310023_INSPECTIONS_20171231

NORTH CAROLINA �
Department of Environmental Qua

n
f¢'a IvLSlon'of:WaterReSonrceS Qi=v =p
Facility Number„ ; © �( €, . O D�v�sion vt S©rl,and Water Censer atifln' .��
N# 11 i= 4� „ �t' a
- a O Otber Agency;..
g a:
Type of Visit: Urtmpliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: ,'it7 Departure Time: County': Region:
Farm Name: �� Owner Email:
Owner Name: S ,ir p_%rti Phone:
1
Mailing Address: ,-7
Physical Address:
Facility Contact: (�11f j /��lj zror� / ��zJ Title: eg�eyn Phone: / jf
Onsite Representative: S{��� Integrator:
Certified Operator: Certification Number: f fyf 9)
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
�, ��
�.:
n iFurrentj, �,
g Currents'
D sti n i
i
Des n C�trrenf -
g
Swore,
�.:
Ca ace Po P
p-.sty
Wet Poplt
Caac� Po
pt:. r� -:..
Cattle,
Ca aci
P:-
Po
Des
..
�.
�P[�;_
Wean to Finish
La er
Wean to Feeder
ONon-La er
Feeder to Finish
73 Y
��
`�'
Design
Farrow to Wean;
Current
Farrow to Feeder
' D Poult
Ca ac PoKy
Farrow to Finish
Gilts
f,
Boars
NO
f
Other
(6a9I
Layers
—.Non-Layers
Pullets
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?
Dairy Cow
Dairy Calf
Dairy Heifer
D Cow
Non-Dai
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes Wo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[] No
❑ NA
❑ NE
❑ Yes
E&No
❑ NA
❑ NE
❑ Yes
[ff No
❑ NA
❑ NE
Page I of 3
2/4/2015 Continued

1E'acili Number: JDateof Inspection: /
Waste Collection & Treatment
'L 4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes O No ❑ 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):�
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
❑ Yes 0 No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
® No
❑ 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 environmental 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
No
❑ NA
❑ NE
maintenance or improvement?
11. 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): (7�ri`mj&_ % AC_' c rS rY�
13. Soil Type(s):� ^
14. Do the receiving crops differ from those designated in the CAWMP? [:]Yes f,No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes Z5 No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [jj� No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
R No
❑ NA
❑ NE
IS. Is there a lack of properly operating waste application equipment?
❑ Yes
No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
g Yes
❑ No
❑ NA
❑ NE
$4-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
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
[f.No
❑ NA
❑ NE
Page 2 of 3
21412015 Continued

VCFacilityNumber: - Date of Inspection: ZZ
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
.7
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
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 ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 0 No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
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?
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
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑Yes ®No ❑NA ❑NE
❑ Yes ®No ❑ NA ❑ NE
❑ Yes [Z No ❑ NA ❑ NE
❑ Yes Ej No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or GAWMP? ❑ Yes
r�] No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
Q No
❑ NA
❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
Phone:
Date:
21412015

1 ypr Ul V 131L: �Jj�d P11a11CC 1lla�JCCLLUII L.J V�1CrIlllUll 1CCVICW LJ OL1111.LU1 C L' VZLIUMLIUR `/ l CL41111mm Hban'Im Ur
Reason for VisitJ- SIE2utine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: / L Arrival Time: © Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Phone:
Facility Contact: Title: Phone:
Onsite Representative: C� /�j 12 o6.1G . S Integrator:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Swine a Capacity:'
"- Wean to Finish
X,•
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder i
Farrow to Finish
Gilts
Boars
Latitude:
Certification Number:
Longitude:
Layer I jDairyCow
Non-LI JDairy Calf *I
Turke s
Other'' Turkey Poults
Other a Other
Discharees and Stream Impacts
Hy _ eifer
Cow
Cow
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 DWR) ❑ Yes ❑ No ❑ NA ❑ NE
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) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [] Yes ❑ No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ❑ No ❑ NA ❑ NE
of the State other than from a discharge?
Page l of 3 21412015 Continued
Latitude:
Certification Number:
Longitude:
Layer I jDairyCow
Non-LI JDairy Calf *I
Turke s
Other'' Turkey Poults
Other a Other
Discharees and Stream Impacts
Hy _ eifer
Cow
Cow
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 DWR) ❑ Yes ❑ No ❑ NA ❑ NE
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) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [] Yes ❑ No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes ❑ No ❑ NA ❑ NE
of the State other than from a discharge?
Page l of 3 21412015 Continued
Page l of 3 21412015 Continued

Facili Number: jDate of Ins ection: Z
'3cyllcl
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
o
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
o
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: T Z!
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _
5. Are there any immediate threats to the integrity of any of the structures observed?
[-]Yes
�No
❑ NA
❑ NE
(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
No
P
❑ 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 environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
q No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[;?�No
❑ NA
D NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
1
9. Does any part of the waste management system other than the waste structures require
❑ Yes
P No
❑ NA
❑ NE
maintenance or improvement?
Waste Aaolication
10. Are there any required buffers, setbacks, or compliance alternatives that need [—]Yes [2"No ❑ NA ❑ NE
maintenance or improvement? r
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes &o ❑ 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? ❑ Yes )2rVo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ZNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes 0 No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reauired Records & Documents
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes WrNo [DNA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Z No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [:]Yes P No ❑ NA ON I,
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes P?r'No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall D Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes if No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes �No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: jDate of Inspection: �d
.24. Did'the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes J"No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes �J ' o ❑ NA ❑ NE
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 ;alqo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
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?
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
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency9
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes [;?No ❑ NA ❑ NE
[:]Yes Z No ❑ NA ❑ NE
❑ Yes P4
4 ❑ NA ❑ NE
❑ Yes �' o ❑ NA ❑ NE
❑ Yes PNo
❑ Yes ZNo
❑ Yes [:3"No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone: Z
Date: 'L d
21412015

[1
Division of Water Resources
Foci ity Number - 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: 9-�npliance 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 0 Denied Access
Date of Visit: Arrival Time: ® Departure Time: County:q_lRegion:
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: r_'A r/,s 1C�I7 4�
Certified Operator:
Sack -up Operator:
Title:
Location of Farm: Latitude:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Phone:
Phone:
Integrator: A Z4
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
rou
Non-L;
Pullets
Poults
Design Current
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?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes ,P^No ❑ NA ❑ NE
❑ Yes
U-T, No
❑ NA
❑ NE
❑ Yes
;a No
❑ NA
❑ NE
❑ Yes �no
❑ Yes 0 No
❑ Yes XNo
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
f'
Page I of 3 21412015 Continued

Facili Number: jDate of Ins ection:
Waste Collection & Treatment
4. Is storage -capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes PNo ❑ NA ❑ NE
• a. If yes, is waste level into the structural freeboard? ❑ Yes P No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: �� 3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):T�_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
R] 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
PNo
❑ 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 environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
rjj 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)
T
9. Does any part of the waste management system other than the waste structures require
❑ Yes
�' o
❑ NA
❑ NE
maintenance or improvement?
T
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [] Yes �No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes o [DNA ❑ 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? ❑ Yes 7 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [fir No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [�No ❑ NA ❑ NE
acres determination? TT
17. Does the facility lack adequate acreage for land application?
❑ Yes o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑Yes No
❑ NA
❑ NE
Required Records & Documents
7
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes PNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes o
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ZrYes ❑ No ❑ NA ❑ NE
❑ 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 P No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes VfNo ❑ NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: - Date of Ins ection: Z
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the rability out of compliance with permit conditions related to sludge? If yes, check ❑ Yes o ❑ NA ❑ NE
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 P No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes D No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
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
Z 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
EfNo ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[.-Z'No ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
O�No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No ❑ NA ❑ NE
Comments (refer',t©quesdb'i #) Explainany-YES answers and/or.any-additional recommendations or an other comments.
Use,drawings of facility to,better explainsituations (use additional pages as necessary).
wA-
V1411-
Se.x k— a E� U;c- c- st3 ec-r��
Reviewer/inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: /
Date:
21412015

a. )F'acttityNum6er �- �� � _ �rDmsion,ofrSo�l and:Water Conservatron . ..`t`
t ��. ..�r.,�. _ ..-� .Y, :::_.�����'Ot�,Agency G-�� .• '. r
type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
lesson for Visit: _Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: 30 Departure Time: County: Region:
Farm Name: Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Back-up Operator:
Title:
Phone:
Integrator:
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
w.
x Design Current ",.. Design Cu�rrrent Design Current
Swine Capacity 'Pop 'Wet Poultry ��Capacity Pope•: 7`Cattle .; 4�Capaci Po
{
.tom. ,
Wean to Finish Layer Dairy Cow
Wean to Feeder t Non -Layer Da' Calf
Feeder to Finish 4° "" '"`"" r Dairy Heifer
AAK Farrow to Weans Design ACurrent Cow
A.
Farrow to Feeder ,Di Poui Ca aci- _ JP Non -Dairy
Farrow to Finish ILayers Beef Stocker
lam
Gilts Non -Layers Beef Feeder
Boars Pullets Beef Brood Cow
Turkeys ,
.Other bra r.F n . Turkey Poults
Other 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 DI
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 J'No ❑ NA ❑ NE
❑ Yes
[E'No
❑ NA
❑ NE
[]Yes
L�JNo
❑ NA
❑ NE
❑ Yes
1 #o
❑ NA
❑ NE
❑ Yes
,❑`No
❑ NA
❑ NE
❑ Yes
.fNo
❑ NA
❑ NE
Page I of 3
21412014 Continued
A

Facili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is' storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes C2-<o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? [:]Yes 0No ❑ NA 0 NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: _ — - -T
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes O 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 j ""
❑ 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 environmental 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 �JD'N o
❑ 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 _,[2'1Qo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ti No ❑ NA ❑ NE
maintenance or improvement?
11. 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?
❑ Yes [3-No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes Q o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes �No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes jallo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes [ErNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes J:3-No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes J: 1\ o
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No 0 NA ❑ NE
❑ 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 ONo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes o ❑ NA ❑ NE
Page 2 of 3 T2� 21412014 Continued

Facility Number: - Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit. YesNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check �es [:]No ❑ NA ❑ NE
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 to provide documentation of an actively certified operator in charge? ❑ Yes_,allo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ,F;TIVo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes �o ❑ 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?
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
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/inspector Name:
❑ Yes 2-No
❑ Yes PNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ZNo ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
[:]Yes �No ❑ NA ❑ NE
❑Yes ��o ❑NA ❑NE
Reviewer/Inspector Signature:

rvision of Water Quality
Facility Number - 2 rJ 0 Division of Soil and Water Conservation
0 Other Agency
E
isit: -ompIiance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
r Visit: outine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: E- a�3Arrival Time: o . Departure Time: County: Region{,. ,/ �
ri
Farm Name: si c A\C'N V _ 1 Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Title:
Phone:
Integrator:
Certification Number: AQZ_0
Back-up Operator: Certification Number:
Location of Farm:
Design Current
"Swine,Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude: Longitude:
Design Current
Wet Poultry Capacity Pop.
La er
Non -La er I _1 __ _ _ j
Non-L
Pullets
Other
Poults
Design Current
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 DWQ)
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 DWQ)
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?
Design Current
Cattle CapacityPop
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
iW
0 Yes 0 No ❑ NA ❑ NE
[:]Yes
ONo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
0 Yes ETNO
❑ Yes No
❑ Yes No
❑NA ONE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412011 Continued

F�
Facili Number: -7 - Date of Inspection: 3 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes .0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes �' o ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., 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 ,ffNo
❑ Yes dNo
❑ NA ❑ NE
❑ 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 structures lack adequate markers as required by the permit? ❑ Yes 2l�o ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) T
9. Does any part of the waste management system other than the waste structures require ❑ Yes):3'"&o ❑ NA ❑ NE
maintenance or improvement?
Waste Anolication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes Pllqo ❑ NA 0 NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below, ❑ Yes P1110 ❑ 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? ❑ Yesi❑ No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ?'�
o ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [:]Yes o❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes o ❑ NA ❑ NE
❑ Yes ETNo ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the 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. r
❑WLTP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below, ❑ Yes,,EfNo
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [;J'No
❑ NA ❑ NE
0 Weather Code
❑ Sludge Survey
❑NA ONE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: 7 Ds ection:
24. Did the facility fail to calibrate waste application equipment as required by the perm t?
❑ Yes
ONo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
XNo
❑ NA ❑ NE
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 to provide documentation of an actively certified operator in charge?
❑ Yes
9No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
FefNo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
PKNo
❑ 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
0 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
ZNo
❑ 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
Rj No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No
❑ NA
❑ NE
Comments (refer to question #1): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
v16y
0. 3
6,6, Z-
() . 8 7
/" 3c
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
S
Phone: <l�- 79.b `7K,-
Date: 3 l
21412011

Q Division of Water Quality
l
Fa ifity, Number O Division of Soil and Water Conservation
- Q Other Agency.a
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit O Routine O Complaint 0 Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Arrival Time: Departure Time: County: Region:
Facility Contact: Title:
Onsite Representative: ��t.✓iL5
Certified Operator:
Back-up Operator:
Location of Farm:
Design . Current
Swine Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Owner Email:
Phone:
Phone No:
Integrator• /n
Operator Certification Number:
Back-up Certification Number:
Latitude: [—] o [_—] Longitude: = ° =
Design Current
Wet Poultry Capacity Population
❑ La er
❑ Non -Layer Ell
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 .CapacityPopulaq
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
mow;
: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 ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
Page I of 3 12128104 Continued

Facility Number: Date of Inspection
-Reauired Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
JZNo
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
G?No
❑ NA
❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21.
Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
JNo
❑ 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
[),W
❑ 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
'Ca'No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
9Mo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
'�TNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
qNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
0No
❑ 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?
i
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
,ZNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
"I
31.
Did the facility fait to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�No
❑ NA
❑ NE .
Adclrhonal Commertts `and/or Drawrngs: -
L c-e C Pv'I[ 1"'U_ J r M 15J 143 �J e.f/4S�[
`3 7 �erv� �cr��s ".�
� so
3 "yam
r3
$I��a
76 4 `s-/lU
3 /, a
p� 7
01 7 k
3,7
r 41,
(r 7
Page 3 of 3 12128104

n
'Division of Water Quality
Facility Number �j p� 0 Division of Soil and Water Conservation l'
- - 0 Other Agency 0
Type of Visit iPfCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit @"Routine O Complaint O F011ow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: I �(•
Farm Name: J
Owner Name:
Mailing Address:
Physical Address:
Arrival Time: ,' O Departure Time: County: Region:01
Facility Contact: Title:
Onsite Representative: &115 G✓�,.5� _
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = f = " Longitude: = ° = 6 "
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
_ 1 ❑ Layer
_,I-�! ❑ Non -Lay er
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
E]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
❑ Daia Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Da Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures: �J
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 l of 3
❑ Yes VNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
In No
❑ NA
❑ NE
❑ Yes eNo ❑ NA ❑ NE
12128104 Continued

FacVty 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:' J
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes P 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 Z No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ONo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ,6No ❑ 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 El NA ❑ NE
maintenance or improvement? ✓
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes P.No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes PNo ❑ 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 Windoww' [:]Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) 09
13. Soil type(s) A(�(
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes [,72'jNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes [' No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes P"No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes ;2 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):
Reviewer/inspector Name T (t� T T Phone:
Reviewer/inspector Signature: Date: /d p
Page 2 of 3 12128104 Continued

F cility Number: 31 — Date of Inspection
i
.� Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes )2rNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box. ❑ WUp ElChecklists ElDesign [I Maps ❑Other 112
21. Does record keeping need improvement? If yes, check the appropriate box below. Yes [I No ❑ NA El NE
El Waste Application El Weekly Freeboard [2 Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes ,❑No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes jNo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes [410
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes ❑.No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes PNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes UNo
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes'j2'No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes )2'No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes J;rNo
❑ 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
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
'[2'No
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes ONo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes o
❑ NA
❑ NE
Additional Comments and/or Drawings:
w 1¢ "'V �l ltlQ q /-0 . G'Q%leC 7 z /l O' o / +,�l
PAYV
J/J/'�Oev 0, _z�, e2
sAdq
/'
y9,3
11`a/0s 61,63
Q, 6 r
h. s-�
Page 3 of 3 12/2&04

r
MA
Type of Visit <� Compliance inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine 0 Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: $c Arrival Time: �� Departure Time: County:LL Region:-j,/
Farm Name: Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: Title:
aen-IS—.9aie�L:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
❑ Wean to Feeder
Weeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Phone:
No:
Integrator:
Operator Certification Nu
Back-up Certification Number:
Latitude: = = = Longitude: = ° ❑ A = u
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
[--]Layer
- I - �� ❑ Non -Layer _ - -- -- -- -- - . -
Other
❑Other _, -- ----- --
Dry Poultry
❑ Layers
j
❑ 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
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
Number of Structures: =1
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.ZNo ❑ NA ❑ NE
❑Yes [I No ❑NA ❑NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
E No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

Fsacilityiumber: 3 — Date of Inspection z
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 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: {
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _V 2-
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yeses 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 IffNo
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes _Ej No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes eNo
❑ 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
❑ NA ❑ NE
maintenance or improvement?
J�lNo
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ NA ❑ NE
maintenance/improvement?
JpNo
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes ,ETNo
❑ 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 Area
12. Crop type(s)
U. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes J`No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes .8 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination`
❑ Yes J2-no
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
•❑ Yes .,ETNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes �fo
❑ NA
❑ NE
Reviewer/Inspector Name V" } Phone:
1
Reviewer/Inspector Signature: Z Date: ,C3
1212810 Continued

Facility ✓+lumber: y Date of Inspection 6
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes,-ET'No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 2 No ❑ NA ❑ NE
the appropirate box. ❑ WDP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. AYes ❑ No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield Aff120 Minute Inspections ❑ Monthly and I" Rain Inspections ZWeather 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?
[I Yes _L]-No ❑ NA ❑ NE
❑ Yes Q-No
❑ NA
❑ NE
❑ Yes QNo
❑ NA
❑ NE
❑ Yes 0 Rio
❑ NA
❑ NE
❑ Yes B'No
❑ NA
❑ NE
❑ Yes [2�No
❑ NA
❑ NE
❑ Yes ,allo ❑ NA ❑ NE
❑ Yes J No ❑ NA ❑ NE
❑ Yes LD'No ❑ NA ❑ NE
❑ Yes .ENo ❑ NA ❑ NE
❑ Yes j;;Ko ❑ NA ❑ NE
12128104

(Type of Visit JD Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit gRoutine O Complaint O Follow up O Emergency P
Facility Number 7 Date of Visit:
Other ❑ Denied Access
rune:
xrPermitted, Cerfied Conditionally Certified 0 Regi`stered Date Last Operated or Abov -Threshold: ....._...._...„.„„..
Farm Name: ....�„��.L%..�1� ! .„ „. „.._ .„ County:
OwnerName: . „.„.......„....:.. „....� . .„._„ ._„..� „...._„„„ __..... Phone No: „.„.......... „„.... ....„.... „....... „............. ......... „.............
+hiring Address:
FacilityContact: .....„.„.„ .................................. .—---------- Title:. ....„_..,„... - - - - --. .„...W�.. Phone No: _ „_...................
Onsite Representative:.... >C?.G-s r� ,S ..„.„------ „...„.. Integrator.fI^ .
Certified Operator:..„....„ .................................... .... ...... ................................................ Operator Certification umber: ........ ........ „......... .............
Location of Farm:
r'.
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �� ��� Longitude �• �� ���
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes P No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes LINO
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) (] Yes UxO
c. If discharge is observed, what is the estimated flow in gal/Min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes 2No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes L3'No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 'Q0110
Structure I Struc% e 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: „.......„. ................... ----------- •........................ ...„............. „.... .....
Freeboard (inches):
12112103 Continued

Facility Number: — Date of Inspection 7
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ YesQo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes PKo
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? ❑ Yes 0.50
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes J2No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes 2.90
elevation markings?
Waste Application
10. Are there any buffers that need maintenancefunprovement? ❑ Yes JRVo
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ;;i1Qo
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type 15�4 )
13. Do the receiving crops differ with rose designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes .Blko
14. a) Does the facility lack adequate acreage for land application? ❑ Yes A No
b) Does the facility need a wettable acre determination? ❑ Yes PrRo
c) This facility is pended for a wettable acre determination? ❑ Yes PO.No
15. Does the receiving crop need improvement? ❑ Yes 'P3.1Qo
16. Is there a lack of adequate waste application equipment? ❑ Yes Judo
Odor I.tisues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge attor below ❑ Yes ,Elo
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ,ETSo
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes [21go
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 ,21CO
Air Quality representative immediately.
Courments (refer to ques6ori #) °Exphrrn °day 1'F.S aasrvers and/or any:irecvimmenrlations or<any Omer comments. .
_
_.
Use dra of facr�i� to better /aril srtustrDllS. (use a�ddrhona! F
I r`y C Final Notes
h' exp Field
s
a o o
fro r I4- (/n � rou�.coLte-.� rctkfj
CQh e-(_6/_ 45
Reviewer/Iospector Named _, - �E j N
Reviewer/Inspector Signature: Date:
12112103 Continued

Facility Number: — Date of Inspection
4
Reauired Records & Documents
21.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes )90No
22.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
dNo
(ie/ WIT, checklists, design, maps, etc.)
❑ Yes
23.
Does record keeping need improvement? If yes, check the appropriate box below.
;Rles ❑ No
XWaste 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 jar�4o
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes Q-No
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes J2�o
(iel discharge, freeboard problems, over application)
27.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes ,01C o
28.
Does facility require a follow-up visit by same agency?
❑ Yes ;?No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes Po
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
)2rfes ❑ No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes , N"o
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes ,B'.qo
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes 014o
34. Did the facility fail to calibrate waste application equipment? ❑ Yes J2,Tqo
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes J;JM
❑ Stocking Form ❑ Crap YieId Form ❑ Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
❑ No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
dditioaal Conunents and/or Drav"angs
�V3 Clsea' d/G3 4j4j/e- c FKa //ss
Ple,cise, 4MWs4r C/o�
A / ■ 7 • r
-- 7 / V G % ark
/y Soj% �
CL T
12112103

Facility Number Date of Visit: it Time:
rO Not Operational 0 Below Threshold
M Permitted OCertifed [3 Conditionally Certified [3 Registered Date Last Operated or.4,bove Threshold
Farm Name: ____ 601d/P6 d-SdhS s County: f
Owner Name:
Mailing Address:
Facility Contact: Title:
Onsite Representative: 4174 P,
Certified Operator:
Location of Farm:
Phone No:
Phone No:
Integrator:UY/i� 1!
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' • u Longitude 0'
Design- ...:Current - De sign a Current.:Des�ga Cuireitt:
Swine Capacity _ !Po ulation Pouitry, 'Ca-- acity Po 'uiation _.::Cattle � Capacity P6uiatton =
Wean to Feeder ❑ Layer ❑ Dairy
© Feeder to Finish ❑ Non -Layer ❑ Noa-Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ other _
❑ Farrow to Finish Total Design Capacity
❑ Gilts
Boars ? - Ti)taU SLW'
.. Nnmbei of Lagoons ©t ❑ Subsurface Drains Present ❑ Lagoon Area ❑ 5 ray Field Area ;
Holdiitg Pnutls % Solid Traps ❑ No Li uid Waste Mana ement 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 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: 1 Z 3
Freeboard (inches): Z$ 7
05103101
❑ Yes 0-n—
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 99-15-0
❑ Yes ZI-No
❑ Yes Uo
Structure 6
Continued

1 '
Facility Number: 3/ — 2;3 Date of Inspection I L
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12, Crop type A ze,
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 [ 0
❑ Yes O'150
❑ Yes ED-No
❑ Yes 93NO
❑ Yes W-ITo
❑ Yes M No
❑ Yes 93 No
❑ Yes E tvo
❑ Yes M-No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 93-No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
gi} o
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
©-No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑-No'
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
EJ_W
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
M-W
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
3-N-6
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/lnspector fail to discuss review/inspection with on -site representative?
❑ Yes
!moo
24,
Does facility require a follow-up visit by same agency?
❑ Yes
[}''lam
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
El]
B_No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to,,questioo #) Eiipiatn any YES answers nad/or auy recommendatioets or sny:other eonwments: .
Lice drawtstgs of fsiciltty to better ezplain situatloas: (use addttaanak pages as necessary) T.. _
,_ _ Field Cony ❑ Final Notes
11 PCe rGt t 3�' f'`k � j o fC s o oC
Reviewer/Inspector Name t•4. _
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Number: Date of Inspection 1
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes P ; o
liquid level of lagoon or storage pond with no agitation.)
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes Z?-O
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes �b
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 Quo
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 B 'N�o
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 0,No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ZI-10
iidditional Camments;and/or Drawings: _
05103101

of VisR jarCompliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit oRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 3 Z 3 Date of Visit:
13 Permitted 13 Certified Q Conditionally Certified 0 Registered
Farm Name: ) e s sot, C'.�
�....... �...................................................................9.1 .............................
......... . .. .
15�4et-% i?aWIc1
OwnerName: ......................................................................................................................
Facility Contact:
Mailing Address:
Title:
Time:
Date Last Operated or Above Threshold:........ �..... ,...
County:
PhoneNo: ............. ................................................. ..... .. . ......
Phone No:
OnsiteRepresentative• ntegrator: m�� ��+
...................rI
......................................................-._.......I..................... ...... .-. ---------------------------------
--
Certified Operator: ........................................................................................... Operator Certification Number: ............................. .............
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude * 4 66 Longitude • 6 64
Design Current Design Current Design C.orrent
Swine _Polry atle CapacityPopulation' ,i Ca aci Po` ulir ion
a' . ❑ Wean to Feeder ❑ Layer ❑ Dairy
❑ Feeder to Finish ❑Non -Layer ❑Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
Farrow to Finish Total Design "Capacity
.-JOGilts
❑Boars Total SSLw
Nnmber'of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid' Traps.-
7 ❑ No Liquid Waste Management System
Discharees & 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: .............. f.� ......_................... Z........ ........ 3 ........-....
Freeboard (inches): 2-y 3 4 S
5100
❑ Yes jRfNo
❑ Yes dNo
❑ Yes No
h /r+
❑ Yes P'No
❑ Yes ;—:o
❑ Yes0
❑ Yes,0No
Structure G
Continued on back

Fgph � Number: 3 f — 2 3 Date of Inspection 14d
�5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes JZNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes eNo
(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 j2rNo
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes ONo
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 maintenance/improvement? ❑ Yes .2rNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes A!fNo
12. Crop type _ ea n FV V � H4nt, sl►�ta i `t
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes j'No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? J31yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? PrYes ❑ No
16. Is there a lack of adequate waste application equipment? ❑ Yes ONO
Renuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes ff No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
❑ Yes JTNo
(ie/ WUP, checklists, design, maps, etc.)
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 ONo
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes ,Mo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes Z No
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes .,6 No
24. Does facility require a follow-up visit by same agency?
❑ Yes,0140
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes ZNO
YiQla�ign]s;e#' dgfc�e��is vtre pter;1 �ltitg tbjs'v�siti Yoh wig lye lr�o furt#►gr;
cor iris• � dense'about. this visit:
Comb ikts (refer to question #)Ex-U4-any YES answeis and/or any i-ecom'teridations or ally other comments.
-
4
CJSr drawings _olf facility to better exp)Eain SitiiatibnS. (use additl0nal pages SS IICCCS4Ary) a _ c m = f� s
7. Nee d maw l'1*3ao`► 3.
ly.&. 11 he 1(;,�c;l,j needs w we8g6te gCres o�e�ef�%�qf>'e� �dn� •"ofed;eta
1
w d k t L cjV e p1 Q h. cl� eeco.^d ke e olo%n o ��
is% l rea5 bee,-loblat ;et 5 neelf 4,0 J2i✓e Gc�'""�veT% lark el;'•r+:. �
fa-Vir-A,V.s
bef^1.vAq be#e_�O' eS4a pec;al! fay e ��ati� .F;ct, .
tieeot ►' hAve one
460(
iq. sve ,� hlf9 e"t w:tf
-4o #,tkE WoMez A•l�i1 ys A
t,v �- : rN 6 o du s a �' �rP Ir'c�F'� o =-t a VV4f a fie(fie(vse, -ilk ►'1 a't Ae
1W
Reviewer/Inspector Name-�vtet.�l� _
Reviewer/Inspector Signature: Date: 110
1 smo

Fac ity Number: Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Oyes ❑ 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 ZNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes Jallo
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 JXNo
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 ,21$fo
32. Do the flush tanks lack a submerged fill pipe or a permanenthemporary cover? ❑ Yes ❑ No
Addifionall Comments and/or _ rawtngs:
i
5/00

�- - - � Dtvisron of Water Quahty '�Comphiince Inspectlon �_ �-
= r Other _Agency< Operation Review`5a 5+� _'x:`',
LO Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of Inspection
XPermitted
Time of InspectionQQ 24 hr. (hh:mm)
[3 Certified © Conditionally Certified © Registered JE3 Not Operational Date Last Operated -
FarmName: ..... 2P Q.S .#J............. ..... .................. County:......... ....... ... .................................................
OwnerName: ................................................... ........................................................................ Phone No:.................................
Facility Contact: .... Title: . Phone No:
.........................................................................................................................
MailingAddress: ..................................................................................................................... ...................................................................................
Onsite Representative: .... i Integrator: t-• ........................
..................... I....................
Certified Operator:.._ ............ Operator Certification Number:.... ..........................................
........................................................................... ....
Location of Farm:
Latitude �'�' 0°° Longitude =• =' ="
...'Design urrenf'. Design Current
Swine ,r. _,. ;_
C
Capacity=Po ulation Poultry Capacity ulation C
❑ Layer [
1-1 AT.... T .,..e. . a r
❑ Wean to Feeder
Feeder to Finish
3 Ljq
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current w.
the Ca `acr `: Po elation=
Dairy
Non -Dairy
Number of LagooJE1 Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds/ Solid Traps' ❑ No Liquid Waste Management System z_
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? (Ifycs, 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 ? Structure 3 Structure 4 Structure 5
Identifier: nn
Freeboard (inches): d��
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes P(No
seepage, etc.)
Continued on back
3123/99
❑ Yes XNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes O(No
❑ Yes NfNo
❑ Yes XNo
Structure 6

tacifiity Number: — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(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
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?
(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?
Rio yiolaioris;or deficiencies were . 6te� irring �his;visitT You will r. . . . .Rio further
corresporicfeirice. a�otit this visit: . . . . .
❑ Yes KNo
❑ Yes kNo
[]Yes XNo
❑ Yes WNo
❑ Yes WNo
XYcs ❑ No
❑ Yes No
❑ Yes Jj' No
❑ Yes ❑ No
[]Yes ❑ No
❑ Yes KNo
❑ Yes NNo
❑ Yes hjrNo
❑ Yes XNo
❑ Yes 9No
❑ Yes YNo
❑ Yes XNo
❑ Yes P(No
❑ Yes jN No
❑ Yes *No
❑ Yes N No
Comfe ments (rer to question #) Explain any YES answers an'd/or any. recommendations or any.other cottiments _ -.`
Use drawings of facility to better explain sttuahonns useaddthonal'pages as necessary) x "
s
IZ,— mac._ C-A/ak" 415
a 5� -ot
2')
td'-•��c

Facility Number: —r'j- Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below WYes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes `j No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 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 XNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes KNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes 41N0
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes [XNo
Additional omments-an or rawtngs: ,t
<::f rile AL
J

L
.e - .. A
D Division of Soil and Water Conservation =-operation Review m
Div1s1on-bf_Soil and Water Conservation'=;Compliance Inspection
Divisiion of Water Quality - CompLanceyInspection .
,. OtherAgency Operation Review
Routine Q Complaint Q Follow-up of DWQ inspection O Follow-up of DSWC review Q Other
Facility Number Date of Inspection
Time of Inspection 24 hr. (hh:mm)
Permitted © Certified © Conditionally Certified © Registered JE3 Not Operational Date Last Operated:
Farm Name: ..... D ..Asa ......... ,.�!t'.:-3.... ...1..... County:..... .... . !.. ................................ ........... ......... .....
Owner Name: .................. ....................................................- ....... ....... Phone No: �i).�d ��.� --
.. (b� �.......:..................
........................ . .
Facility Contact: .............................................................................. Title:............. . Phone No:
Mailing Address:
Onsite Representative:... ..., Dul.� Integrator:� ...............................................
... ............................................................
CertifiedOperator:.....................................................................................................I.......... Operator Certification Number:..........................................
Location of Farm:
Latitude Longitude
Design -Current
Swine. Capacity Ponulation
❑ Wean to Feeder
%Feeder to Finish
❑ Farrow to Wean
[] Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity , Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons 10 Subsurface Drains Present ❑ Lagoon Area
Holding Ponds / Solid -Traps., ❑ No Liquid Waste Management System
ILI Spray Field Area
Discharges & 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, was the conveyance man-made`?
❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ)
❑ Yes ❑ No
c. If discharge is observed. what is the estimated flow in gal/min?
d.. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes 'VNo
3. Were there any adverse impacts orpotential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes x No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes )�No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Freeboard
(inches): ........�.......................... ............. ................. .L............... ................................... ...................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes ((No
seepage, etc.)
3/23/99
Continued on back

Facility Number: —/}3 DuEc ul' (nspection
6.
Are there structures on-si(e 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/improve men t•?
❑ Yes
[-]No
S.
Does any part of the waste mana0etnent system other than waste structures require maintenance/improvement:'
❑ Yes
9No
9.
Do any stuctures lack adequate. gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
�No
Waste Application
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
No
11.
Is there evidence of over application'? ❑ Excessive Ponding ❑ PAN
❑ Yes
XNo
12_
Crop type SG Y
11
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
9No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
XNo
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination'?
9Yes
❑ No
15.
Does the receiving crop need improvement?
Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
ONo
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
XNo
19. 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?
GO 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?
: No•Yiolatigris:or• deficiencies •*• 6noted• dtWing • iiis:visit. • ." wifl•receiye iio. further : ;
rorrespondeizce. about this visit. ... .. .. ... ..
❑ Yes No
&Yes Nogl,�r-
❑ Yes Wo
❑ Yes J'No
❑ Yes IgNo
❑ Yes DjrNo
❑ Yes )<No
❑ Yes ONo
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): .
441, �i i G ►-� c� #
�NX- \C�( - 1 to
J
ReviewerAnspector Name
Reviewer/inspector Signature:
37_,�-'-3 Y4a
Date: -- 14 9q
3/23/99

Facility Number: —�� Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below 19Yes ❑ 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
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
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
I '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
8<No
3/23/99

10 Routine 0 Complaint 0 Hollow -up of f)Wt2 inspection 0 INollow-up of UNW[: review 0 caner
Facility Number Date of Inspection
Time of Iuspection 24 hr. (hh:mm)
E Permitted 0 Certified p Conditionally Certified p Registered 113 Not Operatrona Date Last Operated:
Farm Name: Ro`v1es.&.Son.Farm_##1.......................................................................... County: Duplin WIRO
Owner Name: Stan ......................................... Bowles...._....
FacilityContact: ...............................................................................Title: ...............
Mailing Address:.60.7-Curtic.lid...........................................
Onsite Representative:
Phone No: 2.93:165.4..(jaf1`iicc)...................................................
.................................... Phone No:........"...........................................
.Warsavk..NC.......................................................... Z8.198 ..............
Integrator:].!'lu.rpdty..Eami1yXarrms ..........................
Certified Operator: CltrcictaplwxE................... Rowles .............................................. Operator Certification Number: 18010.............................
Location of Farm:
Latitude Longitude ©• ®� ®°
- Design. Current - = Design Current Design. urrent
p y ' p rY m" Capacity Population Capacity Population_
Swine _ Ca actf Po ulation :Fault °Cattle
❑ Wean to Feeder
® Feeder to rms
❑ Farrow to ean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
_ Number of Lagoons ❑ Subsurface Drains Present ❑ agoon rea 17 Spray FWWXrea
'Holdmg-Ponds�J Solid Traps- �.- p o LiquidWaste Management System -
1_S
Discharges & 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, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑Yes p No
c. If discharge is observed, what is the estimated flow in galfmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
.3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? 0 Yes ❑ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? p Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure C
Identifier:
Freeboard(inches): ...............18.............................................................................................. ............... .... ..............................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes []No
3/23/99 seepage, etc.) Continued on back

Date of Inspection
aacil&y Number: 31-2371
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
i7 No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
Cl Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
[]No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21,
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) _
❑ Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
a . Xldviola'tions,or' de 'den'cies.were.nnted:durinf4, is visit.': You ivill.i•ei e'ive n i further :: .
corx6Mdek6. about this:visit; • : • : - . • . • :... • .::.:::::::::::.:.:.:::::: :
Reviewer/Inspector Name � ve � mm Lewis m
Reviewer/Inspector Signature. Date:

Division of Soil and Water Conservation [3Other Agency
[a Division of Water Quality
Longitude • _ _�
Population
n' , Current .�
itv, Population Ev
l(outine O Coni laint O Fcsllow-u cif DW ins action 0 Follow-up of DSWC review 0 Other
Date of Inspection
Facility Number 1 3 .. ��� -�
Time of Inspection _ }3�1 24 hr. (hh:mm)
13 Registered [I Certified © Applied for Per nut' Permitted 0 Not O eratinnal Date Last O erated• .
Farm Name: ............. ........r.................................... County: .... ..lih......................................... ............
...........
Owner Name:---------------------------5 ........ .... :it�l.................................................. Phone No: ��16 ���`..ZGS.`t...........--------.--..................
Facility Contact:............Cr.N?fl..................... Title:................................................... Phone No
MailingAddress:..............ka........L5.......KSY!................................................... .......�h�4 YT4K?.,..f`�{%.......................................... 1.?...........
Onsite Representative :.......... ClnY.3S....... %.t P_s .................................................... Integrator:......O...................................................
Certified Operator; ............................................. .--......... Operator Certification Number .........................................
Location of Farm:
5.t a ...... LZ. o.7... ....r►�i.... .....1s} ..of...-....C' .100................................
......................................... ............................................................. ............................................................................... T
Latitude •:6 «
Somme
Current..
Povii6tioii
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
General
L Are there any buffers that need maintenance/improvement? ❑ Yes IiNo
2. Is any discharge observed from any part of the operation? ❑ Yes El No
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 observers, what is the estimated flow in gal/min?
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 lagoonstholding ponds) iequire
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 M No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes P No
❑ Yes 10 No
Continued on back

Fact; Numher: I f — Z3
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 2 Structure 3 Structure 4
Identifier:
.................................7..............................1.....................................................
Freeboard (ft): ........... iLl......................... Z-2-- 2'S
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?
❑ Yes No
❑ Yes ( No
Structure 5 Structure 6
................................... ........ ........... I ...............
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 W `M_P, or runoff entering waters of the State, notify DWQ)
15. Crop type ..............` } c�?16!I� ........................ ihfr ....... Y►tL-............. ...... ............ ................................................
.
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
❑ No
Yes
❑ No
0 No.violations or defiden' des. were' noted -during this:visit. - .You.wi11 receive no further
correspondence about this:visit:- ' -
❑ Yes- O No
❑ Yes MNo
❑ Yes No
❑ Yes No
,Yes ❑ No
❑ Yes 0 No
IN Yes ❑ No
❑ Yes AN No
N Yes ❑ No.
❑ Yes [' No
❑ Yes gNo
❑ Yes W No
Coti�ntents (irefe'r to question #j -.Explain any`; ES answers andlor a:—n v -recommendations or any other comments.
Use drawtI.ngs.of f ilitv'to hetter`explaiii situations '(use additional pages as necesSarv) .c
F�
a Wtf,.S 6' ! n"er' ti L1' t7-1O,k y�Cer 1 tv.ar
6iV--e, wc,l a f (0- oon 3. �vt)sior u.+rcc�� sVxovM b�
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�e %�. �nok) �S J gW�9tJO'_ 6U10O_k_e1 _
oor� C °,�oillfl a44-, J • %
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ru`"O"t t�vx �"cens. Rkv1 �nw4c c�OZer o - .i
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1 S. Besrmua t v`l # 5hau
1
�Z. %1 Lb`aV d (3Y [ �iCc �101� 3hO��`�'} ! 1^ 1 Cicti . S Y reCCvr� qS �10'(J�O [7Q 111 'rt` k} Ul l
elr `� �+ f�(� t�Sl C-©YVLt-,r CtCYCCL e_ �%r 1 geL� eA GV�IS�(h�S • Sd�� �irtl7fS� t
i1UM t!�UY►�IO
be data! N, �v�. l9,V_- Z � t1 �e, cisec} � � ore �. c vs Sej . lslc��t 71�� 09jj
S shnt�tl 11 • s _ s6,j e vur�
Re ew0 nspector Name c 1't0.#n �:Yf %`may
Reviewer/Inspector Signature: =za e--. Date: / g

1011outine OComptaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 00ther
Date of Inspection �, t- I
Facility Number Time of Inspection U.1 24 hr. (hh:tnm)
Total Time (in fraction of hours
Farm Status- 0 Registered [I Applied for Permit (ex:1.25 for I hr 15 min)) Spent on Review 2,
[I Certified C9 Permitted or Inspection (includes travel and processing)
0 Not Operational Date Last Operated: .... . .... . ..... . ..... . .....
Farm Name: ...�j-j..,.JJAL-A& -WJ' L&
--A
County:
Land Owner Name- . ..... Phone No:
Facility Conetact:.----.. . ..... Title: Phone No:
Mailing Address: --L.CL . .... . . ...... ...
Onsite Representative:... . . ..... ......... Integrator:...
Certified Operator: . ..... Operator Certification Number:
Location of Farm:
. ............. . . . ....
Latitude & 4 " Longitude 1 0 4 (4
Type of Operation and Design Capacity
:` Design, CurrentON
NODesign &rl�,A!.
t 6 t 6-
ava on
........... Wen . .....
ARM1W
§ ici6a,cifVX. oin on
ffWean to Feeder 10 LaM
,,,,10 Dairy
0 Feeder to Finish 0 Non -Layer ❑ Non -Dairy
Farrow to Wean
,wa
'�U
Farrow to Feeder jtqva1,"eS1gn,,CapaCifyrs
A
Farrow to Finish
.... ....... ...
191 qW11
sl=�r W
0 Other �77
. . . . . . ............ . ........
�UM v—N—M ww's i�
Number 1,Lagoons lHoldmg Ponds 0 Subsu ce Drains Present
10 Lagoon Area �pra�yfleld Area
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Lagoon D Spray field 0 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 gal/min?
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
4/30/97 maintenance/improvement?
.Yes [I No
[I Yes allo
[I Yes EM No
D Yes 12 No
0 Yes
R No
[I Yes
IN No
0 Yes
Ed No
[I Yes
Fq No
Continued on back

■--....%..�-
dror �
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
NrNo
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
21 No
8. Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
IR No
Structures [Lagoons arrd/or Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
ELNo
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
10. Is seepage observed from any of the structures?
❑ Yes
19No
11. Is erasion, or any other threats to the integrity of any of the structures observed?
Yes
❑ No
12. Do any of the structures need maintenance/improvement?
Yes
❑ 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
EffNo
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 Sp.:at cls,} �........... .............. _W... _.................. _........ ...._ ...� ...._
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP).
❑ Yes
® No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
No
18. Does the receiving crop need improvement?
RYes
❑ No
19. Is there a lack of available waste application equipment?
❑ Yes
INNo
20. Does facility require a follow-up visit by same agency?
❑ Yes
Q No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
®.No
For -Certified Facilities Qn1j
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
® No
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
KNo
24. Does record keeping need improvement? J@ Yes ❑ No
Comments {refer to'questtonA{f1 Explain -any YES answers'andlor any recommendahans or any�other comments_- t�� r-� `
Use.drawings of facility to better explain situations'` {use ioditionat pages as necessary) y F
►. M Yt s o rc . `7 E ae a--y--•( F-� Q
z'Jo � tL v e �,., W....,,�,L 2-5FE) 1 t �"
tI. �; 11 r, e..roi 6 ✓l Gv �s a✓N A ✓Lt-r L-ru 1.
ba-£. ar-E S 10o�-�,, oa 11S
o t� c v t o, b a ti" s ,�. e.�r o--y-k o v k-r i °a o e
L n l t t-� e w to b y r f a e). o to e. r 1-� 1 ; a. F ►-i e e w�
toe, 'Q-a mow, w0.�t4 o� t° g00Y, i# Z a.wa 31 •�
t8 lorre�E wed Pm;v'e-.,1_S i✓► as Val. U
W-k�-et e w Y-'& -t i" @A b
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
cc. Division of Water Quality, Water Quality Section, Facility Assessment49nit 4/30/97

•
•
Site Requires Immediate Attention:
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANEVIAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 10 3 , 1995
Time: f . o e QC (xi
Farm Name/Owner: U��eS �' 5n Jc-;X-m 146
Mailing Address:
County:
Integrator. t'
Prone:
On Site Representative: _ Ply one:
Physical Address/I
Type of Operation
Design Capacity: _
Number of Animals on Site:
DELI Certification Number: ACE DELI Certification Number: ACNEW
Latitude: Longitude: 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, . 3 Ft_ 0 Inches
Was any seepage observed from the laaoon(s)? Yes o No Was anv erosion observed? Yes o No
Is adequate land available for spray? Yes 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 Dw-ellinas? Yes or No
100 Feet from Wells? Yes or No
Is the animal waste stock -oiled within 100 Feet of USGS Blue Line Sire: m? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Man Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar gran -trade devices? Yes or No If Yes, Please Expi. n.
Does the facility maintain adequate waste management records (volur*-es of manure, land applied.
spray irrigated on specific acreage with cover crop)? Yes or No
Additional Comments:
L. LeAA-�-�
Inspector Name
cc: Facility Assessment Unit
Signature
Use Attachments if Needed.
4-1

sz_
Site Requires Immediate PD1I3
el
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD 3 r I Z
DATE: i , 1995 j [
Time:
Farm Name/Owner:! Ardso ^
Mailing Address:
County: 6LW I c!-A-
Integrator. 4 f "t'e-, Phone: /' 9 1 I
On Site Representative: ll/�- _ _ Phone:
Physical Address/Location: S /Z- 1 '/5jr
Type of Operation: Swine `f Poultry Cattle
Design Capacity:' J= K la ' 2,� Number of Animals on Site: tt �—
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: ° �4 " Longitude: qO 2 Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon haves xcient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately I Foot + 7 inches) es No Actual Freeboard: 2 Ft_ C-1 Inches
Was any seepage observed from the iagoon(s)? Yes otio VVas any erosion observed?s or No
Is adequate land available for P q spray? Yes or No Is the cover crop adequate? Yes or No
q P Y _
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings e or No
100 Feet from Wells? e or 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& If Yes, Please Explain.
Does the facility\ maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover`,crop)? Yes or No
Inspector Name
Si ture
cc: Facilitv,Assessment Unit Use Attachments if Needed.