �d NE
❑ Yes
❑ No
❑ NA PNE
❑ Yes
❑ No
❑ NA
❑ Yes
No
ZONE
ElNA ElNE
❑ Yes
�No
❑ NA ❑ NE
Additional Comments and/or Drawings:
W�
Ff}L�
� �' F- E � � p �OGC:IJ � � � •�2s cN,y�eG� Y
l/nJFOGL �'1
w
Page 3 of 3 12128104

f {Division of Water Quality
Facility Number 5 0 Division of Soil and Water Conservation
- - - 0 Other Agency
IType of Visit JO Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit 0 Routine 0 Complaint O Follow up O Referral O Emergency 00ther ❑ Denied Access
Date of Visit: ,&j1/ Arrival Time: ,i Departure Time: County:
Farm Name: ' AC% ZZ Owner Email:
Owner Name: F Phone: _
Mailing Address:
Physical Address:
Region:
Facility Contact: Title: Phone No:
Onsite Representative: OAR, ZOE 'igZn/ Integrator:
v
IJ I
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: 0 O = 4 = Longitude: = ° 0 ` = "
Design Current Design Current ' Design WCunt
Swine Capacity Population Wet..Poultry Capacity Population Cattle. Capacity- Populatib,
❑ Wean to Finish ❑ Layer ElDai co
❑ Wean to Feeder ❑ Non -Layer
ElDai Calf
Feeder to Finish Z l 1/0, El Dairy Heifer
El Farrow to Wean DryPoultry ❑ Dry Cow
❑ Farrow to Feeder ❑
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other i
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure XApplication Field ❑ Other
a. Was the conveyance man-made?
on- airy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
Oyes ❑ No ❑ NA ❑ NE
❑ Yes /No
❑ NA
❑ NE
0Yes ❑ No
❑ NA
❑ NE
000
❑ Yes A No
❑ NA
❑ NE
❑ Yes ONo
❑ NA
❑ NE
❑ Yes XNo
❑ NA
❑ NE
12128104 Continued

Vpcility.Number
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Stnicture 1 Structure 2 Structure 3 Structure 4
Identifier: )�/_Z
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes Vf No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes
to No
❑ NA
❑ NE
❑ Yes
[, No
❑ NA
❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �No ElNA ElNE
maintenance or improvement?
Waste ADDlication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes V No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. Oyes ❑ No ❑ NA ❑ NE
❑ Excessive Ponding 71 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 Area
12. Crop type(s)
13. Soil type(s) ,�(
14. Do the receiving crops differ from those designated in the CAWMP? ❑ ,ICJ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ;ff No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ YesXNo ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ZNo ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or. any other: comments. -
Use drawings of facility to better explain situations. (use additional pages as necessary):
y 2j r
�j
Reviewer/inspector Name Phone: /0
Reviewer/inspector Signature: ,tr, Date: 2-
Page 2 of 3
1212R/OQ Continued

Facility ]Number: _ Date of Inspection / d'
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA 0 NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA PNE
the appropriate box.
❑ WUP El Checklists El Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA )�,NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and F Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
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?
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
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Comments and/or Drawings:
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes VNo
❑ Yes ZO No
❑ Yes ❑ No
❑ NA ❑ NE
El NA El NE
❑NA ❑NE
El NA [3 NE
❑NA ❑NE
❑ NA XNE
❑ Yes IV)'
No ❑ NA ❑ NE
❑ Yes VNo ❑ NA ❑ NE
❑ Yes A No ❑ NA ❑ NE
)21 Yes
❑ No
❑ NA
❑ NE
❑ Yes
ZfNo
❑ NA
❑ NE
Yes ❑ No ❑ NA ❑ NE
D lv f f2�G�'�
e-4wSF,o �� i� it ��;FOLD
-iur1PF_,O �� 11i3 0-;L 4,36 i5evIn 61,00,,0,n 7 //,'300,;- -
y� A�Q Gv4-5 ��r D�F /�•'ooP,r., L�, GzG,9�zv,J
e4 F �A s ,� �
raA Y91r
� 3 �
IV
;; �r C':ffcr.
Poe i yxEd_5,
Page 3 of 3 12128104

❑ Division of Soil and Water Conservation [3 Other Agency
al Division of Water Quality
0 Routine 0 Complaint Follow-up of DWQ inspection 0 Follow-uE of DSWC. review 0 Other
Date of Inspection I__V_LKC_7�J
Facility Number S Time of Inspection 3' 24 hr. (hh:min)
© Registered ;B Certified J0 Applied for Permit Permitted [3 Not O erationa] Date Last Operated:
Farm Name: __.......6m. i.....G .t �......... Countv:.....Lial. IXh.....................................................
Owner Name: � '..... Swaim ............................................... Phone No:..� i.:^.i. S ...Y1i.5.........
65;
............
- R..
FacilityContact {� .. Title:................................................................ Phone No: ... N.015..5:n.U..........
Mailing Address:...i5......rriS�y �.af,�......Gu»...... 0.................................................... RVAI...........
Onsite Representative:....... �....51,44..................... Integrator....&Iwf'x.................._....................... ......................................... ......................
Certified Operator:.......................................................
Location of Farm:
Operator Certification Number: ....... ..Z ...........
Latitude ' " Longitude • ° 44
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gaVmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. is there evidence of past discharge from any part of the operation?
4_ Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
Continued on back

�R k
Facility Number: 5'
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes El No
Structures (Lagoons,Holdinu Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? `N Yes ❑ No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: Z
Freeboard(ft) .............►....................................... ..........
10.
Is seepage observed from any of the structures?
❑ Yes
❑ No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
No
12.
Do any of the structures need maintenance/improvement?
K Yes
❑ No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes
❑ No
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
❑ No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type............................................................................................................................................................................................................................................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
PO No
17.
Does the facility have a lack of adequate acreage for land application? -
❑ Yes
❑ No
18.
Does the receiving crop need improvement?
❑ Yes
❑ No
19.
is there a lack of available waste application equipment?
❑ Yes
❑ No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
21.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
22.
Does record keeping need improvement?
❑ Yes
❑ No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
❑ No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
R1 No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
❑ No
0 No:violatioits•or derkieRcie's were -noted during this;visit.- Yodm'iU receive•noAirther-:
• correspotidehce about -this'.visit:; • ::::: .
»'- 'Lx Z ':'Yf' 3 '!C
Ctimrrt (refer.to question #) Eatplaa nany .YES ans�sers andlvr any recommerdatrons or any, nfher crtittents^
[Jse drawings of E'actlity�to better explain situations (use additional pages as :necessary)�r �M-Ed
9. �—a�Oer -st r— l�.�s � h ictca�' ce�aaar • La�ec:� lcuzf s�tvi� h� Jcwe�tb t� rt�,��
i
reC�onSi�j 4 4irmty w,4An.cr.
11�
4
eV&Si6n : t• (,.Go�Or.2. �aa( �02Gh i CG'tij rliJe 't� /jai!' fvo%ian O,
jnG�e_j�ec�
;nvuw-�,k� cvAli o [-a�caen -1t-
kz�����}���r5
(�(( �1't�• �SZt^ 0r. 1 Ar t � i F-� fn?c.�l p LLi�� M S�F�a �l`1 f �[� cJ 4'Y� C
l�l Yr�1 • f��j ] [ j r
T1I • �� Q � + t'LT105 at i +rt VO iYv Cxs� fii tt/ LG VI.
l
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: f�-- ^�� Date: I

s Division of Soil and=Water'eConservati6n - Operation Review �,
[3 Division of Soil and:Water•Conservation.--Compliance Inspection
n = Division of Water Qualyty �Cotnpliiance Inspections
Other Agency
O eragonR
- ©- p. _ eview� .
_ ry
JoRoutine Q Complaint Q Follow-up of DWQ infection O Follow-up of DSWC review-WOther
Facility Number S Date of Inspection j
Time of Inspection 24 hr. (hh:mm)
© Permitted [3 Certified [3 Conditionally Certified 0 Registered 113 Not O erational Date Last Operated:
Farm Name: 1H L r County:...��� ..................... V t
,C//// f.......................................................
Owner Name:................ CJef be o' �W�! € Phone No:
.................................................................................................._....----..................................-.........
Facility Contact: .............................................................................. Title:...................... ._ ........ Phone No:
MailingAddress: ................................................... ..............................
Onsite Representative: 3 .u,T ` o), ..... Integrator:... fOt!'nf._W.....//..��....'�-plik,...........
...�
Certified Operator:
Location of Farm:
Operator Certification Number:..........
Latitude �• �° �•� Longitude �• �' �'�
Swine
Design Current _ Design;: Current_.: Design Current
Capacity PopulationPoultty Capacity- Population' Caftl ' Capacity' Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Number of:Lagoons e ; ❑Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area
0=
,Holding Ponds / Solid Traps �: ❑ No Liquid Waste iVlanagement System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?.
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system'? (If yes, notify-DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste 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: ! 2—
Freeboard (inches): ��
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc-)
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
° ❑ Yes ❑ No
Structure 6
❑ Yes ❑ No
Continued on back
3/23/99

Facility Number: 2 s Date of Inspection
6. Xre djier'e structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
[:]Yes [:]No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15_ Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Re aired 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?
•*61-ations :ot• deficiencies -were 'n' dix`it g ibis: visit: Y©it will reeeiye lio further
- corresponc#ene abau1 this visit- . .. . ... .... . ....... . . . ...... .. . .
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes IN No
❑ Yes ❑ No
❑ Yes ❑ No
_ a .: __
Comments (_refer. to question #): EX —it in any'YES answers an_ d/or any recommenda_ bons or any other comments °
Use-drawings`of facilr t6 better ex- lain situations use ad ty, :1 p ( ditional pages as necessary)
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Reviewer/Inspector Name _ - s�e ,0,7 4_/Ii. 1-
Reviewer/Inspector Signature: AUa Q Date:
3123/99